Caregivers Meeting - Care in Advance Dementia
- The session began with Mrs. Safiya (Psychologist and Co-ordinator, ARDSI Hyderabad Deccan) introducing the guest speaker, Dr. Gayatri Palat to the audience.
- Dr. Gayatri then introduced her team members [Dr. Gillian Fyles (from BCCA, Canada) ,Dr. Rohina and Dr. Chaitanya] to the audience. She then asked the participants to introduce themselves to everyone.
- While introducing themselves, many of the participants (i.e., the caregivers) shared about the patients they were taking care of, their personal experiences and the problems and difficulties faced by them.
- Dr. Gayatri informed the participants that the type of need required by each patient and each caregiver is different from that of others.
- Total dependence, total loss of self identity and the inability to recognize others are some of the symptoms and features of dementia. She also stated that the associated disease also differs from person to person. The complications caused by dementia also vary from one person to the other.
- The speaker described the following as the criteria for advanced dementia:
- The person is bed bound
- He or she has lost the ability to have a meaningful conversation
- Weight loss of 10% or more
- Recurrent infections
- Multiple pressure sores
- Hip fractures
- Pneumonia
- The session proceeded with Dr. Gayatri explaining about the meaning of Palliative Care. Palliative Care is a new speciality in medicine which deals with improving the quality of life of the patients and their families. In this type of care, the pain is treated through spiritual and psychosocial treatment.
- She then moved on to explain about the physical problems commonly found in cases of advanced dementia. These problems are: bed wetting, confused aggressive behavior, hallucinations, delusions, eating problems, and repeated hospitalization. In many cases of advance dementia the patient becomes bed ridden, who then requires complete 24 hours care.
- Dr. Gayatri then explained that the physical aspects of caring, be it any disease, are similar to a large extent.
- In cases of advanced dementia, constipation is a very common problem. Lack of privacy, the change in the environment or improper environment, lack of physical activity, immobility, low intake of food and water and medication are some of the main factors which result in constipation.
- Dr. Gayatri stated that constipation is one of the causes for aggressive and confused behavior in advanced cases of dementia (especially in older patients). She suggested that high fibre food should not be given to a bed ridden patient. In the larger context there are several reasons which can cause aggressive and confused behavior, like environmental factors and physical ailments which might sometimes be completely unrelated to dementia.
- The session proceeded with Dr. Gayatri explaining the reasons for loss of appetite. According to her, the reasons for loss of appetite in advanced cases of dementia are: medication, a natural process where in the body requirement comes down when a person is sick and painful muscle spasms. She mentioned that painful muscle spasms are very common in people with dementia.
- Finally, Dr. Gayatri stated that keeping the patient functionally active slows down the progression of dementia.
- Towards the end of the session, the caregivers expressed their need for a 24 hour helpline which could provide medical care for the dementia patients.
- The session concluded with Mrs. Rukhsana Ansari (General Secretary, ARDSI Hyderabad Deccan) giving the vote of thanks.
