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Thursday, October 29, 2009

Treating Dementia, but Overlooking Its Physical Toll

Dementia is often viewed as a disease of the mind, an illness that erases treasured memories but leaves the body intact.

But dementia is a physical illness, too — a progressive, terminal disease that shuts down the body as it attacks the brain. Although the early stages can last for years, the life expectancy of a patient with advanced dementia is similar to that of a patient with advanced cancer.

The lack of understanding about the physical toll of dementia means that many patients near the end of life are subjected to aggressive treatments that would never be considered with another terminal illness. People with advanced dementia are often given dialysis and put on ventilators; they may even get preventive care that cannot possibly help them, like colonoscopies and drugs for osteoporosis or high cholesterol.

“You can go to an intensive-care unit in most places,” said Dr. Greg A. Sachs, chief of general internal medicine and geriatrics at Indiana University School of Medicine, “and you’ll find people with dementia getting very aggressive treatment.”

The continued focus on treatment to prolong life often means that pain relief is inadequate, and symptoms like confusion and anxiety are worsened. A new study suggests that family members would be far less likely to subject their loved ones to such treatment if they had a better understanding of dementia as progressive, debilitating illness that ultimately shuts down the body after years of mental deterioration.

Harvard researchers recently followed 323 residents of 22 nursing homes. All had end-stage dementia, meaning that they no longer recognized family members, could speak fewer than six words and were incontinent and bedbound. During the 18-month study period, more than half of the patients died.

During the last three months of life, 41 percent of the patients received at least one “burdensome” treatment, like transport to the emergency room, hospitalization, feeding tubes or intravenous treatments. Advanced dementia patients are particularly prone to infections because of incontinence, risk of bedsores, a depressed immune response and inability to report symptoms.

When the investigators looked more deeply into the reasons for treatment decisions, they discovered stark differences based on what family members knew about dementia. When they understood its progressive and terminal nature, only 27 percent of the patients received aggressive care. For family members who did not understand the disease, the figure was 73 percent.

“When family members understood the clinical course of dementia and the poor prognosis, the patients were far less likely to undergo these distressing interventions,” said the study’s lead author, Dr. Susan L. Mitchell, senior scientist at the Institute for Aging Research of Hebrew SeniorLife in Boston. “Dementia is a terminal illness and needs to be recognized as such so these patients receive better palliative care.”

The study also found that pain control was often inadequate. One in four subjects were clearly suffering from pain, but that number may understate the problem, because the patients were unable to talk about their pain.

Dr. Sachs, at Indiana, notes that care for patients with dementia has changed very little in the past 30 years. As a teenager, he watched his grandmother decline from Alzheimer’s disease. During her final months, she was repeatedly treated for infections and put in restraints or sedated to control agitation.

“Seeing my grandmother in that state was so distressing that my mother eventually stopped taking the grandchildren to visit,” Dr. Sachs wrote last week in an editorial in The New England Journal of Medicine. “My grandmother had little in the way of comfort or company toward the end. In my medical training, I learned how my grandmother’s final months were typical for people dying from dementia.”

A 2005 report from the Alzheimer’s Association showed troubling trends in care at the end of life. In a sweeping review of the medical literature, the investigators found that 71 percent of nursing home residents with advanced dementia died within six months of admission, yet only 11 percent were referred to hospice care, which focuses on comfort rather than active treatment.

Simply transferring a dementia patient from the nursing home to a hospital can lead to confusion, falls or a decline in eating — which in turn, often leads to further aggressive treatment.

Geriatricians say a large part of the problem is that the patients are unable to make their wishes known. In the absence of a living will, family members often struggle with guilt and are afraid to stop aggressive treatment because they do not want to be seen as abandoning a loved one in mental decline.

Dr. Sachs says doctors need to spend more time explaining the prognosis for advanced dementia, making it clear that palliative care does not mean less care.

“We’re not talking about aggressive care versus no care,” he said. “Palliative care is aggressive and attentive and focused on symptom management and support of the patient and family. It’s not any less excellent care.”


Source: http://www.nytimes.com/2009/10/20/health/20well.html?_r=1

Monday, October 26, 2009

Holy Family Dementia Support Group Mumbai

Dear Friends,
We are pleased to Invite you for 1st meeting of Holy Family Dementia Support Group on Saturday 31st Oct 2009 at 4pm.

Holy Family Dementia Support Group is supported by Silver Inning Foundation & ARDSI Greater Mumbai Chapter.

