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On 16th February, 2019 Samvedna Senior Care Foundation conducted its Support Group meeting for caregivers of dementia patients. A group of caregivers from in and around Gurgaon and Delhi came to attend the meeting. The topic of discussion for the meeting was “Importance of early detection and intervention and managing challenging behavior”. The session was opened by Dr. Jayashree Dasgupta, Project Director, Samvedna Senior Care.

The meeting started with a brief icebreaking session where all the participants (caregivers) introduced themselves and shared their experiences about their loved ones.  Dr. Jayashree Dasgupta initiated the talk while focusing on the different dynamics of dementia and its importance of early detection of the disorder. Caregivers shared about their hard times in handling their loved ones and how they became more accepting of the disorder. The session was interactive with participants learning from each other’s experience.

A common challenge shared by all was – how to introduce professional help for their loved ones. Some of them also shared about family dynamics playing a part in the decision making process whereas others had challenge with their loved ones being highly intellectual and refusing help. These issues were discussed at length and some ideas were exchanged on how to break the resistance. It was interesting to hear one caregiver share that they had introduced the attendant as a nurse from a nearby hospital. They also made some important social behavior changes to integrate the attendant as a family member for easier acceptance.

The other challenge shared by the participants was about how the personality of their loved ones deterred them from making some changes in their care ecosystems like clothes and personal care. Dr. Jayashree emphasized to the caregivers to make the changes gradually, since the progression of the disease over a period of time will make it inevitable for the person with dementia to seek more help.

Dr. Jayashree also discussed the need for cognitive stimulation and socialization as being integral to the care of a person with dementia. Lastly the session ended with question and answer rounds where some caregivers discussed their problem and how Samvedna Senior Care could help them.

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation. Please call us for more info – Delhi NCR – 98184 21446, 124 4229659 or write to us on contact@samvednacare.com

Dementia Support Group – Our Dementia Support group in Delhi NCR is a platform for caregivers to share feelings and support each other. More – https://www.samvednacare.com/dementia-support-group

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Samvedna Senior Care has been conducting dementia support group meetings for families regularly for the past 5 years. As a part of our interactions we have come across many caregivers and heard their experience in handling their loved ones. Caring for an individual with dementia can be challenging and at times it can also be overwhelming. Frustration and stress is a normal and valid emotional response to many of the difficulties faced by a caregiver. While some irritation may be a part of everyday life as a caregiver, feeling extreme frustration can have serious consequences for the caregiver or the person they care for. It negatively impacts the caregiver’s physical health and may lead to some serious consequences.

In discussion with various caregivers the following came up as being critical to how they handled the stress factors:

  • Acceptance vs. Denial: The changing behavior of the person and transformation into a different personality is most painful. The fact that each day maybe different for a person with dementia is painful. If you are hoping that your loved one is not ill, or expecting to get better or convincing yourself that he/she will get better then you are most likely refusing to accept the diagnosis of dementia. As hard as it maybe it is important to recognize and acknowledge your loved one’s condition. It is important for us to understand that nothing is in our control and the only way we can succeed is to accept the situation. The dementia world is a gentle, loving and caring place. If we could experience their world then we would realize that all their behaviors that are stressing us are normal for them.

“I accepted my mother and accepted how she will react and say. As a result of acceptance I actually ended up being happy myself. The day I learned to embrace my mother’s health condition was the happiest days of my life”.Col Yadav, caregiver to his 90 year old mother.

  • A sense of purpose after giving up a career: Caregiving responsibilities can interrupt work on a daily basis. This causes lost hours / days on the job and in some cases lost promotions and wages. In some cases caregivers have no choice but to leave their job in order to take care of their loved ones.

“I had a decent job and I was satisfied with it. Seeing my father’s heath condition I had no other option but to leave my job. Till a point I regretted but seeing my father happy and caring for him in his need makes me feel good and satisfied. It depend how you see your work”. A daughter

  • Caring for yourself along with the emotional toll: The journey of the family is inevitably filled with stress and mixed emotions. It is important to do what is necessary for your health in order to take care of your loved one. Dementia, especially Alzheimer’s disease, causes a long, slow deterioration of mental and physical capacity. Watching this is painful and takes an enormous toll on caregivers who must try to remain positive and upbeat.
  • Family Dynamics:  Mostly women feel more responsible in their caregiving duties than men, and try to balance multiple tasks like raising children, caring for elderly parents and managing a job. Many times people admit to us that it is easy to care for one’s own parents than for the in-laws as the bonds are much deeper. Often past relationships with the person with dementia causes caregiver stress, negligence and avoidance. What is interesting is that many women caregivers complain that their mothers-in-law affected by Dementia are still demanding of them while being nicer to the sons!
  • Guilt: Caregivers feel guilt over feelings that they want it all to end, or being impatient with the care receiver too much. Some children feel that they are not doing enough for the mother/father and blame themselves for their condition. Some caregivers feel guilty about thinking of their own needs and see themselves as being selfish if they take time out for their own socialization needs.

These stress factors in turn lead to negativity and other changes in the personality of the caregiver:

  • Anger is a normal part of being around someone who needs help on an ongoing basis and who might not be accepting of help. Caring for someone with dementia in particular can be even harder, as the care receiver can be irrational and aggressive. It is not always possible to be in perfect control of your emotions. Anger “just comes out” sometimes.

