‘ Jagruti ’ Dementia Care

21
‘Jagruti’ Dementia Care DR. AMAR SHINDE M.B.B.S., D.P.M., F.I.P.S. (Consulting Psychiatrist) www.jagrutirehab.o

description

‘ Jagruti ’ Dementia Care. DR. AMAR SHINDE M.B.B.S., D.P.M., F.I.P.S. (Consulting Psychiatrist). www.jagrutirehab.org. ‘JAGRUTI’ Rehabilitation Centre. We have 120 Bedded Rehabilitation Facility. It is just 4 km from Hadapsar . - PowerPoint PPT Presentation

Transcript of ‘ Jagruti ’ Dementia Care

Page 1: ‘ Jagruti ’ Dementia Care

‘Jagruti’ Dementia Care

DR. AMAR SHINDEM.B.B.S., D.P.M., F.I.P.S.

(Consulting Psychiatrist)

www.jagrutirehab.o

rg

Page 2: ‘ Jagruti ’ Dementia Care

‘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.

www.jagrutirehab.o

rg

Page 3: ‘ Jagruti ’ Dementia Care

‘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

www.jagrutirehab.o

rg

Page 4: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 5: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 6: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 7: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 8: ‘ Jagruti ’ Dementia Care

* 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

www.jagrutirehab.o

rg

Page 9: ‘ Jagruti ’ Dementia Care

‘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.

www.jagrutirehab.o

rg

Page 10: ‘ Jagruti ’ Dementia Care

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…

www.jagrutirehab.o

rg

Page 11: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 12: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 13: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 14: ‘ Jagruti ’ Dementia Care

1)Aripiprazole

2)Olanzapine

3)Quetiapine

4)Risperidone

www.jagrutirehab.o

rg

Page 15: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 16: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 17: ‘ Jagruti ’ Dementia Care

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

www.jagrutirehab.o

rg

Page 18: ‘ Jagruti ’ Dementia Care

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 ???

www.jagrutirehab.o

rg

Page 19: ‘ Jagruti ’ Dementia Care

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.

www.jagrutirehab.org

Page 20: ‘ Jagruti ’ Dementia Care

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

Page 21: ‘ Jagruti ’ Dementia Care

www.jagrutirehab.o

rg

Thank You