Activity for Support Group:
Counseling, Training of family members, Training of professional care givers, Monthly Meeting, Awareness campaign,Sharing, Lectures, Reference Service etc
All services are free.Only therapy if required will be charged.

The Team:
Dr.Charles Pinto will be Adviser and Consultant.
This group will be headed by Ms.Raheen Jummani,Clinical Psychologist.
Sailesh Mishra will be coordinator.

Contact : Ms.Raheen Jummani - 9029000091 , Email:silverinnings@gmail.com

Date: Sat 31st Oct 2009

Time: 4.00 pm

Holy Family Hospital
MUMBAI 400 050

Date and Time for future meetings :
Last Saturday of every month at 4pm to 5pm.

Area of operation:
At present the group will function for the resident of Santacruz to Mahim Area of Mumbai City.

The 2010 IANA (International Academy on Nutrition and Aging) Albuquerque, New Mexico (USA)

The 2010 IANA (International Academy on Nutrition and Aging) will be hosted in Albuquerque on July 26-27, 2010 at the Hyatt Regency Tamaya, Santa Ana Pueblo, New Mexico, USA (http://www.healthandage.com/html/min/iananda)

The meeting will focus on Nutrition and Age Related Diseases including Sarcopenia, Cognitive decline, Frailty, Alzheimer, Long-term Care, Vascular Diseases, Cancer... Preventive trials and multidomain Intervention approaches with physical exercise, nutrition, cognitive exercise are also solicited.

Deadline for submitted symposium (abstract must be limited to 500 words) is December 6, 2009

Deadline for oral communications and poster is February 15, 2010 (abstract must be limited to 300 words)

For more information contact:
University of New Mexico
Office of Continuing Education
MSCO9 5370 - University of New-Mexico
Albuquerque, NM 87131-0001
Tel (505) 272-3942
Fax (505) 272-8604
Email: KBreckenridge@salud.unm.edu

These senior citizens do not miss the vote bus

In order to facilitate hassle-free commuting on polling day for the elderly and senior voters residing in Athashri Housing Society, located in three parts of the city — Pashan, Bavdhan and Hadapsar— the society authorities roped in special private buses to ferry them to the polling stations on Monday.

“It has been a practice to make special arrangements to take our senior residents to polling booths in privately owned buses. This saves time and energy. All the voters were enthusiastic about exercising their franchise and the bus had to make two trips,” said Vijay Raikar, manager of Pashan Athashri.

The polling booths for the 350 Athashri residents, including a number of elders in Pashan were in Sutarwadi and Abhinav Art College. “By 11 am, we were back home after voting,” said Suhas Bapat, a resident. Eighty-one-year-old VS Raja said, “I never miss an opportunity to cast my vote. Since the transportation was arranged, there was no question of being sluggish and not stepping out to vote.”

At the Athashri in Bavdhan, only ten residents voted. “There are 105 flats in this society. In the occupied flats, there are 55 residents and out of that, only ten people voted. The others did not show interest,” manager Deepak Patil said.

An office-bearer of ‘Nivara’, an old-age home in Navi Peth, said, “There are around 140 residents here. Many of them are too old or preoccupied with their own problems. For the Lok Sabha polls, some of the inmates voted. But this time, nobody seemed keen.”

However, the overall picture was not discouraging. Like 75-year-old Vishwanath Bhatt near Bopodi, whose weak eyesight did not deter him from casting his vote, many senior citizens ventured out and voted. While waiting for a vehicle to ferry him to the polling booth, Bhat said, “I have been voting for the last 35 years and always make it a point to exercise my franchise. Though my eyesight has become weaker, it will not pose a problem when I vote.”



Saturday, October 24, 2009

Promoting Aging Activism to Assure the Rights of Older Persons

International Day of Older Persons
Workshop: Promoting Aging Activism to Assure the Rights of Older Persons 2009

Susanne Paul, Global Action on Aging President, chaired an afternoon workshop focused on human rights of older persons on the International Day of Older Persons at the United Nations. Participants included Nora Berra, French Minister for Older Persons; Javier Vasquez, Human Rights Law Advisor for the Pan American Health Organization; Maria Luz Melon, First Secretary of the Permanent Mission of Argentina to the United Nations, and Alexandre Kalache, Global Ambassador, HelpAge International.