“She knows how to do that work, she cannot do it now”. 

  • Social withdrawal from friends and activities that used to make you feel good. As a caregiver shared  “There was a time when I use to involve myself, now I don’t feel like going out and meeting people.”
  • Anxiety about the future and facing another day. No two days are the same for a person with dementia and caregivers can get anxious about coping with the sudden change in behavior.
    “What happens when they need more care then what will I do?”
  • Depression – feeling hopeless or helpless, the inability to sleep, or trouble getting up and facing the day for prolonged periods of time without any respite can be extremely detrimental to your mental health.
  • Exhaustion – sometimes as a caregiver, you feel that you can’t do anything right or that things just don’t go as planned no matter what you do or how hard you try. And if you are physically and emotionally tired, you are more likely to get frustrated with your loved one. “He doesn’t wear his diapers, earlier he used to do all his work by his own.”

Caregiving can take you to a different chapter in life, and there must be a time when you feel guilty of “not doing enough”, you ask “why my parent”. There are some occasions where you overlook your work, inappropriate behavior causes you social embarrassment, you miss the person who is no longer there for you.  When you are unsatisfied, it is important to differentiate between what is and what is not within your power to change. Frustration often arises out of trying to change an uncontrollable circumstance. As a caregiver for a person with dementia, you face many situations in normal daily living activities. Unfortunately, we cannot simply change the behavior of a person with dementia so we have to cope according to their needs. Stress among caregivers ultimately affects quality of care that is being provided to the patient.

We often see that caregivers are unprepared to provide care due to inadequate knowledge about care giving along with financial burden and physical and emotional stress. It is important for the caregivers to seek professional help through support group meetings, forums and interacting with counsellors to cope with their stress levels.

Remember the Dementia patient is not giving you a hard time, the dementia patient is having a hard time. – Anonymous

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation. Please call us for more info – Delhi NCR – 98184 21446, 124 4229659 or write to us on contact@samvednacare.com

Our Dementia Care services are

At-home services –
Dementia intervention activities by trained Care Specialists (already mentioned above). These services are available in Delhi NCR. More – http://www.samvednacare.com/dementia-care

In-Home Trained Attendant Service –
Samvedna Senior Care’s trained in-home attendant service brings to you verified attendants and nurses, specially trained by specialists in elder care and dementia. Our staff is trained to not only take care of your elderly loved one’s physical wellbeing through top class personal care and nursing, but also their emotional wellbeing.  The attendants are monitored by our Senior Care Specialists (psychologists and MSWs)

Our service is available across Delhi, Gurgaon and Noida. We offer both male and female attendants as per request, for 12 and 24 hour shifts. Know more about our Trained Attendant Services herehttp://www.samvednacare.com/attendant-care-services.

Counselling for Ageing Related Disorders in Anand Niketan, New Delhi –
Studies show that elderly may be more prone to depression and loneliness, which can lead to higher rates of unhappiness. To address this issue, we have designed counselling and therapies for seniors with anxiety, low mood or depression, mild cognitive impairment/ memory difficulties, or dementia. More –https://www.samvednacare.com/counselling

Dementia Cafe, Sector 57 Gurgaon –
From initial stage to advanced stage, all individuals with dementia feel the need for social interaction at times. Our Dementia Cafe is a safe and friendly place for your loved one with dementia to chill and socialize. The cafe is aplace where they will find a fun activity, a warm chair and companionship. Every Tuesday and Thursday, 11-1PM. More – https://www.samvednacare.com/dementia-cafe

Cognitive Wellness Programme, Sector 57  Gurgaon  –
Samvedna’s Cognitive Wellness Programme is designed for seniors with mild cognitive impairment, early dementia or Parkinson’s,and elderly lacking in enthusiasm and motivation. The aim is to stimulate the mind of the elderly to slow the progression of the disease or impairment. The sessions are 3 days a week – Monday, Wednesday and Friday, 11AM-1PM. More – https://www.samvednacare.com/cognitive-wellness-programme

Dementia Support Group –
Our Dementia Support group in Delhi NCR is a platform for caregivers to share feelings and support each other. More – https://www.samvednacare.com/dementia-support-group

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This article is the first in our series on dementia care, written by Dr Jayashree Dasgupta, MPhil, PhD, Neuropsychology, NIMHANS.

What is Dementia ?

Dementia is an umbrella term used to describe a group of symptoms where there is a gradual death of brain cells that eventually lead to problems in thinking and behavior.  There are many types of dementia and this is the leading cause of disability amongst the elderly. In fact, globally, there are about 50 million people with dementia and in India alone, there are over 4 million people with the disease. Staggeringly, one person develops dementia every 3 seconds which means 10 million new cases develop every year.

Although there are many types of dementia, the most common is Alzheimer’s disease which accounts for about 70% of all dementias. In the initial stages, a person may experience difficulty remembering things and making simple decisions, have difficulty finding words to express themselves and have episodes of confusion. Since the person usually has awareness about their difficulties at this stage, they often make attempts to hide memory lapses and excuses to avoid things they find difficult. Often, this is done very successfully making it hard to identify the initial symptoms. Both family members as well as the dementia patient themselves, often overlook these symptoms as being a normal part of ageing. However, it is important to remember that although age is the largest risk factor for dementia it is not a normal part of the aging process.

