jagrutirehabcentre@gmail.com

020-69333220/1

Dementia Care


Dementia Care


We have started a new facility of 100 beds for care & treatment of Dementia ; Neurologically disable patients.

  • Dementia a chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning”
  • It May be associated with loss of social judgment, higher functions & forgetfulness. Which interferes with day today communications ; activities of patients.

Dementia Care Centre in Pune

How common is Dementia?

Its estimated that 44 Million People in the World have Dementia Today
Every 70 seconds someone develops Alzheimer’s disease.

We provide consistent observation & assistance to the old patients, right from their daily activities to recovering certain physical & cognitive functions.

We Have Special equipment’s like Fowler Beds, Bed pans & pots, Walkers, Traction set, Nebulizer, ECG machine, oxygen cylinders, airways, emergency medicines. For the Bed-ridden patients Airbeds, Wound dressings, bed-sore care available.

Why early Diagnosis & Treatment -

Most types of Dementias can’t be cured but, if detected early there are various ways to treat them or at least maintain mental functions & prevent deterioration. Also if there is an early diagnosis, person can plan their own treatments & Future. They can find out the right people, hospital & authority of their property, to lead a fulfilled life.
Also there are Treatable Causes which can mimic Dementia, which treatable.

Depression Brain Infections Brain Tumors
Hypothyroidism Vit B12 Deficiency Vit D 3 deficiency
Head Injuries Over medications Normal Pressure Hydrocephalous
Types of Dementia
  1. Alzheimer’s Dementia
  2. Vascular Dementia
  3. Dementia with Lewy Bodies
  4. Fronto-Temporal Dementia
  5. Rare Causes

Alzheimer’s Dementia

Alzheimer’s Dementia is the most common form of Dementia. Around 70% of patients are having this type of Dementia. It increases with age. There is loss of Brain cells due to formation of Plaques ; Neuro fibrilary tangles which lead to shrinkage of Brain. The Gray matter of our brain is responsible for thoughts, Memory, higher functions like calculation, Planning ; organization etc. Due to loss of neurons in these areas lead to deterioration of these functions.


Vascular Dementia

This is the second most common form of Dementia. It’s estimated that around 15-20% of all dementias are due to Vascular Dementia. It’s due to disturbances of the blood supply to the brain, i.e. Stoke. It may be hemorrhagic or occlusion of blood vessels. Because of it Brain cell die ; may cause Dementia Symptoms. Atherosclerosis is the main reason for these types of Dementias. Type I diabetes, Smoking ; small vessel disease are particularly are more vulnerable.


Dementia with Lewy Bodies

Lewy bodies are small, circular lumps of proteins that develop inside the brain cells which causes disturbances in neurotransmitters, acetylcholine ; Dopamaine. There are also symptoms of Parkinsonism in this Dementia such as shaking, tremors, slowness & rigidity


Fronto-Temporal Dementia

Fornto Temporal dementia is caused by damage ; shrinking of two areas, Frontal ; Temporal Lobes of Brain. These are also called as Early onset Dementias as they start at early age i.e. before 65 yrs of age. Usually these types of Dementias are rapidly progressive ; may cause death within few yrs of diagnosis. Usually these are genetically transmitted ; found in families.


Rare causes of Dementia
  • Huntington’s disease
  • Progressive Supranuclear Palsy
  • Cortico-Basal Degeneration
  • Metal Poisoning e.g. Lead
  • Alcohol Dependance
  • Medications like steroids
  • Vitamin Deficiency
  • Head Injury
  • Normal Pressure Hydrocephalus
  • Hypothyroidism
  • Wilson’s disease
Memory Loss

Usually recent memory loss is remarkable. Patient may forget names, routes, passwords etc. But he can remember well his days in younger age or school name or birth date, etc.

Person may get confused in unfamiliar environment & may get lost.

Difficulty in finding the words.

Changes in personality & behavior

Depressive symptoms, loss of interest may be there.

Early symptoms are often mild, called as cognitive impairment, slowly get worse. This is the right time to treat patients with current medications.

Some patients develop forgetfulness slowly while others fast.

Vascular Dementia symptoms usually develop suddenly but slowly recover & they may persist without much worsening.

Dementia with Lewy Bodies develops visual hallucinations & their activities become slower as Parkinsonism increases.