Nora Berra, French Minister for Older Persons

Nora Berra opened with the following statement: "We wish to attach roles and rights to older persons. Our presence here is an example of our efforts to deliver a universal message." With that, she emphasized "equality, liberty and fraternity," and discussed the implementation of the 2002 Madrid Plan of Action in France. She explained France's "social integration, care and consideration, education, labor market, social services and other life issues for older persons." France recognizes such rights because the government is committed to excluding no one based on age, gender or income. Mme.

Berra called for a global approach to respond to the worldwide increase in life expectancy, using the current figure of 600 million people over the age 60 as the basis of her argument. We "must consider life expectancy as an achievement over time, [especially as] it allows individuals to live more and bear witness to what is changing in the world." Overall, however, she asserted that we "need a better strategy for integration of older persons." "They are a pillar on which French society resides; they relate to their children and grandchildren and serve as a vehicle of transmission of values," she stated, and as a result, "the perspective about older persons has been changing in France." She explained that older persons participate in a range of activities and "commit to society on a voluntary basis; [in addition,] they create an enormous source of wealth in the business community and provide training and tutoring."

Berra asserted support for the Madrid Plan in June 2009 along with the World Health Organization, resulting in positively reinforcing the image of older persons in French Society. She concluded that "each older person benefits from services tailored to their needs and [thus,] France promotes older persons living at home as long as possible, [only to be moved when] keeping a person home is no longer possible and there is therefore a need for an intermediary system." On the topic of home care, she additionally discussed the Alzheimers' condition that currently affects 1.6 billion individuals, and the need to provide a master plan to pay for costs of such needy individuals-a situation which France will address in a seminar in 2010 or 2011. Last, she concluded with the simple, yet enduring statement that "older persons deserve our common reflection worldwide"-a statement that set the stage for the speakers who followed.

Maria Luz Melon, First Secretary of the Permanent Mission of Argentina to the United Nations Maria Luz Melon, spoke on behalf of Dr. Luciano Di Hector Cesare, who was unable to attend the workshop. She opened her speech with the statement that in Argentina, there were no specialized medical policies or interventions for older persons in 1971 and thus, Heads of State expressed commitment to securing them. She stated that age discrimination is a basic violation of human rights and with this in mind, we need new models to integrate older persons, not only recognizing them as a group, but also as an integral part of society. She posed the question, "We can say older persons are integrated now, but are older persons treated equally?" She responded by saying that Argentina needs to address this issue in a comprehensive manner. "Member States cannot succeed in isolation, and we need to devote more resources [such as] those of civil society and academia, to assure national and international accountability and monitoring." She said that Argentina supports a convention that enumerates the rights of older persons to become part of obligatory and binding laws in governments. She concluded that society needs a different and positive change on elder rights because it current situation is a "global problem that needs a certain dialogue and [thus,] we need to change the way we think."

Javier Vasquez, Human Rights Law Advisor for the Pan American Health Organization

Javier Vasquez opened his presentation with questions for the audience. "Why a new convention?" he posed. He continued, "Why a new treaty?" His answers set the foundation for his arguments. "Very few countries have implemented fundamental rights and freedoms of older persons. We need to protect their rights, decision-making process, healthcare and financial choices. There are gross violations of basic human rights and many countries, laws, policies and plans are not protecting older persons against abandonment, discrimination and abuse." He asked, "What are some rights that need to be protected?" He referred to simple necessities such as water, food and essential medicines, explaining that older persons often face physical barriers. He added that "older persons do not have contact with community at large due to age." Thus, we "need clear procedures and mechanisms [that] give older persons the possibilities of making decisions-procedures that have not [yet] been established by law."

Vasquez then asked the audience the following rhetorical question. "We do not see older persons claiming rights and advocating because how can they be a voice when they are involuntarily pent up?" Vasquez then continued with examples of abuse against older persons. "Older persons have the right to live and we need to be their voice," Vasquez said. "They need to be free from physical, mental, financial and emotional abuse in order to prolong their life. Some examples [of such abuse] include [when older persons are forced] to eat meals, tied to beds, [placed in] physical positions that make wounds and injuries worse, and [issued] threats of abandonment. These actions can provoke more problems when taking into account the physical, mental and emotional vulnerability [of older persons]." Thus, we "need to examine the biological and social aspect of aging."

