DEMENTIA

Dementia is a neurodegenerative disease characterized by progressive deterioration in intellect including memory, learning, orientation, language, comprehension and judgment. The irreversible decline in global intellectual and physical functioning affects the person with dementia and causes significant distress to their family and carers.

Moreover, dementia is not merely a problem of memory. It reduces the ability to learn, reason, retain or recall past experience and there is also loss of patterns of thoughts, feelings and activities. Dementia also results in a progressive decline of cognitive abilities, poor self-healthcare, physical dependency, wandering, aggression and difficult behaviours.

Dementia is caused by gradual changes and damage in the brain. The most common cause of dementia is Alzheimer’s disease in which the brain cells degenerate and die more quickly than they would as part of the normal ageing process. Other forms of dementia include Vascular Dementia in which brain cell death is caused by conditions such as stroke, Lewy Body Dementia and dementia due to Parkinson’s disease.

Researchers have uncovered many facts about the disease but they have not yet been able to fit these puzzle pieces together in order to form a complete picture of how dementia develops and how it can be treated.

Although a high proportion of elderly people with dementia are cared for by their people at home; the onset of behavioural problems can be challenging and is one of the main reasons for subsequent institutionalization of Persons with Dementia (PwD).


THE NEED

The World Health Organization (WHO) predicts that by 2025 about 75% of the estimated 1.2 billion people aged 60 years and above will reside in developing countries. The rate of growth will be the highest (around 336%) in India, China, South Asia, and Western Pacific regions, 235 - 393% in Latin America and Africa. The prevalence of dementia differs widely for different regions of India. Various reasons have been suggested that include different methodology, screening instruments, defining criteria, multi-ethnicity and multicultural and environmental factors.

The Dementia India report 2010 has estimated that over 3.7 million people are affected by dementia in India with a higher prevalence of the disease in women; 2.1 million are women while only 1.5 million are men. This is expected to double by 2030. The prevalence of dementia also increases with age. By the age of 65 years the proportion of people affected is 1 in 20 increasing to 1 in 5 by the age of 85 years.

The cost of taking care of a person with dementia is met by their families and the financial burden is only likely to increase in the coming years. The challenge posed by dementia as a health and social issue is of a scale that can no longer be ignored. Despite the magnitude, there is gross ignorance, neglect and scarce services for people with dementia and their families. Along with that there is lack of awareness and stigma. There are presently about 8 residential care facilities exclusively for people with dementia in India and only ten day care centres offer professional care. Domiciliary care is provided in around five centres and about 100 memory clinics are functioning. Hence, the currently available services are grossly inadequate to meet the needs of the over 3.7 million people with dementia in India.


WHAT WE DO

Dementia care requires a holistic approach, ranging from assistance with establishing the diagnosis, management and further planning. Keeping this in view, Nightingales Medical Trust has the following projects dedicated to different needs of people with dementia:

  • Memory Clinic – at Nightingales Centre for Ageing and Alzheimer’s, Kasturinagar; Nightingales Sandhya Kirana, Shanthi Nagar; ETCM- Nightingales Dementia Care Centre - Kolar
  • Day Care  at Nightingales Dementia Day Care Centre, Shanthinagar; Nightingales Trust – Bagchi Centre for Active Ageing, JP Nagar and Nightingales Elders Enrichment Centre, Sanjaynagar
  • Training for caregivers – at Nightingales Centre for Ageing and Alzheimer’s, Kasturinagar  
  • Residential Care (short & long term)  at Nightingales Centre for Ageing and Alzheimer’s, Kasturinagar and Nightingales Medical Trust – Dhanavantri Hospital Society Dementia Care Centre (NMT – DHS), Frazer Town. To cater to the dementia needs of people on the outskirts of Bangalore, NMT also runs the ETCM- Nightingales Dementia Care Centre in Kolar which is about 60 kms from Bangalore 

 

 


 

 

