Functional Rehabilitation of Persons with Dementia

The Monthly Care-givers meeting was held on Saturday, 17th September, 2011
from 2:30 - 4:00 p.m, at Conference Hall, 1st Floor, Millennium block, NIMS.

This month's topic was "Functional Rehabilitation of Persons with Dementia". The audience comprised family members and ARDSI volunteers.

Ms. Rukhsana Ansari, Secretary of ARDSI Hyd Deccan and also a caregiver her-self started the session with a group activity, where the participants were divided into two groups. Group 1 shared the major events and Group 2 shared the small events in their life which caused them happiness and positive feelings. She emphasized the importance of making small events happy in the patient's life.

Mr Anil, family caregiver shared his experience with his mother who is a Dementia patient from past 4 years. Initially it started with slight memory loss and repetitive questions. He said that everyone has their own way of handling and they kept their frustration aside and dealt with situations. In some things they needed guidance for which Ardsi Hyd Deccan helped. Initially they used to get confused with her behaviour, but started working towards cause and solutions. Ardsi suggested to engage an attendant who can keep the patient busy, which worked in his case. He highlighted the following points before concluding his talk.
1) Consult a Medical expert.
2) Engage an attendant for the patient.
3) Not to take personally for whatever the patient say.
4) Keep the person active.

Later Ms.Rukhsana Ansari gave a power point presentation on Functional Rehabilitation for Patients with dementia.

She emphasized on understanding the changes happening in the patient's brain, that makes the approach of care giving much more easy.

She gave practical tips on how to manage different problems faced by the Dementia patients. Functional decline in patients creates helplessness, frustration, dependency on others, loss of role in their families etc. The goal of functional rehab is to retain functional abilities and allow for a normal life as much as possible. One needs to recognize the process of reverse ontogeny that starts of by loss of declarative memory, followed by loss of procedural memory and finally primitive skills. Instrumental Activities of Daily Living (IADLSs) are affected first followed by Basic ADLS and with this knowledge, carers can setup milestones to help patients maximize their functional potential.

Caregivers should think from the perspective of the patient and extend their support to lead normal life as much as possible without affecting their routine and day to day activities. Especially care should be more extended in the basic but very important activities of the life i.e., feeding, dressing and Toiletries. Special feeding devices, comfort dressing and toiletries, and walking devices need to be arranged for rehabilitation purpose.

Environmental modifications, assistive devices, can be used to reduce incontinence, improve feeding, walking etc. Simple changes such as proper night lighting, labelling, removing clutter, cueing, maintaining an activity schedule, timed voiding help in making significant improvements in patient's daily life. The signs of aspiration and how to deal with them were discussed.

A question and answer session followed.