Vasquez claimed that "access to information is crucial for older persons to make decisions, but this is not always available and [therefore,] we need an International convention to make clear mechanisms and procedures with in a legal framework. He also spoke of long-term care stating that "none of these rights will be enjoyed if the government does not adopt clear measures that take care of terminal illness and preventative pain." He added that we "need mechanisms in long-term care and the adoption of international policies in social security, education, recreation and work." With the prospect of international cooperation in mind, he concluded that "the inter-American agency is committed to the implementation of international measures [and that] an international convention is a great opportunity for NGOs and governments to explore specific standards in the rights of olderpersons."

Alexandre Kalache, Global Ambassador, HelpAge International

Using a Powerpoint presentation as his guide, Alexandre Kalache discussed the "social exclusion" of older persons that constitutes a "human indignity." He also talked about "symbolic exclusion," and explained that many older persons are "left behind" as a result. He mainly addressed the following forms of exclusion that impact old people: institutional exclusion, socio-economic exclusion, territorial exclusion, identity exclusion, social capital exclusion and socio-political exclusion-which, collectively, leave older people disempowered and unable to neither exercise their rights nor fully express their unique personas. He pointed out that nations need to address these exclusions and solidify elderly rights as an integral part of society in order to promote "inclusion"-which would "ensure that everyone has the right to appreciate the treasure of life."

He did not merely use words, however, as support for his argument. His powerpoint pictures explained what he was trying to convey. For example, he showed a picture of his mother, Lourdes, at her 90th birthday party and reported that she has had a privileged life with the best of the best and thus, was included in society"-which now allows her to enjoy the "treasure of life." In contrast, he explained that his Nanny from childhood, with whom he has lost contact and only up until recently has found, did not share the same fortune as his mother; she currently lives in poor health and serves as an example of a person much affected by the aforementioned "exclusions" as she now lives an impoverished life alone and in a foreign land with which she has few attachments. He explained that due to society's lack of enforced elderly rights, she now suffers in her old age as a result of a life spent trying to stay afloat-a common phenomenon that affects many and, without the implementation of elder rights, will continue to do so.

The closing remarks focused on the necessity to promote advocacy for the fundamental rights of older persons.

Question-and-Answer Session

The speakers responded to inquiries and statements from the audience, such as questions about the reasons for the need of a convention, the reasons behind lack of pro-convention efforts from urban countries and the address of HIV and older persons.

Jean-Pierre Gonnot, Acting Director of the Social Integration Branch, Division for Social Policy and Development in the UN Department for Economic and Social Affairs (DESA) Jean-Pierre Gonnot, Acting Director of the Social Integration Branch, Division for Social Policy and Development in the UN Department for Economic and Social Affairs (DESA), concluded with brief remarks drawn from his experience staffing sessions leading to the UN Convention on the Rights of Persons with Disabilities. Gonnot explained that although older persons are largely invisible due to the fact that their fate is not consider a priority and, therefore, ageing has not gained much traction on the development agenda in many countries. Consequently, many Member States don't see the point in having a convention which raises many concerns, one of which is its financial implications. He continued, stating that the first step toward a convention is making the development case for a convention, e.g. that MDG1 cannot be achieved without addressing the needs of older persons, followed by laying out the human rights case which includes establishing the technical statements to be put into the convention itself. Taken together, these arguments provide a basis for beginning work on a convention for older persons. Gonnot also noted that older persons can exercise their rights under the Disability Convention's provisions when it comes to the rights violations that they typically face such as the right to health and freedom from exploitation, violence and abuse.

By Veronica Lewis, Global Action on Aging


Friday, October 23, 2009

Watch 'Life After Retirement' show by IBN 7 News Channel on 25th Oct 2009

Silver Inning Foundation is proud to inform you that due to our joint effort and our advocacy programme IBN7 Hindi News Channel will be broadcasting one hour programme on `LIFE AFTER RETIREMENT` in their popular programme `ZINDAGI LIVE` on Sunday, 25th October,09 at 8pm.

In this programme two of the our suggested Active Senior Citizens Mr.M.V.Ruparelia from Mumbai (he is also very important member of Silver Innings) working for Welfare of Senior Citizens and Mr.Abid Surti, the famous Cartoonist from Mumbai working for Social Campaign of Save Water will be participating with other two active elderly.

Please, inform your friends and family members and Senior Citizens to watch the show as this will encourage/inspire some to start some useful activity. This programme will be repeated in next 4 days as per timings given below.

Following are the show time IST :
Sunday, 8 pm 25-10-09.

Monday\Tuesday, 12:30 Am(Mid Night-26/27-10-09 & 27/28-10-09.