Frequently Asked Questions

We provide a comprehensive range of services for dementia. It includes an outpatient memory clinic, day care, short term or respite care, in-patient admission for assessment and treatment of challenging behaviours, training of caregivers - both family and professional and long term residential care.
Currently, we have day care facilities in 3 centres in Bangalore: Nightingales Dementia Day Care Centre in Shanthinagar, NEEC in Sanjay Nagar and NBCAA in JP Nagar.
We currently have three residential care facilities: Nightingales Centre for Ageing & Alzheimer’s, an 86-bedded facility in Kasturi Nagar, Bangalore; ETCM Nightingales Dementia Care Centre, a 36-bedded facility located in the premises of ETCM Hospital, Kolar; and NMT-DHS Dementia Care Centre in Annaswamy Mudaliar Trust Hospital which has 8 beds for patients with high nursing needs.
Short term admission can range from a few days to 2 months.
An initial assessment in the memory clinic is done to ascertain the diagnosis and the needs of the patient. The family is then taken for a tour of the facility. Once they decide on the type of room, formalities for a short term admission are completed. All long term admissions have to be preceded by a short term admission. This allows us to assess the patient better and also allows the family to ensure that they are getting the best care possible before committing to long term admission.

Nightingales Centre for Ageing & Alzheimer’s: 2 sharing, 3 sharing, 4 sharing and 7 sharing.

ETCM Nightingales Dementia Care Centre: Dormitory and 4 sharing.

Nightingales Centre for Ageing & Alzheimer’s

You can make the payment by cash, Bank Transfer or DD. Details for the bank transfer are:

Nightingales Centre for Ageing & Alzheimer’s:

Account Name: NIGHTINGALES MEDICAL TRUST

Account No: 06681010000097

Code: IFSC SYNB 0000668

Electronic Clearing Scheme: 560025105

Bank Name: Syndicate Bank

Branch: Kasturi Nagar Branch, Bangalore

ETCM Nightingales Dementia Care Centre:

Account Name: NIGHTINGALES MEDICAL TRUST

Account No: 06681010000420

Code: IFSC SYNB 0000668

Electronic Clearing Scheme: 560025105

Bank Name: Syndicate Bank

Branch: Kasturi Nagar Branch, Bangalore

Payment details (by cash or DD or bank transfer) of Refundable deposit, non refundable admission fees and bed charges for the period it is booked.

3 Photos of Applicant and 4 photos of Resident

Agreement signing by the Applicant and Guarantor

Applicant & Guarantor’s self-attested Photo Id

Payment details (by cash or DD or bank transfer) of Refundable deposit, non refundable admission fees and bed charges for the first month in advance.

3 Photos of Guardian and 4 photos of Resident

Agreement signing by the Applicant and Guarantors.

Self-attested photo ID (preferably Passport copy) of Applicant and guarantors.

You can make the payment by cash, Bank Transfer or DD. Details for the bank transfer are:

Nightingales Centre for Ageing & Alzheimer’s:

Account Name: NIGHTINGALES MEDICAL TRUST

Account No: 06681010000097

Code: IFSC SYNB 0000668

Electronic Clearing Scheme: 560025105

Bank Name: Syndicate Bank

Branch: Kasturi Nagar Branch, Bangalore

ETCM Nightingales Dementia Care Centre:

Account Name: NIGHTINGALES MEDICAL TRUST

Account No: 06681010000420

Code: IFSC SYNB 0000668

Electronic Clearing Scheme: 560025105

Bank Name: Syndicate Bank

Branch: Kasturi Nagar Branch, Bangalore

After breakfast all residents are encouraged to join in group exercises and cognitive stimulation activities which continue till afternoon. Following lunch most of them take a short nap before coming down for evening group activities. On certain days of the week we have specialized therapies as pottery, music and dance.

We admit the patients of in all stages of dementia. We also admit patients who have suffered a stroke, fracture, or are suffering from Parkinson’s. We also admit elderly patients with chronic mental illness. We can offer short term respite admissions to normal elders if they feel comfortable in this surrounding.

Initially, patients are disturbed as they are surrounded by the people they don’t know. They constantly ask to go home. The staffs are trained to reassure new patients and deal with them patiently until this becomes a familiar surrounding for them.

We try and encourage maximum involvement with the family initially and insist on periodic visits from the family. We also try and facilitate day visits home and their participation in family functions.

We do not encourage patients to spend much time in their rooms. They are kept constantly engaged and retire to their rooms only to rest.

The cost includes Nursing care, Food, Laundry, In-house doctors visits, Psychological support and bed charges. It also includes basic physiotherapy by a physiotherapist once in 2 weeks.

A list of clothes required and toiletries will be provided to the family at the time of admission.

For most patients the ratio is 1:3 or 1:4

Attenders will be there 24/7 and the nurses are there to supervise the clinical and nursing requirements.