Reasons for change in behavior

So why do these problem behaviors occur? All our behavior is the result of billions of neurons that form a complex network and communicate with each other inside our brain, pretty much like a highly-complex rail network. But in Alzheimer’s disease, there are changes in the brain that disrupt these networks causing a breakdown in communication and neuronal death. Scientists understand that this is due to abnormal ways in which proteins behave causing what are known as neurofibrillary tangles and amyloid plaques.

In a healthy brain, protein fragments (amyloid) are broken down and eliminated from the body. However, in Alzheimer’s disease, these accumulate to form hard insoluble clumps or plaques in the spaces between neurons. Neurofibrillary tangles are found within a cell and formed as a result of abnormal Tau protein which is essential for building the cell’s transport network for nutrients, and other important substances. Once this essential transport system gets disrupted, the cells die. Imagine a highly efficient rail network (our brain) delivering goods (our behaviors). Over a period of time, if garbage accumulates at a particular junction the network gets blocked and goods cannot be delivered. Also, if there is disruption to a train’s fuel supply, the train won’t be able to run and eventually get discontinued. This is similar to how amyloid plaques and neurofibrillary tangles cause communication blocks and brain cell death in Alzheimer’s disease. The loss of memory and other behavioral problems are a result of this breakdown.

Need for cognitive stimulation

Unfortunately, scientists do not yet know how to stop or change these abnormal processes in the brain and there is no cure for dementia. However, that does not mean there is nothing one can do. Research has shown that cognitive stimulation and engaging in new activities helps slow progression of the illness and maintain quality of life. But how does cognitive stimulation help? The brain has a unique property called neuroplasticity which is the ability to reorganize itself by making new neuronal connections. Going back to how thinking about the neuronal connections in the brain like a train network, this would be similar to finding another route by which to deliver goods, bypassing the blocked junction. This property of neuroplasticity helps the brain adjust itself to disease and is believed to act as a buffer in some individuals. Although it will not reverse the degenerative processes, by encouraging and supporting a person with dementia to remain engaged in mentally stimulating activities, one can help stimulate the brain to make new connections and help maintain well-being.

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation. Please call us for more info – Delhi NCR – 98184 21446, 124 4229659 or write to us on contact@samvednacare.com

Our Dementia Care services are

At-home services –
Dementia intervention activities by trained Care Specialists (already mentioned above). These services are available in Delhi NCR. More – http://www.samvednacare.com/dementia-care

In-Home Trained Attendant Service –
Samvedna Senior Care’s trained in-home attendant service brings to you verified attendants and nurses, specially trained by specialists in elder care and dementia. Our staff is trained to not only take care of your elderly loved one’s physical wellbeing through top class personal care and nursing, but also their emotional wellbeing.  The attendants are monitored by our Senior Care Specialists (psychologists and MSWs)

Our service is available across Delhi, Gurgaon and Noida. We offer both male and female attendants as per request, for 12 and 24 hour shifts. Know more about our Trained Attendant Services herehttp://www.samvednacare.com/attendant-care-services.

Counselling for Ageing Related Disorders in Anand Niketan, New Delhi –
Studies show that elderly may be more prone to depression and loneliness, which can lead to higher rates of unhappiness. To address this issue, we have designed counselling and therapies for seniors with anxiety, low mood or depression, mild cognitive impairment/ memory difficulties, or dementia. More –https://www.samvednacare.com/counselling

Dementia Cafe, Sector 57 Gurgaon –
From initial stage to advanced stage, all individuals with dementia feel the need for social interaction at times. Our Dementia Cafe is a safe and friendly place for your loved one with dementia to chill and socialize. The cafe is aplace where they will find a fun activity, a warm chair and companionship. Every Tuesday and Thursday, 11-1PM. More – https://www.samvednacare.com/dementia-cafe

Cognitive Wellness Programme, Sector 57  Gurgaon  –
Samvedna’s Cognitive Wellness Programme is designed for seniors with mild cognitive impairment, early dementia or Parkinson’s,and elderly lacking in enthusiasm and motivation. The aim is to stimulate the mind of the elderly to slow the progression of the disease or impairment. The sessions are 3 days a week – Monday, Wednesday and Friday, 11AM-1PM. More – https://www.samvednacare.com/cognitive-wellness-programme

Dementia Support Group –
Our Dementia Support group in Delhi NCR is a platform for caregivers to share feelings and support each other. More – https://www.samvednacare.com/dementia-support-group

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Samvedna Senior Care Foundation held it Dementia Support Group meeting for family members of persons with dementia on January 5th , 2019. The event was held at our senior centre in Gurgaon. Dr. Jayashree Dasgupta, MPhil, PhD, Neuropsychology, NIMHANS, presided over the meeting, the topic for this meeting was “Caregiver stress and coping strategies”.

Dr. Jayashree initiated the discussion by asking the participants (caregivers) how they felt about taking care of their loved ones.  Some of the common problems shared by all participants while dealing with their loved ones were – restlessness, sleep cycle disorder, fear of falls, hygiene issues and struggling with their own emotions. Caregivers further shared about their glitches of stigmatization, guilt and issues like financial constraints and finding a good attendant/ help for their loved ones.