Wednesday, 12 noon 28-10-09.
Thursday, 2 pm

Warm Regards,
Sailesh Mishra

Founder President - Silver Inning Foundation

Silver Innings Gero-Psychological Care Programme Launched for Senior Citizens in India

This Diwali – the festival of lights, Silver Innings is happy to Gift its one of its kind in India a Gero-Psychological Care Programme, a Holistic approach to our elderly.

One of the most important aspects of being human is our emotional or psychological nature. Our Gero-psychological care program, therefore, is founded on the belief that even the very best physical care is not sufficient as there is something more to it. During this time of transition--often from independent to community living, from self-sufficient to increasing dependency--emotional and psychological care are especially crucial.

Our elderly can encounter psychologically painful issues of loss and adjustments in lifestyle, often complicated by medical problems, memory loss, and depression requiring specialized care. We offer program that addresses the psycho-social-emotional needs of Senior Citizens. This is a specialized program that focuses on the unique psychological and emotional needs of the Elderly.

Silver Innings trusts that Elderly are best looked after and cared for in their own homes environment and community. With our experience we understand that our Elderly are looking for that human comfort and caring. This service will be provided in home, Institutions and consulting rooms depending on the need of the individual or group.

The ultimate goal of this programme is to bring that Hope, the Sense of Belonging and 'Smile' on the face of our Elderly."

Trained Clinical Psychologist and Volunteers will provide these services.

About Silver Innings:

This Gero-Psychological Care Programme is an intuitive of Silver Innings Psychological Healing Services. Silver Innings is a Social Entrepreneur organisation working for cause of Elderly; it also hosts Silver Innings.Com www.silverinnings.com Pioneer in promoting web based application for Elders, it’s a Comprehensive and dedicated Website for Elderly. Providing need base services, networking and advocacy for Senior Citizens forms important aspect of Silver Innings. The group also consists of Silver Inning Foundation a registered NGO dedicated for Senior Citizens and their family. At Silver Innings we are working towards creating Elder Friendly World where Ageing becomes a Positive and Rewarding Experience.

Contact: Silver Innings Gero-Psychological Care Programme HELPLINE 9029000091 (Monday to Sunday 10am to 5 pm)

Ms.Raheen Jummani, (Clinical Psychologist)

Honorary Head, Silver Innings Psychological Healing Services


Silver Innings is Social Entrepreneur Organisation.25% of revenue generated from this initiative will be spend on funding activities of ‘ Silver Inning Foundation’ , an NGO dedicated for Senior Citizens.

Friday 23rd Oct 2009

Sunday, October 18, 2009

Lifelong Learning Requires Investment Now in Education for Older People

My dad is approaching 80. With the start of the autumn term, he is once again travelling around Suffolk and Norfolk teaching adult evening classes in subjects as varied as local history and jazz appreciation. Some of his students are many years his senior.

My father-in-law is 91. He still attends an art group and talks by visiting speakers at his retirement home. He also specialises in devising general knowledge quizzes for his fellow residents.

Neither of them, I'm glad to say, would fit anywhere near Shakespeare's description of the seventh age of man: "Second childishness and mere oblivion, sans teeth, sans eyes, sans taste, sans everything."

Both would, however, fit into the "fourth stage" of learning outlined by the hugely impressive report from the Inquiry into the Future of Lifelong Learning, published last week.

The inquiry proposes dividing the stages of learning into four age groups: 18-25, 25-50, 50-75, and 75+. It calculates that at present the proportion of spending on learning is tilted too heavily towards the under-25s.

It estimates the current spending ratio across these four groups is, respectively, 86:11:2.5:0.5. By 2020, it says, this should shift to: 80:15:5:1. While still leaving most money going to younger learners, this would double funding for the over-50s and over-75s.

The inquiry's premise is that "the right to learn throughout life is a human right". That alone would justify this rebalancing of resources. But it also makes a more practical case: as our society ages, by 2020 we will see the number of people under 25 fall by 9% and the numbers in the "fourth stage" rise by 28%.
Bearing in mind the evidence about the impact of learning on physical and mental health, employment and social engagement, there is a compelling case for increasing public spending on all types of adult education, including holiday Spanish or pilates, which are sometimes dismissed by government ministers as less worthy of public subsidy.

But we know these are tough times for public spending. Gordon Brown has finally used the "c" word. There will be spending cuts. Education cannot hope to escape unscathed, and some areas, such as schools, tend to get more protection than others. The Lifelong Learning inquiry could not have come out at a less propitious time.

