Times of India
01 November 2010
By R Vasundara
Chennai, India

Welfare Dept Request For Govt Centre Yields No Response
Srinivasan’s day begins with his wife attending to his morning toilet, his bathing and then his breakfast. Well into his seventies, this ex–government official, who once took the nitty–gritties of a government administration in his stride, is today as helpless as an infant. Srinivasan is a dementia patient, a condition of severe loss of memory, brought on by degenerative diseases like Alzheimer’s, vascular dementia and Parkinson’s Disease.

"He had to be told every time where the bathroom was and it came to a point where he was not able to remember his own identity," said Dr R Sathianathan, the director of Institute of Mental Health. "In such cases, the entire burden falls on the caregiver, or in the case of Srinivasan, it was his wife. But, since his family was affluent, they were able to afford hired help. However, there are many others who are not so fortunate."

According to the World Alzheimer’s report 2010, today there are over three million dementia patients in India and the numbers continue to rise. Of the three million, around 90–94% of the patients in urban areas live at home and are looked after by family members, while 95–99% of rural patients stay at home. Despite this, there are very few day care centres for such patients in India to give temporary respite to caregivers. Tamil Nadu has only one privately run day care centre, that is located in Chennai.

"We are aware of the problem,"said R Vasuki, director of Social Welfare in Tamil Nadu. "We have been toying with the idea of requesting for a government–run day care centre for elderly patients, but nothing concrete has come about yet." Taking cognisance of this, the Union government has issued a grant under the Integrated Programme for Older Persons, where organisations applying to set up day care centres for dementia patients would receive a 90% subsidy from the government.

However, there were few takers for the scheme. "The programme was launched in 2008," said Vasuki. "Despite the fact that we did give it a fair amount of publicity in TN, it is only this year that we have received one application for such a centre from Sivaganga district."

Chennai–based psychiatrist, Dr R Tara says that the issue concerns logistics. "How many people are prepared to drop elderly patients everyday and pick them up," she asks. "It will not do to hire regular volunteers. Staff trained in dealing with such patients are hard to find."

Adds Dr Sathianathan, "Such a day care centre needs a large plot of land or a building located on the ground floor in calm surroundings. Also, being elderly people, they may develop sudden illness. So, it is necessary that a multi–disciplinary medical team is at hand always. After all, taking care of an elderly person is very different from taking care of an elderly dementia patient. The latter are like six month old babies."

Gaps In Healthcare

• Over 3 million dementia patients in India at present
• 90–94% of patients in urban areas and 95–99% in rural areas in India live at home and are looked after by family members unlike US and Europe
• There is only one day care centre for dementia patients in TN, which is privately run
• Grant issued by the Centre for day care centres in 2008 has attracted only one application so far

Dementia is severe loss of memory that is brought on by brain degenerative diseases like Alzheimer’s, Parkinson’s and Vascular Dementia. Patients suffering from moderate to severe dementia lose their cognitive functions and sometimes even forget their own identity