The participants shared their experience and tips in handling dementia patients in the group. Some of them mentioned how they missed the person who was no longer there for them and it was evident that many of them were still struggling to understand and accept their family member’s condition completely.

Dr. Jayashree advised the participants on how they could deal with their challenges and how to not overwhelm themselves by clustering all the issues. She explained that it is best to classify the challenges and then deal with them one at a time, she also advised to prioritize and work on solutions for each challenge. She emphasized to the caregivers the importance of taking time off from their responsibilities and relaxing themselves.

Dr. Jayashree also explained the importance of cognitive stimulation activities and how important it is to involve dementia patients into activities that they love. During the session there were questions raised by the caregivers about different problems, these were also taken up by the Samvedna Dementia counsellors and some of the families too shared their experiences.

The group also strongly felt the need for better support systems like day care centers, more support group meetings and need for trained caregivers to help the families.

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation. Please call us for more info – Delhi NCR – 98184 21446, 124 4229659 or write to us on contact@samvednacare.com

Dementia Support Group – Our Dementia Support group in Delhi NCR is a platform for caregivers to share feelings and support each other. More – https://www.samvednacare.com/dementia-support-group

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When an elderly member of the family gets diagnosed with a chronic ailment which might require long term care, one has to plan the caregiving responsibilities. One needs to rope in all the support available, professional caregivers/attendants can be of tremendous help if hired through reliable professional organizations. Hiring the right attendant and then building a rapport with her/him goes a long way in helping manage the elderly’s care. A good helping hand can free you up to let you take care of your personal and professional commitments, health and socializing needs and overall help reduce caregiving effort. 

Once you have identified a good attendant it is important to build a relationship with her because it will help in:

1) Building ownership and responsibility – One should be willing to help them setup the care initially and communicate with them regularly. Sharing your caregiving goals with them and helping them understand the requirements can help build responsibility. Encouraging and acknowledging them regularly will motivate them to stay committed to their duties.

2) Going that extra mile – If the attendant connects well with you then she will be able to manage her own caregiving stress. Many a times the elderly can be impolite or extremely demanding because of pain or their condition, in times like these it is important to empathize with the attendant and help them understand the condition of the elderly. With a good communication mechanism established the attendant would be willing to go that extra mile to discharge her duties.

3) Help them maintain continuity – Many times caregivers get frustrated with a particular family/household and ask for rotation duties. However, if one establishes a good rapport then it will earn you their loyalty. Checking up on them regularly and taking care of their reasonable personal needs can help cement a good relationship based on mutual respect, trust and affection.

So how does one form a good rapport?

1) Clarify commitment and responsibilities – The foremost thing is to set your expectation and clarify the duties which you need help for. Share your caregiving goals so that you are both on the same page. For example if your loved one is bed ridden, then hygiene and helping them turn around frequently to avoid bed sores could be a very important care goal. Ask the attendant to share his/her understanding in order to avoid any communication gap.   

2) Ensure language is no barrier If one can get an attendant who speaks the same language it can help a lot. But this may not be practically possible all the time. However, make sure that language poses no barrier in communication.

3) Approach each individual with an open mind– It is important to review and be aware of the attendant’s past experience. There could be some tasks he/she has not done earlier, help them understand those tasks and encourage them to seek clarifications. Give them a three to four days to settle in get comfortable with their duties.

4) Communicate often Caregivers are given the important duty of providing support and encouragement to your elderly loved one. Being in touch with them over the phone a couple of times during the day can help build a good relationship. Too much supervision or being totally hands off will not help and can be detrimental to building the relationship. Many a times attendants tell us that the family is too busy to even acknowledge them and understand their challenges. Remember you have hired them for caregiving support but you still remain the primary caregiver. It is important to make some effort and check on them regularly, while creating a safe space for the attendants to express their thoughts about their role and their concern for the person receiving care.

5) Encourage and show gratitude – A caregiver’s responsibilities whether paid or unpaid can be stressful. It is important to acknowledge and thank them regularly for their contribution. Small tokens of appreciation like a smile, a hug or some time off can make a lot of difference in the quality of care. Take time for a conversation expressing your appreciation of the important role they play in your loved ones life.

A great advise by Mother Teresa – “It is not how much you do, but how much love you put in the doing.”

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation.

In-Home Trained Attendant Service

Samvedna Senior Care’s trained in-home attendant service brings to you verified attendants and nurses, specially trained by specialists in elder care and dementia. Our staff is trained to not only take care of your elderly loved one’s physical wellbeing through top class personal care and nursing, but also their emotional wellbeing.  The attendants are monitored by our Senior Care Specialists (psychologists and MSWs)

Our service is available across Delhi, Gurgaon and Noida. We offer both male and female attendants as per request, for 12 and 24 hour shifts.

Know more about our Trained Attendant Services here http://www.samvednacare.com/attendant-care-services. You can also call us on 98184 00561 or write to us on contact@samvednacare.com.

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Dark mornings and even darker evenings with chilly grey days in between means winter is here — and with the cold season comes the winter blues.