The inquiry has been shrewd. It has not pressed for a big increase in public spending, even though its report hints at some of the broader savings education could bring by, for example, reducing the incidence of depression in the population or delaying the entry of the elderly into care. Instead it has played into Lord Mandelson's strategy of "wise" rather than "big" spending.

Ever since the Leitch report, the adult learning budget has been targeted at job-related training for recent school-leavers. That shift has gone too far. It takes no account of our ageing society and the reality that one-third of our adult lives is now likely to be spent in retirement. Nor does it recognise changing patterns of employment, with 15% of the population aged 65-69 still economically active.

As the inquiry notes, public spending on education is already distributed on the basis of "to him that hath shall be given". The young, better educated and wealthier receive the giant's share.

Of course, as we seek to escape recession, there must be investment in skills training. But it is time for a better balance. Adult education is struggling. In my area, there is a good range of classes available. But prices are not cheap: £166 for a term of Spanish lessons or £211 for a 31-week course in making soft furnishings.

When you compare the hours spent by 25- to 64-year-olds in formal learning, we are the dunces of Europe, averaging just over 100 hours a year, compared with well over twice that amount in most other countries.

With many more of us heading for long periods in retirement, increasingly living on meagre pensions, we will need something to keep us engaged, sociable and sane.

We could just sofa-surf, watching other people do things on telly, but lifelong learning would do more to keep us out of the hospital or the nursing home.



Tuesday, October 13, 2009

Elderly to vote but rue govt apathy

This time the silver brigade, which has always been conscious about its responsibility as a citizen and rather diligent about casting its vote, feels ignored and does not seem to be too upbeat about the election.

Over years, every poll booth had seen senior citizens exercising their franchise without fail. While some queue up just before the afternoon siesta, for others, like 82-year-old Lamington Road resident Adi Jasswalla, casting their votes right in the morning has become a ritual. Even before he goes on his daily morning walk around August Kranti Maidan, Jasswalla makes sure he casts his vote. Joining him in the queue are his octogenarian fiends and neighbours. “I am going to be on time this year as well. It is my right and I will vote till my health fails,’’ says the retired banker who lives alone. He believes security is on the top of people’s mind, his age.

However, Sailesh Mishra, founder president of the Silver Inning Foundation, a community of senior citizens, says the elderly are not too enthusiastic this time around. “They feel that they have been ignored though they form over 15% of the vote bank,’’ he says, pointing at the state government’s failure to implement the National Policy for Older Persons (NPOP).

NGOs for senior citizens, like Help Age India, also wonder about what happened to the Maintenance and Welfare of Parents and Senior Citizens Act. “The state declared that it would be implemented on March 1, but nothing has happened,’’ says Prakash Borgaonkar, joint director, Help Age India. Under the Act, a Maintenance Application can be filed by senior citizens who are unable to protect themselves from abuses by their children or relatives.

Introducing geriatrics as a subject in government colleges and directing special attention to “teaching schoolchildren how to take care of elders’’ are a few of the other demands, says Mishra.

He also said a special ward should be started in every municipal hospital.

Senior citizens feel that the government has ignored them, failing to implement several policies.



Saviours of the old

An extremely jovial 60-year-old, Mandakini Kamtekar was a person of cool temperament. Not until one day when her family began noticing extreme behavioural changes in her."She became very aggressive, almost to the point of hitting us. She kept forgetting things and would pick up a toothbrush and start brushing her teeth," recalls Jyoti, daughter-in-law of Kamtekar. As the lapses in her memory increased, the family approached Devendra Save, a practising psychiatrist and a core team member of Silver Innings Dementia Support Group who diagnosed Kamtekar as a patient of Alzheimer's, a common form of dementia, a brain disorder that affects a person's ability to carry out daily activities and is most common in old age.

Just a year-old initiative, the Silver Innings Dementia Support Group,a collaboration between Silver Inning Foundation, a NGO for elderly citizens and Alzheimer's and Related Disorder Society of India (ARDSI) has already reached out to 57 families. It is a collaborative initiative meant to assist patients diagnosed with dementia and specifically Alzheimer's. Moreover, on the occasion of World Alzheimer's Day on September 21, it plans to launch a first-of-its-kind geriatric psychological service in the city. As part of the service, clinical psychologists will not only provide free consultation on the phone to seniors but also pay a visit to the home of an Alzheimer's patient and chalk out the future course of treatment in consultation with the family.