1:1 care is provided for those patients who have clinical need such as extremely high nursing needs, those who are at a very high risk of falls or have behaviors which could cause harm to themselves or others.

Medicines & consumables can be procured by us and they will be added to the bill.

Visiting hours are restricted to 3 hours per day. During this time families will be permitted to visit the patients in their rooms. They can also visit the patients outside these hours; however they will not be permitted to enter the rooms. They can spend time with the patients in the garden area or at the reception.

The food is pure vegetarian and prepared in the cafeteria at the centre. If there are any special requests from families we can procure these at an additional cost.

Nightingales Centre for Ageing & Alzheimer’s is India’s largest comprehensive residential care facility located in Bangalore.

Nightingales ETCM Dementia Care Centre is India’s first telemedince enabled residential care facility for people with dementia located in Kolar (60kms from Bangalore) at the premises of ETCM hospital, which is a 110 years old Christian missionary hospital.

The team of specialists at NCAA remotely monitor the patients at ETCM through teleconferencing and viewing the video footage. Staff are also trained through this mode. This has allowed us to bring down the cost of care making ETCM affordable and ensuring the quality, if care is maintained.

The team comprises of physicians, psychologists, dementia trainers, nurses and trained caregivers headed by geriatric psychiatrist.

Families can keep in touch over telephone or by visiting in person. You can contact your relative through phone and also through videoconferencing. You will be a given a video chat ID to talk to your relative. You have to inform the time a day in advance. At NCAA skype calls can be organized if prior request is sent by email to the clinical team.

We are very aware of the increased risk of wandering in patients with dementia. Our facility is secured with a high fence wall all around and a secured single exist gate. Immediately on admission all clothes of the patients are tagged with a badge displaying contact numbers in case they are lost. Patients are not allowed to leave the facility unless they are accompanied by the staff or family.

At Nightingales Centre for Ageing & Alzheimer’s: Gate is manned by security 24 hours and is also under CCTV surveillance.

At ETCM-Nightingales Dementia Care Centre: Exits are access gates and is also under CCTV surveillance.

Nightingales Centre for Ageing & Alzheimer’s: There are caregivers who are monitored by nurses. Team of psychiatrist, psychologists and physicians go for rounds and review the patient condition on daily basis. The whole facility is under CCTV surveillance.

Training is also an important part of quality control, All new recruits undergo a 10 day structured training program before being posted on the floors. They are then assigned a buddy who is a senior caregiver who trains them on the floor and only after that they are assigned their respective patients. We also have retraining modules conducted on a regular basis.

ETCM-Nightingales Dementia Care Centre: The facility is established based on Hub and Spokes model with Nightingales Centre for Ageing & Alzheimer’s as the hub. The facility is CCTV monitored from Bangalore. The interaction with patients happens on daily basis through virtual rounds. There is a specialized software designed for the management of dementia patients which includes daily monitoring of activities, routines, vital and behaviours.

In case the patient requires a specialist consultation we check with the family regarding preference of hospital and make arrangements for the patients to be reviewed. We are able to provide basic medical care which includes catheterization, nasal tube feeding, IV fluids, IV antibiotics, Oxygen, dressing of bedsores.

Nightingales Centre for Ageing & Alzheimer’s: Doctors visit takes place every day. Any medical problems that need attention are taken care of at that time. There is no laboratory in the facility. This service is outsourced and samples are collected from the centre. As there is no ICU facility, patients requiring ICU facility will be transferred for more acute care until they stabilize.

ETCM-Nightingales Dementia Care Centre: Since the centre is located in a hospital, emergency can be handled immediately. Physicians and experts are available at the hospital and will attend to patients need when required.

Nightingales Centre for Ageing & Alzheimer’s: We don’t have laboratory or radiological services in the centre. There is an ambulance available which can shift patients if the need arises.

ETCM-Nightingales Dementia Care Centre: All lab investigations can be done at the ETCM hospital.

Once the patient is shifted to another hospital we would require more involvement from the family in terms of liaison with the doctors there and making decisions regarding future care. We also keep in touch with the doctors and monitor the progress of the patients.

We also need the family to make arrangements for a caregiver to be with the patient if required during their stay in hospital.

The CCTV recording is to ensure the safety and security of the client. It is used for internal purpose. You will not have access to the recording. The video will not be used for any other purpose without your consent.

You can make that decision. However, you would have to sign a high risk consent and give the information in writing.