If you or your loved one struggle with the “winter blues” you know how difficult it can be to make it through the holiday season. Although winter does bring in the festive holidays it also means less sunlight, shorter days and colder weather. As a result it leads to reduced physical activity, more sleep, less interest in activities, social withdrawal, unhealthy eating and a general sense of feeling low.

This condition is termed medically as Seasonal Affective Disorder (SAD), it can happen at the onset of any season. However, winter depression or winter blues are the most common. Serotonin and melatonin levels both drop significantly which causes major changes in sleep and mood—two critical components of overall health and wellness.

During winter months many elderly may find themselves feeling low and down, it can be due to reduced sunlight, shorter days, and the holidays coming to an end or they could be missing their loved ones.

Here are a few tips for elderly to follow which will help in dealing with low mood during the winter months –

1) Brighten up the surroundings- allowing enough sunlight into the home can help brighten up the mood instantly, intake of Vitamin D from natural light works as a mood enhancer and it is also good for overall health. Getting natural light in winters can at times be a challenge, light therapy can be an option to treat SAD symptoms and other conditions by exposure to artificial light.

2) Eat a balanced diet – Eating a balanced diet is essential for older adults and is a natural way to boost mood and energy. Improved nutrition also helps prevent colds, flu and injuries that are more prevalent in cold weather. As we all know requirement of vitamins, minerals, carbohydrates, proteins and fluids changes in old age hence all these nutrients need to be packaged in easy to digest small meals which can be spread throughout the day. Adding plenty of natural colours to your diet with one or two seasonal fruits can be a good source of anti-oxidants.

3) Stay Active – Exercise, while important all year round, can be vital in lifting the mood during the winter months. Physical activity such as Yoga, Frankel exercises help    increase the blood flow to the whole body. Retaining good flexibility for joint movement through stretching really helps when wearing layers to combat the cold. Performing a minimal amount of daily physical movement and exercise also helps prolong memory loss and cognitive decline associated with aging.

4) Planning for events – Whether looking forward to a party or celebration, or planning / redecorating for an upcoming event, it can help create positive feelings. Inviting family members over for lunch, having brunch outside with grand children or visiting friends can help generate positive emotions and excitement.

5) Stick to a Schedule – When experiencing the winter blues, it can be tempting to alter your schedule to avoid activities and socialization – and hibernate instead, but one should try to maintain their schedule of going out, exercising or visiting any community services.  Changes in schedule can also lead to disturbances in mood.

6) Accomplish Goals – If you’ve been putting off a task, whether big or small, winter is the time to tackle it and complete it. For this you can maintain a to-do list and write all your task as per priority and when completed you can cross it off, it will motivate you to complete more tasks on your list, and help you feel better and energetic.

7) Socialize – Being around other people and/or talking to them can lift your spirits. Get together with friends or family or simply give them a call, a small get-togethers with loved ones can help brighten the mood.

8) Mind StimulationMental exercises such as crosswords, puzzles, Sudoku, Scrabble can help one stay mentally alert. Reading a good book by the fire place or in the sun can lift the mood and help stay active.

How can you help as a caregiver to an elderly ?

If a loved one seems a little down this winter, it will be good to make an extra effort to spend some additional time with them. As a caregiver one should be aware of any symptoms of SAD, and look out for them and seek timely help from a doctor or counsellor to counter the depressive symptoms.

As caregivers, it is easy to underestimate the power of communication and connection with those around us. Sometimes a simple afternoon spent with the person you are caring for – listening to music, playing cards or looking at photo albums can drastically improve their mental well-being.

If you are concerned about a loved one’s mental or physical health professional care providers can help with any kind of depressive symptoms through counselling and companionship services for elderly.

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation. Please call us for more info – Delhi NCR – 98184 21446, 124 4229659

Counselling for Ageing Related Disorders in Anand Niketan, New Delhi –

Studies show that elderly may be more prone to depression and loneliness, which can lead to higher rates of unhappiness. To address this issue, we have designed counselling and therapies for seniors with anxiety, low mood or depression, mild cognitive impairment/ memory difficulties, or dementia.

More – https://www.samvednacare.com/counselling

General Wellbeing:

With our General Well Being Services we aim to raise the quality of life of seniors, specially those who may have limited mobility and social interaction due to various constraints. Our interactive programme keeps them active and engaged through physical, mental and social activities, all in the comfort of their home.

More – http://samvednacare.com/general-wellbeing

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WHO recently reported that India’s alcohol consumption has doubled in a decade. Rises in heavy drinking among all classes and backgrounds indicate a potential surge in reporting of alcohol-related brain damage (ARBD). If someone you know is a heavy drinker, displays signs of mental confusion, difficulty walking, and has vision problems, they might be already be affected. In this post, we talk about brain disorders caused by alcohol misuse, and the signs to look out for.

30% of the Indian population are alcohol consumers, with at least 11% being moderate-heavy drinkers, as per the 2014 WHO Global Status Report on Alcohol and Health. 17% of these account for 20-30% of alcohol-related issues needing hospitalization. In 2018, WHO reported that 3 million deaths every year are due to alcohol consumption and diseases caused by alcoholism. Among the diseases caused by alcoholism, alcoholic dementia and Wernicke-Korsakoff’s Syndrome are some of the most common yet most under diagnosed conditions.