The support group started by Sailesh Mishra, founder president, Silver Inning Foundation offers a variety of services to aid patients suffering from Alzheimer's. Mishra, who left a well paying corporate job to help the elderly in the society says, "I think the seniors are the most ignored and neglected lot." Mishra, earlier associated with Dignity Foundation, branched out to form his own NGO and then the dementia support group.

Anu Vijay Kumar, a human resource manger in a reputed firm, was leading a happy family life with her two children and husband, also a senior executive in a firm. However, she was in for a rude shock when she learnt that her husband had fallen prey to Alzheimer's at the age of 52. This was eight years ago. Today, her husband, is confined to a wheelchair. He doesn't recognise Anu and their children; has forgotten the language and is totally dependent on Anu, who continues to juggle between her job and taking care of her husband.

However, for Kumar, help and advice from Silver Inning Foundation helps her provide correct treatment and support to her husband. "I keep consulting them often. I have now decided to get my husband's bed barricaded from all sides to avoid any falls and I will be talking to Mishra about it," says Anu.

The group also spreads awareness about dementia and Alzheimer's. "What you need for Alzheimer's is food for the brain. While abroad there are Alzheimer's products like talking clock, bold font calendars, day reminders etc, here there are no products of this sort. This goes on to show the apathy and lack of awareness about Alzheimer's ," rues Mishra.

Their message has helped people like Kamtekar and her family who have tried to explain to their distant relatives that Mandakini is not "mad" as they think her to be and doesn't need to go to an asylum but just needs love and care.

Since, there is no universal therapy to treat Alzheimer's patients, the techniques to keep the patients brain pro-active varies. Mishra, on receiving a call, personally visits the patient's home along with a psychiatrist and psychologist to understand the problem and offer solutions. But Mishra says that the involvement and understanding of the family is extremely vital. "Alzheimer's only gets worse with time and the patient becomes entirely dependent on the family. Our effort is to just make their time and living a little easier," he says. Contact: www.silverinnings.com

By Humaira Ansari / DNA



The age of reason

Gradual loss of memory and cognitive reasoning is often seen to be a ‘natural’ process of ageing. However, not many people recognise that these symptoms may point to a deeper, and more widespread, mental malaise.

A recent report released by Alzheimer’s Disease International states that more than 35 million people worldwide will suffer from AD and other forms of dementia by next year. Dementia, which is the loss of cognitive functioning, remembering, and reasoning to the extent that it interferes with a person’s daily life and activities, “is not part of ageing, but a disorder of the aged,” Dr Charles Pinto, Emeritus Professor of Psychiatry at Nair Hospital, Bombay Central, points out.

However, the risk for dementia increases, as one grows older. It is estimated that one out of every two people above the age of 85 have some form of dementia, while 5 per cent of those above 65 are at risk. While there is no known way of preventing it, reducing one’s risk of heart disease, and keeping physically, mentally and socially active, is believed to reduce the risk of Alzheimer’s disease.

The A word
Alzheimer’s disease (AD) is the most common kind of dementia and accounts for nearly 50 per cent of all dementia cases worldwide. It is an irreversible, progressive brain disease, where the brain develops abnormal clumps and tangled bundles of fibres that slowly destroy memory and thinking skills, and eventually even the ability to carry out the simplest tasks.

The report released by Alzheimer’s Disease International on September 21, also says that number of people suffering from AD and other forms of dementia will double every 20 years. The number of people with dementia in India just four years ago was 32.5 lakh. By 2020, there will be more than 56 lakh people in India with dementia according to the report.

(www.alz.co.uk/research/ asiapacificreport.html)

At great risk
According to Pinto, the increase in number of dementia cases among the old can be attributed to an increase in the aged population, an improved life expectancy and greater awareness of the condition. According to a 2005 World Health Organisation study, life expectancy at birth for men is 64 years, and for women is 66 years. In 2002, life expectancy for both was 53 years.

“Within the next couple of decades, India will have a higher population of older people than it does now. The same holds true for most developing countries,” Pinto said.

At the same time, he pointed out, Indians are at risk for all forms of dementia because of their attitude towards their health. Risk factors for AD include diabetes and hypertension, common ailments among Indians. The lack of proper infrastructural support such as day care centres and homes for persons with dementia, combined with our disinterest in seeking treatment makes us prime targets.

