There is a treatment gap of more than 90% for dementia patients in Goa. A study in Goa has revealed that only 51% of patients with dementia are taken to a doctor. Of these, only 5% receive diagnosis and treatment for the condition.
Shockingly, in some cases of dementia detection, families refuse to give dementia specific medication to the patient, mainly citing reasons such as high cost of medication, the family doctor advising against taking medication, and the fear of side effects.
The other major barriers to closing this treatment gap include low levels of awareness about dementia as a medical disorder amongst people, besides scarce care arrangements for elders in the public health sector and the specialities of old age psychiatry or geriatric medicine being poorly established in the state.
The study notes that though dementia is widely recognized, the condition is not thought to constitute a health problem and is construed as a normal part of ageing by both primary health practioners and family members, reveals the study, Closing the treatment gap for dementia in India', conducted by 10/66 Dementia Research Group India. It has been published in the Indian Journal of Psychiatry in 2009.
Not surprisingly, Dr Amit Dias from the department of preventive and social medicine, Goa Medical College and Hospital, who spearheaded the study said, "Dementia is construed as a normal part of ageing and not perceived as requiring medical care. Thus, primary health physicians rarely see this condition in their clinical work and the problem is occasionally attributed to abuse, neglect, or lack of love on the part of children towards a parent."
According to statistics available with the Goa Dementia Society, there are around 3000 people with dementia in Goa, of which about 8.3% persons are above the age of 60. The study notes that these numbers are expected to increase dramatically in the years to come due to the demographic transition, especially with life expentancy increasing.
According to the study, even the care for those with dementia in Goa was almost entirely family-based, with little or no formal services in the state, thus making them more vulnerable.
"Though we pride ourselves on the system of family care and support for older persons, elderly care is often conditional upon the child's expectation of inheriting the parent's property," the study notes.
This, Dr Dias said, has an adverse affect on patients and they experience dependency anxiety'. "People are often neglected in their homes and sometimes abused.
"This leads to dependency anxiety' among older persons, besides the stigma associated with the psychological and behavioral problems associated with dementia. This is the situation not just in Goa but throughout the country," said Dr Dias.
"An effective home based intervention reduces caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia, Dr Dias added..
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Sunday, July 12, 2009
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