Dementia diagnose, management and Care Plan


Proposed by Dementia-Nepal

Dementia Nepal is a non-profit organization that was founded in 2018, Dementia Nepal has objective to make coordination and cooperation of companies - members in the context of social contribution and awareness of the patient’s with dementia, family member, health professionals and their caregivers’ needs.
Additionally, Dementia Nepal is the creation of diagnosis management, car, services and conditions that improve the quality of life of patients and their carers, the promotion of research, the education and training for all the stakeholders, the provision of useful information and advice on dementia problems and the prevention of the marginalization of people with dementia
It offers daily care to people affected by Alzheimer’s disease or other forms of dementia. Physicians, psychologists, speech therapists, social workers, nurses, physiotherapists and administrative personnel are employed at the Day Care Centers.
The Day Care Centers’ activities include
Memory clinic

• Neuropsychological assessment

• Cognitive training interventions

• Physical training programmes

• Other specific therapies (art therapy, speech therapy, occupational therapy, reminiscence therapy), individually or in groups. In addition, the Slove-Nepal organizes numerous educational programmes and support groups for formal and informal caregivers of people with dementia.

• Memory Clinic, The Association Memory Clinics offer neurological and neuropsychological evaluation to people above 60.

• The “Care at Home” programme.  The “Care at Home” programme. addresses to people with dementia who due to movement problems do not have access to the Day Care Centers services at a regular basis and offer support and cognitive training to people affected and counseling or psychoeducation to their caregivers.

• Education and support for caregivers.
The Solve-Nepal at a regular base provides educational seminars for caregivers how to taught, how to deal with the practical and psychological burden of dementia, Psychoeducational programmes for caregivers, These programmes focus on caregivers’ specific needs providing the necessary information about dementia symptoms, progression and available treatments, Likewise ,specific skills enabling them to effectively cope with issues related to dementia, training in the management of the physical, psychological and financial burden of dementia

• Psychiatric Clinic for caregivers - The psychological burden of dementia is an important, yet underestimated aspect of dementia. In comparison to the general population, caregivers are in greater danger of developing depression and various psychosomatic conditions. The Association offers psychiatric support to relieve them from their psychological burden.

• Alzheimer café “Alzheimer Café” provides intervention for people with dementia and their caregivers, promotes discussions, exchange of information about dementia, share of experiences, emotional support and socialization of its members. Memory Clinic The Association Memory Clinics offer neurological and neuropsychological evaluation to people above 60.

• The “Care at Home” programme. The “Care at Home” programme addresses to people with dementia who due to movement problems do not have access to the Day Care Centers services at a regular basis and offer support and cognitive training to people affected and counseling or psychoeducation to their caregivers.

• Education and support for caregivers The Solve Nepal at a regular base provides educational seminars for caregivers how to taught, how to deal with the practical and psychological burden of dementia, Psychoeducational programmes for caregivers, These programmes focus on caregivers’ specific needs providing the necessary information about dementia symptoms, progression and available treatments, Likewise ,specific skills enabling them to effectively cope with issues related to dementia, training in the management of the physical, psychological and financial burden of dementia
• Psychiatric Clinic for caregivers The psychological burden of dementia is an important, yet underestimated aspect of dementia. In comparison to the general population, caregivers are in greater danger of developing depression and various psychosomatic conditions. The Association offers psychiatric support to relieve them from their psychological burden.
• Alzheimer café “Alzheimer Café” provides intervention for people with dementia and their caregivers, promotes discussions, exchange of information about dementia, share of experiences, emotional support and socialization of its members.

 Objective 1: Human Resource Development for dementia care

Objective 2: Inpatient care for people with dementia

Objective 3: Establish a National Dementia research and training Center 
We do not have prevalence rate of dementia in Nepal, nor any clinical trial about what works well for people of dementia and their caregivers. 
Therefore. The national health policy of Nepal should establish a ‘National Dementia Research and Training center’ to:

Objective 4: Establishment of Memory Care Services

 Suspected people with dementia should have memory café access in early diagnose. The Memory Café is a monthly social group comprised of people with memory loss and their loved one(s). Its mission is to provide a safe, comfortable, engaging environment where people with memory loss and their care partners can laugh, learn and remain socially engaged with others traveling the same journey

Objective 5: Awareness-raising, legal and financial planning Advocacy

The understanding level of public health concern is less and the treatment gap as well with the health professionals. The common concept is the dementia issues as a part of aging for which nothing can be done- that means, people with dementia do not know that they suffer from a type of ‘disease’ for which treatment and care are possible. Therefore, we need to share the following things; It is disease with a curable possibility for ageing people. Need to stablish dementia friendly society, to improve the public concern on dementia, invest in health system and provide care services, people with dementia make and continue a positive contribution to their communities managing healthy social life habit, provide valuable information about medical management and social/behavioral strategies to manage challenging behaviors among individuals with dementia

 Objective 5. Dementia management, care in every local level care center

Friendly Day care services are essential for keeping people with dementia in their own homes without feeling isolated and cut off from the rest of the society. 

Objective 6: Availability to affordable medication 

•We focus the subventions dementia medication should affordable and accessible.
Objecttives 7- Early Dementia Optimal management in general practice
The assessment and management of dementia is lengthy and complex. General practitioners (GP) are often prominent to contactfor people with dementia, and their families. GPs have first role in providing primary care, identification, assessment, provision of information, referral and ongoing management in terms of suspected people.

Objecttives 8- Informing the person with dementia
There is an emerging consensus among health professionals that favours disclosure of a dementia diagnosis. However, some people with dementia and/or their carers may not wish to know their diagnosis. Wherever possible the patient undergoing assessment should be allowed to decide if they want to be informed if a diagnosis of dementia is confirmed. Proper advice on Pharmacological and Nonpharmacological treatment, Screening for comorbid conditions and drug Effects (Computerised tomography, Pathology tests),  further recommendations for post diagnose.
The services provided to patients with dementia are

The cognitive therapies consist of memory, attention and language enhancement programmes

 The psychotherapeutic programmes include

The services provided to caregivers are

The team of care at home is consisted of a Doctor, a Dentist, a Psychologist and a Social Worker. The objective of this team is to implement visits in houses of patients with dementia of final stage or less advanced stage that for various reasons are not able to reach the center. Main concern of the team is the permanent education of the caregivers as well as the clarification of queries about the disease and the learning of simple dexterities that can improve effectively the daily care of the patient and the quality of life of the caregiver.