Alcohol’s Real Impact on the Human Body

Alcohol is often considered a stimulant. In reality, this substance and its many variants play the role of depressant on the human body. Many individuals find themselves addicted to alcohol and suffer severe consequences in every aspect of their lives – whether physical, mental, professional, and social.

Research shows that alcohol intake can contribute to cognitive decline, and if left unchecked, can cause irreversible brain damage. For example, day-drinking, binge drinking, and regularly drinking alcohol in excess increases your risk for developing Alzheimer’s and vascular dementia in later life.

For some, even slight intake of alcohol causes severe adverse impacts on their health and can set them on the path towards permanent alcohol-related brain damage. Heavy drinkers face an even higher risk of developing such conditions.

How much alcohol is too much alcohol?

In India, AIIMS physicians define a standard drink or 1 alcohol unit (which is equal to 10ml of absolute alcohol) as follows:

  • 300-400 ml of standard beer, or 100-150ml of strong beer
  • 100-250 ml of wine, or 60-90ml of fortified wine
  • 30ml of spirits (whiskey, rum, gin, vodka, brandy etc)
  • 40ml of arrack (country liquor)

However, India is yet to define a national alcohol policy, but the widely accepted definition of a “heavy drinker” as per the guidelines set by the U.S. Department of Health and Health Studies is ‘someone who drinks too much at one time or over the duration of a week’. This is further classified by gender as follows:

  • Men: 4 or more drinks in one sitting OR 14 drinks or more during a week.
  • Women: 3 or more drinks in one sitting OR 7 drinks or more during a week.

Given the recent rises in access to disposable income and “eating-out” culture, as well as changes in attitudes regarding consumption of alcohol, it is not surprising that WHO found that India’s alcohol consumption has doubled in a decade.

While men are more likely to be diagnosed with alcoholism or brain damage caused by alcoholism, more women are now reporting similar difficulties. Women are also at higher risk for alcohol-related brain damage with regards to age and duration of drinking habit.

What is Alcohol-related Brain Damage?

Alcohol-related brain damage (ARBD) refers to brain disorders caused by excessive intake of alcohol.

You are at high-risk for ARBD if you fit the following factors:

  • Moderate or heavy drinker
  • Aged 40s to 50s
  • Having nutritional deficiencies due to lack of care about diet
  • History of hypertension, high cholesterol, heart attacks, stroke (all caused by damaged blood vessels, often caused by heavy drinking)
  • More men are affected than women.
  • However, women are susceptible to develop ARBD at younger ages and with fewer years of excessive alcohol consumption.

ARBD is triggered by damage to the nerve cells from overconsumption of alcohol. Falls while intoxicated can cause head injuries are also classified as ARBD.

The two most common forms of ARBD are alcoholic dementia and Wernicke-Korsakoff’s Syndrome.

What is Alcoholic Dementia?

Alcoholic dementia, also known as alcohol-related dementia, is the most common form of ARBD. It is like Alzheimer’s in that memory and cognitive abilities are affected. It is also irreversible.

Symptoms are:

  • Problems in decision-making, risk assessment, planning, organizational skills, judgment
  • Impulsivity, emotional outbursts, irritability
  • Trouble paying attention, feeling “slow”
  • Reduced sensitivity and empathy for other people’s feelings
  • Socially inappropriate behaviours

What is Wernicke-Korsakoff’s Syndrome?

Wernicke-Korsakoff’s syndrome is a degenerative brain disorder resulting from severe thiamine (Vitamin B1) deficiency due to alcohol abuse. It is a disease consisting of two separate syndromes: Wernicke’s encephalopathy and Korsakoff’s psychosis. 80-90% of individuals with Wernicke’s encephalopathy develop Korsakoff’s psychosis.

The symptoms of Wernicke’s encephalopathy are:

  • Mental confusion: the person is exhibiting disorientation and/or memory is impaired.
  • The person is very underweight and not eating a healthy or nutritious diet
  • Paralysis of the eye muscles or jerky eye movements.
  • Poor balance: motor coordination is affected.

When Wernicke’s encephalopathy remains untreated, it leads to Korsakoff’s psychosis, characterized by:

  • Memory loss – the person is unable to form new memories or learn new information (anterograde amnesia).
  • Difficulty with walking – loss of muscle coordination (ataxia).
  • Eye movement problems – double vision, drooping upper eyelids.
  • Hallucinations are commonly reported as part of mental confusion.
  • Confabulation: the person exhibits exaggerated storytelling (“unbelievable stories”).

Unlike other diseases related to alcoholism, the person affected by Wernicke-Korsakoff’s Syndrome usually lacks insight into their condition and may display personality changes. This is due to the brain structure being affected by alcohol misuse.

How to diagnose, how to treat

There are no specific lab tests or procedures to diagnose alcoholic dementia or Wernicke-Korsakoff’s syndrome. These conditions are often mistaken for other issues such as intoxication, withdrawal, infection, head injury. The current methods of diagnosis involve a neuropsychiatric examination and a full medical checkup while checking for memory loss and other cognitive changes. It is important to ask about prior alcohol use.