Fronto-Temporal Dementia

Fronto-Temporal Dementia typically has more changes in behavior & personality than Memory. Usually these develop very quickly, may be in months. This develops early in sixties & person may be working before onset. Symptoms corresponding to frontal lobe like repetitive behavior, difficulty in language, Mood disturbances may be there.


Later Stages

As dementia progresses memory become more disturbed. Patients tend to forget names of near relatives, also daily routine of person may get affected. They tend to forget to eat & sleep. They can’t take care of themselves & may need assistance in everything. They may find difficult to understand simple information, tasks or instructions.


Communication

There may be difficulty in speaking or may loss ability to speak. There is need to communicate them with nonverbal communications like touch & gestures.


Mobility

Gradually their movement get restricted. They can’t move without support & may become bedbound. Sometimes rigidity may develop due to less movement. There are chances of bedsores which eventually lead to ore seriousness.


Incontinence

actually they are not incontinent; they forget toilets & pass urine & stool anywhere. Diapers may be required, sometimes they are unwilling to use diapers & then the real problem occurs.


Eating

Loss of petite & weight loss is common in later stages. It’s important to give them food on timely basis, sometimes multiple times as they forget or may say I just ate. Swallowing difficulties are common, may lead to choking. Aspiration pneumonias are common.


Treatment

Most Dementias progress slowly & they don’t have cure. But there are some medications available which may slow the progress of the Dementia. If diagnosed earlier the results & quality of life may remain very good. Person may remain independent for long. Also we have to find if any treatable condition like vitamin deficiency, hypothyroidism, depression, tumor, etc. is there to treat it.


A] Medications

There are number of Medications available e.g.

Aricept (Donepezil)

This is Acetylcholinesterase inhibitor. It is having very good results & can slow the progress of dementia. Others in this class are Rivastigmine & Galantamine.

Memantine

It’s another drug used in combination with donepezil or as a monotherapy. It reduces cyto toxicity by acting on Glutamatergic (NMDA) receptors. Its also showed efficacy in slowing the progress of Dementia.
Both of these drugs may reduce the Behavioral symptoms of dementia effectively.

Antipsychotics

These drugs are used to reduce the behavior of an aggressive patient. But at Jagruti we don’t recommend them as they may cause more side effects as falls, sudden deaths & increased morbidity & confusion in patients.

Antidepressants

It’s based on more emotional than factual things. Always there is some reason is there for any behavior of the patients. Ex. We have a patient Dr Potnis, she always asks when is my father coming to take me, although her father expired 20yrs back we have to tell her that he will come tomorrow or we have talked with him just now he will come. Immediately her behavior gets stabilized for some time. If we tell her that he is expired then she will get agitated & get unmanageable.

B) Psychosocial Intervention

Psychosocial Intervention does not slow down the progression of Dementia but are helpful in managing the symptoms.

Cognitive Stimulation

It includes various activities & exercises designed to improve memory, problem solving skills & language ability. These can be used to reduce aggression, improve communication, improve eating habits, to reduce incontinence etc.

Validation Therapy

It’s based on more emotional than factual things. Always there is some reason is there for any behavior of the patients. Ex. We have a patient Dr Potnis, she always asks when is my father coming to take me, although her father expired 20yrs back we have to tell her that he will come tomorrow or we have talked with him just now he will come. Immediately her behavior gets stabilized for some time. If we tell her that he is expired then she will get agitated & get unmanageable.

In this case we acknowledged her concerns & she got relieved for some time. Such therapy is used to divert the patient to another conversation.

Behavioral therapy

These therapies can be used in various difficult behaviors of a patient. E.g. If a person is having symptom of wandering, we can engage him in some activities so he will be occupied & his symptom will reduce. Also aggression can be reduced using these techniques.

Challenging Behaviors

We are using various psychological interventions to reduce their challenging behaviors without using antipsychotics. A lot of time there are unmet needs, e.g. hunger, thirst, bowl bladder calls, some things they want. We have to carefully observe the patients & respond accordingly.

Family Therapy

Its important issue, as many have difficulty in understanding & accepting the fact that their loved ones are having Dementia. We have to address care givers burden. Many people are having depressive symptoms & helplessness. Supportive therapies work for them or respite is another good example to reduce their burden.