‘ Jagruti ’ Dementia Care
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Transcript of ‘ Jagruti ’ Dementia Care
‘Jagruti’ Dementia Care
DR. AMAR SHINDEM.B.B.S., D.P.M., F.I.P.S.
(Consulting Psychiatrist)
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‘JAGRUTI’ Rehabilitation Centre
We have 120 Bedded Rehabilitation Facility.
It is just 4 km from Hadapsar.
We provide rehabilitation facilities for schizophrenia & other psychological patients
as well as De-Addiction programme.
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‘It’s our core belief that human life is intrinsically valuable’
Our goal at ‘Jagruti’ to provide the best possible physical and emotional support to individuals to lead to fulfillment of lives.
Jagruti Dementia Care Center Since 4 yrs
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Acceptance:- Provide an atmosphere where each individual feels understood, supported, and secure.
Communication:- Verbal or Non-Verbal.
Respect:- Each individual feels valued for who they are, in happy times as well as in challenging times.
Three imp aspects
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Private (single)
Semiprivate (Two Sharing) rooms.
The rooms are warm and welcoming.
Mostly we ask people to bring their own personal belongings to feel more at home and more comfortable.
Each room comes with a regular bed, but we will provide a hospital bed if a client needs one.
Living condition
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Meals: At Jagruti all meals and snacks are prepared in our kitchen and are shared in family style. Snacks, including fresh fruit and vegetables are available
Transportation: medical appointments, community outings or simply a trip to the garden is provided.
Activities: may include listening to music and music therapy, reading, religious activities, nature, bird watching, playing in-house games. Looking at family photo albums or items in a treasure box can help to trigger wonderful memories.
Housekeeping and Laundry : Housekeeping and laundry are included in the in house facilities.
Living condition
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High Staff Ratio: Our high staffing ratios and social activities are designed to care for the whole person and to meet each individual’s deep emotional and spiritual needs.
We offer seminars for caregivers and family members to learn about memory care issues.
Medical Care: ‘Jagruti’ provides almost all medical care except ventilation. Physicians on call basis.
End of Life and Hospice Care: Our goal is to provide dignified, comfortable palliative care to individuals and their families who are going through the end of life process.
SPECIALIZED CARE
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* Fowler beds* Wheelchairs of all types* Vital signs* splints* Changing tubes* Psychotropic medications * Nebulizers* Suctioning
* PEG Procedure
Instruments
* Feeding Tubes* Intracath & IV* Oximeters* Oxygen cylinders* Insulin pens* Air pressure mattresses/beds* Toilet Chairs* Diapers
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‘JAGRUTI’ DEMENTIA CARE Long term care & Rehabilitation for Dementia & Geriatric
patients
> 30 Dementia patients are there currently.
Psychosocial Interventions like Group therapy, Music, Yoga, Pranayam, Occupational therapy.
Individual counseling, psychotherapy Family Therapy & their involvement in the treatment.
Social skill enhancing programme.
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Antipsychotic drugs are commonly prescribed off-label to older adults for several disorders
e.g. behavioral disturbances and psychosis associated with dementia.
What I Prefer ? Psychosocial intervention 1st & then Low dose antipsychotic, as & when required
E.g. Tiapride 25-50 mg, Amisulpride 50mg, Quetiapine 25mg etc
Want to Share…
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Psychosis in older people is common.
One half of the patients with dementia have co-morbid psychosis.
Psychosis is a serious condition, it can lead to difficulties in patient care.
Patients may hurt themselves or others, and psychosis is the most common cause for Institutionalization of dementia patients.
Psychosis needs active treatment.
Psychosis in Older Patients
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In some cases, especially in older patients with milder psychosis, psychosocial interventions, such as
supportive therapies group therapies. Music therapies. Family therapies.
staff who work over a long period, can deliver effective intervention & can make a big difference.
Simple talking down & keeping them busy will make the difference.
Non-pharmacologic Treatments
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conducted at the University of California,
San Diego (UCSD), assessed the safety and
efficacy of 4 commonly prescribed atypical
antipsychotics in older individuals with
psychosis of various causes.
A new study
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1)Aripiprazole
2)Olanzapine
3)Quetiapine
4)Risperidone
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No significant change from baseline to 6 months on the BPRS.
Medication to which the patient was randomized was not working or was causing intolerable side effects
One quarter of the patients had serious adverse events.
One half of the patients had non-serious adverse events.
A little more than one third developed the metabolic syndrome within 1 year of starting the treatment.
Findings:- Effectiveness Versus Safety
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There is lack of effectiveness in later life.
more side effects over the age of 40.
with age, there are changes in drug metabolism, changes in the brain and other bodily systems, that can increase the risk for side effects.
Findings:- Lack Of Effectiveness
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lowest possible dose,
increase it slowly
‘as long as it's needed’
it can be a clinical dilemma, as any antipsychotic will have side effects in older people.
Use Antipsychotics
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off-label Antidepressants like SSRI
mood stabilizers valproate, oxcarbamazepine
benzodiazepines like lorazepam, clonazepam
Whatever you do, be careful to start at lower doses and increase slowly.
Other Options ???
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Whether Pharmacologic Or Psychosocial?
There are no specific treatments that are close to the finish.
Psychosocial interventions as dance and music therapy, can be very effective, and more research is needed here.
They can have an important role and clearly have a place in overall mental health management of dementia pts.
The key lies in personalized medicine.
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Care givers burden is too much in Dementia
Family members gets immediate relief when they admit patient in ‘Jagruti’
Cleanliness & food are the main Targets
We charge monthly basis to reduce the charges with good medical Facilities
‘Jagruti’ Dementia Care
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Thank You