Abstinence from alcohol is vital to ensuring that the alcohol-related brain damage and disorders do not continue to progress. Treatment from a clinical perspective focus on thiamine re-supplementation but this is useful only if the condition is correctly detected early enough.

Psychological therapeutic approaches are employed to help the individual come to terms with their condition and re-learn the necessary skills to thrive again. While some may require lifelong assistance depending on the severity of the brain damage, many are able to find meaning in a new start.

How Samvedna can help your loved one with ARBD

Our team comprises of highly qualified experts in neuropsychology, mental health, and dementia care. Trained in detecting and understanding mental health problems, our professionals will able to help create and implement client-appropriate and individualized non-pharmacological interventions for clients with ARBD.

If you suspect that a loved one might be having trouble due to alcohol misuse, contact us at 98184 00561 or write to us on contact@samvednacare.com.

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation. Please call us for more info – Delhi NCR – 98184 21446, 124 4229659 or write to us on contact@samvednacare.com

Our Dementia Care services are

At-home services –
Dementia intervention activities by trained Care Specialists (already mentioned above). These services are available in Delhi NCR. More – http://www.samvednacare.com/dementia-care

In-Home Trained Attendant Service –
Samvedna Senior Care’s trained in-home attendant service brings to you verified attendants and nurses, specially trained by specialists in elder care and dementia. Our staff is trained to not only take care of your elderly loved one’s physical wellbeing through top class personal care and nursing, but also their emotional wellbeing.  The attendants are monitored by our Senior Care Specialists (psychologists and MSWs)

Our service is available across Delhi, Gurgaon and Noida. We offer both male and female attendants as per request, for 12 and 24 hour shifts. Know more about our Trained Attendant Services here http://www.samvednacare.com/attendant-care-services.

Counselling for Ageing Related Disorders in Anand Niketan, New Delhi –
Studies show that elderly may be more prone to depression and loneliness, which can lead to higher rates of unhappiness. To address this issue, we have designed counselling and therapies for seniors with anxiety, low mood or depression, mild cognitive impairment/ memory difficulties, or dementia. More – https://www.samvednacare.com/counselling

Dementia Cafe, Sector 57 Gurgaon –
From initial stage to advanced stage, all individuals with dementia feel the need for social interaction at times. Our Dementia Cafe is a safe and friendly place for your loved one with dementia to chill and socialize. The cafe is aplace where they will find a fun activity, a warm chair and companionship. Every Tuesday and Thursday, 11-1PM. More – https://www.samvednacare.com/dementia-cafe

Cognitive Wellness Programme, Sector 57  Gurgaon  –
Samvedna’s Cognitive Wellness Programme is designed for seniors with mild cognitive impairment, early dementia or Parkinson’s,and elderly lacking in enthusiasm and motivation. The aim is to stimulate the mind of the elderly to slow the progression of the disease or impairment. The sessions are 3 days a week – Monday, Wednesday and Friday, 11AM-1PM. More – https://www.samvednacare.com/cognitive-wellness-programme

Dementia Support Group –
Our Dementia Support group in Delhi NCR is a platform for caregivers to share feelings and support each other. More – https://www.samvednacare.com/dementia-support-group

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As we age, our dependency and hence need requirement for support increases. Dependency can be physical, social, psychological, or/ and  emotional and it can be even more critical if a senior develops any form of disease which has an impact on their cognitive abilities, for eg, dementia or any other related disorder. Under such circumstances, our elderly loved one needs a helping hand from a person with compassion and sensitivity to understand the disease and its related symptoms.

At the same time it is important that we don’t impact the dignity and sense of independence of our elderly loved one. Hence it becomes important for the caregiver to be trained and educated to sensitively solve the problems of our loved ones.

  • But the major question arises who should be that helping hand and what skills, qualities and training should he have?
  • And why do I really need such trained person for geriatric care if I already have a dedicated maid at home?

The answer can be understood through the following important areas:

1) Change in the Indian family system – City life is becoming more fast paced and competitive with time, and demanding careers and lifestyle take up a large part of our time. This has certainly impacted the older Indian’s existing pattern/way of care. Earlier, children used to take care of the physical and other needs of their aging parents but now they hire a carer for them. They create a support system for their elderly, so that the elderly can lead an active and engaged life.

2) Increase in population
Undoubtedly, the geriatric population as well as the number of people with dementia (4 million) is increasing at a high/steady rate in India. So the rising geriatric population clearly indicates that demand for trained attendants and nurses will increase.

3) Brain disorders need constant care
We all know that disorders like dementia are incurable, but they are manageable. A trained attendant is a critical element of dementia care that can help to improve quality of life of your loved one.  The disease is progressive in nature and it requires constant care of the patient. Moreover, the care has to be person centered and flexible which is not possible until someone trained person steps in the care process.

4) Challenging behaviours require skills to handle
Soft skills, knowledge and training is required to manage challenging behaviours of seniors especially in dementia. How to distract if the patient is anxious, how to react if your loved one is hallucinating, how to control pacing, how to manage anger, agitation and catastrophic changes, all such situations require the expertise of a trained attendant. Moreover, the training enables attendant to prepare for the unexpected in advance and how to deal with it when it comes.