To tackle the epidemic proportions of dementia we are facing, we need to ensure early detection and treatment, by visiting memory clinics and screening camps. At the same time, we also need to recognise the precise nature of AD, and not confuse it with the processes of ageing.

Growing old is not an inexorable journey towards incapacity.

While there are support groups for caregivers to help them cope (see box: Support system), living with a family member who has Alzheimer’s is by no means easy. While drugs currently available for AD help reduce the symptoms and behavioural changes that affect a patient, they cannot arrest the progress of the disease. As a result, the condition of the patient worsens. Khoparkhairne resident Renu Suchdev, 49, took care of her father during the last few months of his illness. She shares her story with us. See ‘Keeping the memory alive’.

What is alzheimer’s?
According to Sailesh Mishra, president, Silver Inning Foundation, and member of Alzheimer’s & Related Disorders Society of India (ARDSI), patients of AD often face difficulty making decisions, short-term memory loss, temporal disorientation, and exhibit signs of depression and aggression.

Patients of AD should continue with activities they have been doing, like keeping accounts or checking the mail, for as long as they can. It doesn’t matter if the account log doesn’t add up in the end — it is necessary for them to establish a habit and stick to it. For this, they need the help of their caregivers. It isn’t enough to tell them to do something — they need to be helped keeping up with the task. Like keeping a journal, for instance. Also, keep their environment as unchanged as possible and simplify instructions for them.

Initial symptoms of AD include repeating statements; misplacing items; forgetting names of familiar persons and objects; getting lost on familiar routes; personality changes; losing interest in things that interested them earlier; inability to learn new information. At an advanced stage, the person forgets everyday details, and loses awareness about him/herself. At such a time, even simple tasks like eating, wearing clothes or bathing become difficult to perform.

Cope with the condition
Does an elderly person in your family have AD?
1. Accept that it is a disorder — many confuse it with ageing.
2. There are going to behavioral disturbances that affect daily living — you need to be supportive, not critical.
3. Do not stop their medication.
4. Check for other disorders and take care of physical and nutritional aspects of these people.
5. Don’t take it on all by yourself. Caregivers need to have time out. Divide the work equally among all members of the family, or seek support.

Support system
* Silver Innings Dementia Support Group, for residents from Bhayander to Andheri in Mumbai,India offer home visits of therapists and training for care givers at a nominal cost. Helpline number: 09987104233.

* Holy Family Dementia Support Group for Caregivers, Holy Family Hospital, Bandra. Will start on October 10, 2009. Contact: Sailesh Mishra, 09819819145

* Dignity Foundation runs a day care centre for dementia patients in Lamington Road. Contact: 23898078. There is also a full-time home for them in Neral. Contact: 02148-236600/236635

* Prof Cathy Greenblat, Professor Emerita of Sociology at Rutgers University, is currently in town delivering a series of lectures on Alzheimer’s Disease. Contact Silver Inning foundation for more details.

* Memory Clinics are present in JJ Hospital, Holy Family Hospital,Nair Hopsital and Sion Hospital.


Dhamini Ratnam, Hindustan Times



Thursday, October 8, 2009

Celebrating the 10th Anniversary of the International Year of Older Persons

Towards a Society for All Ages

United Nations Secretary-General Ban Ki-moon Message on the International Day of Older Persons, 1 October 2009

This year marks the 10th anniversary of the International Year of Older Persons.

Over the past decade, we intensified our efforts to build a "society for all ages" and to promote international commitment to the United Nations Principles for Older Persons. The Principles are founded on the need to build an inclusive society that emphasizes participation, self-fulfilment, independence, care and dignity for all. To transform them into deeds, we have campaigned for policies that will enable older persons to live in an environment that enhances their capabilities, fosters their independence, and provides them with adequate support and care as they age.

The motto "towards a society for all ages" was adopted in 1999 and reaffirmed at the Second World Assembly on Ageing, held in Madrid in 2002. It emphasizes the need to treat older persons as both agents and beneficiaries of development. This emphasis - and the United Nations Principles - take on even greater importance as the world struggles to confront global food, energy, climate, financial and economic crises.

The international community is also devoting increasing attention to the human rights of older persons. We must put an end to age discrimination, abuse, neglect and violence against older persons. I urge states to put the necessary legal protections in place, and I urge all partners to help countries develop the capacity and institutions to achieve this objective.

On this International Day, let us reaffirm our commitment to the vital work of upholding the UN Principles for Older Persons and achieving a society for all ages.


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