Psychosocial Rehabilitation of Persons with Dementia in Indian Context

Dementia is a disease characterized by progressive deterioration. A therapeutic nihilism exists regarding interventions even among the healthcare professionals. So the focus of psychosocial rehabilitation is to help the persons with dementia to lead a better life and to reduce the distress of the caregivers. The main aim of management is to treat the symptoms which are amenable to treatment and to stabilize the condition of the patients by controlling the factors contributing to the deterioration. Psychosocial interventions include cognitive rehabilitation, management of behavioural problems, stimulation and emotion-oriented interventions to improve functioning and to reduce the distressing symptoms. Empowering the family members to look after their relatives is important in rehabilitation activities. Educating family members regarding the nature, course and prognosis of the disease, developing skills and attitudes necessary for caring people with dementia and developing strategies to manage the distressing symptoms of dementia are the major components. Distress among the caregivers can be reduced by individual counselling and participation in support groups. Training of professionals, paraprofessionals, health workers and community volunteers is an essential prerequisite for the implementation of community-based programmes. A multidisciplinary team approach is essential. Services for dementia are non-existent or far from adequate in Indian context. Services like memory disorders clinic, day care centres, respite care and institutions for long-term care are needed. Culturally appropriate, cost-effective models of care suited to Indian context is important.