5) Social component of dementia care
Generally patients with the moderate/ advance stage dementia require an attendant for their personal care like assistance with walking, bathing, eating, toileting etc. But we shouldn’t ignore the fact that our loved one still has some social, psychological and emotional needs. An Ayah or maid wouldn’t be able to understand such unmet needs so a trained attendant is required.

How do we train the attendants?

Keeping the rising need in mind, Samvedna Senior Care has taken the initiative to train the attendants-nurses and make them well equipped for geriatrics and dementia care. The participants are moderately (senior secondary) educated with some certification in caregiving, and have experience of working in hospitals and are able to administer medical care to the patient like injections, IV drips, keeping track of vitals like BP, sugar and medication management.

Our training module comprises of both theoretical and practical learning and it gives vital information on handling geriatric problems especially in dementia care. We understand that geriatric patients require much more than physical care. We train our attendants to understand the importance of social, emotional and psychological support which is needed by the patient. Similarly, we guide them to develop their own coping strategies to maintain mental peace at work and their lives.

Our strength

The training at Samvedna is provided by the qualified dementia experts who have on field experience in handling the symptoms of dementia. The participants are taught about the disease in detail from the beginning which covers primary causes of dementia, its symptoms, the anatomy of brain and possible ways to handle challenging behaviours in dementia.  We also give the participants an opportunity to share the challenges they encountered in caregiving process. The training programme ends with role plays and detailed discussions around the queries raised by the participants.

We at Samvedna Senior Care aim to help seniors live happy, active and independent lives, in the comfort of their home and community through interactive caregiving.

Samvedna Senior Care was established in October 2013 with two complementary goals – firstly to provide quality home care services to seniors with limited mobility or dementia and hence social interaction, and secondly to facilitate stimulating community interaction and participation.

In-Home Trained Attendant Service

Samvedna Senior Care’s trained in-home attendant service brings to you verified attendants and nurses, specially trained by specialists in elder care and dementia. Our staff is trained to not only take care of your elderly loved one’s physical wellbeing through top class personal care and nursing, but also their emotional wellbeing.  The attendants are monitored by our Senior Care Specialists (psychologists and MSWs)

Our service is available across Delhi, Gurgaon and Noida. We offer both male and female attendants as per request, for 12 and 24 hour shifts.

Know more about our Trained Attendant Services here http://www.samvednacare.com/attendant-care-services. You can also call us on 98184 00561 or write to us on contact@samvednacare.com.

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When I set out to start Samvedna in early 2013, honestly, I had a hazy picture of what I wanted to do. The only thing that was clear to me was to make a difference in the lives of seniors, break the mundane routine and do something about their loneliness and social isolation. The idea of an activity centre, a platform for seniors to socialize and also channelize their energy in a positive way, was thus born. Soon we realized that a lot of seniors cannot come to the centre because of mobility issues, hence the home services were developed.

Dementia and other chronic ailments pose a major challenge for the families, understanding and coping with the disease is key and many a times families do not get the right support or diagnosis for their loved ones. I am happy to share that today Samvedna Senior Care provides services to help elderly with dementia as well as support the family. Our counselling services help families, individuals and the patient cope with their situation and manage their conditions. Our in home doctor services help reach out to chronically ill patients and provide a huge relief to the family.

The senior care industry is now recognized as a service sector by CII, much needed to fulfill the huge gap in quality senior care, senior living and nursing and caregiving services. The demand for specialized care homes to meet needs of elderly with chronic ailments like Dementia and palliative care is going to rise. The challenge for the sector will be to provide quality care and services at price points that appeals to different pockets. The other challenge is to build a workforce of care professionals across the spectrum from caregivers, care specialists, physiotherapist and social worker, psychologists and doctors specializing in geriatric care. Due to the gap in adequate infrastructure facilities and to keep the cost of care low, there will be a rise demand for in place ageing solutions.

In the past 5 years we at Samvedna have been working tirelessly to design these solutions and see how best we can serve varied needs of people. We now have two short duration dementia care programmes, Cognitive Wellness Programme and Dementia Cafe, running at our centre to address early dementia patients and give them a social platform, and provide short term relief to families. Our geriatric counselling centres in Gurgaon and Delhi helps address elderly and families needing psycho-social support. Our in house trained elder care attendants provide relief to families who have demanding long term caregiving responsibilities. Our specialized home visit services by counsellors and social workers make a huge difference in the lives of elderly whose children live far away.

We have recently been recognized as one of the 25 best social enterprises by the Yes Foundation, through this support we hope to replicate our centre model and open atleast three more centre over the next two years.

Our warm and compassionate team continues to grow and we would like to encourage people with interest in geriatric care to come join us to help us achieve our mission. Our team also works with academic and scientific societies to share and exchange our experiences working with elderly.

I would like to thank all the people who have stood by me in this arduous journey to promote professional senior care services. Without the encouragement of family, friends and a committed team we would not have accomplished what we have set out to achieve. Here is toasting to more years to Samvedna Senior Care. Cheers !

Warm regards,
Archana Sharma
Founder, Samvedna Senior Care

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This month Samvedna Senior Care completed 5 years. Here are some pictures from our celebration of this beautiful landmark in our journey, made possible by our vibrant members and compassionate team! Many more to come

     

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