Support for families and people living with Alzheimers

NATALIE WATLINGTON, WESTERN CAPE HEALTH DEPARTMENT SPOKESPERSON FOR METRO SOUTH

World Alzheimer's Day is observed on September 21 annually and this year's theme is “Never too early, never too late”.

The campaign aims to emphasise the pivotal role of early identification of risk factors and adopting proactive risk reduction measures to delay, and potentially even prevent, the onset of dementia.

According to Alzheimer’s South Africa, dementia as a collective name for progressive degenerative brain syndromes which affect memory, thinking, behaviour and emotion.

Alzheimer’s disease and vascular dementia are the most common types of dementia and are responsible for up to 90% of cases of dementia. Symptoms may include loss of memory, difficulty in finding the right words or understanding what people are saying, difficulty in performing previously routine tasks, and personality and mood changes.

Many people and their families will experience dementia in their own way, eventually, those affected are unable to care for themselves and need help with all aspects of daily life. There is currently no cure for dementia, with some limited treatments, focusing attention on the importance of care, information, advice, and support.

Florence Sylvester a patient at the Lotus River Community Day Centre (CDC), was diagnosed with dementia in June 2019 and her husband of 40 years, Charles Sylvester shares that although visits to a primary healthcare facility can be daunting, the experience at the facility has been an example of how healthcare workers have been supportive and gone the extra mile.

Geriatric care within the health system is a branch of medicine that deals with the problems and diseases of ageing people, and it is this form of intervention where treatment and support are offered to patients with Alzheimer’s or dementia at all healthcare facilities.

Dr Aysha Gasant is part of a multidisciplinary team at Lotus River CDC and shares the relationship between a community day hospital and a tertiary hospital: “We have patients with Alzheimer’s that are already in our care who attend the clinic for their chronic visits, like Florence, as well as new patients who present for assessment due to concerns of memory impairment or behavioural problems. We also have a very good relationship with Groote Schuur's Memory Clinic for referrals and feedback in terms of patient’s diagnosis and treatment plans.”

Community Health Centres are areas of access where vulnerable members of society can receive the holistic support and guidance for referrals they require. Lotus River CDC has worked hard to offer inclusive and supportive services to the elderly, and vulnerable members of the community.

Dr Haniem Salie, Senior Medical Officer at Lotus River CDC, said Alzheimer’s and dementia conditions are a public health crisis that does not always get the attention it deserves.

“As a primary health care team, we can play a pivotal role in the health care journey of patients and their families. The problem is that the condition is often diagnosed very late. This necessitates the need to increase awareness at all levels of health care and with all levels of practitioners,” said Dr Salie.

The team at Lotus River CDC recommends that the best approach to support your loved one is a multidisciplinary healthcare approach, with a comprehensive care package by a primary health care team, which includes nurses, mental health practitioners, a social worker, a health promotions officer, pharmacists, physiotherapists, doctors, and the dental team.

The growing elderly population in Lotus River and its surrounds has led the team to make adaptations to their provision of care to accommodate people diagnosed with Alzheimer’s and to support families caring for their loved ones. This means continuous ongoing learning by the healthcare team, attending geriatric workshops, and working hand-in-hand with the pharmacy team for any new developments or drug innovations.

The facility fast-tracks patients who are disabled, both intellectually or physically as well as frail care patients which include those living with dementia or Alzheimer’s.

“We realise that we can no longer just consider patients over the age of sixty-five only as requiring extra support. Rather than their age, we need to look at the needs of every patient. Whereas a big component of patients over this age can navigate our system very well, you will have patients suffering from Alzheimer’s or dementia who look perfectly normal on the outside and physically competent, but their cognitive decline doesn’t allow them to navigate the normal processes in the clinic. These are the patients that we want to be fast-tracked in the clinic so that they don’t fall through the ‘cracks’, and they don’t spend an extended time in the clinic,” says Dr Salie.

Charles Sylvester shares that he is appreciative of the initiatives the team has put in place to assist his wife, Florence during their visits.

“When I have had queries around Florence’s medication there is a dedicated window to query this. I could leave my details and query with the clerk, and they followed up with a phone call. During our visits, the doctors have always been understanding, and show compassion. We have never been met with irritation or made to feel like a nuisance. At a recent visit one of the doctors had even said they will guide us in referring my wife back to the Memory Clinic at Groote Schuur”.

Dr Salie shares although there have been some great strides, there is still much to be done. “There are cases of patients, thankfully not often, who we see that are neglected. Concerning examples are patients who are either hypothermic, dehydrated or not physically well. Sometimes children are asked to stay home to look after family members who are suffering physically. This is where our social workers and home-based care team play a pivotal role, and we are very thankful for them. Although the team have much to do, and a great geographical area to cover, we are still able to refer patients to home-based care, especially those who need extra support for hygiene or medication support, or who need to be checked a few times a week.”

Patients are seen at the clinic, but the team understand this is only the tip of the iceberg.

“There is a population at risk that we are not even reaching. Patients with cognitive decline in the community that we don’t even know of and so I do believe that we must raise awareness in the community and do household assessments to pick up the patients who need intervention. Intersectoral partnerships within the community will go a long way. Therefore, campaigns run during Alzheimer’s month to raise awareness does much to help our communities realise the importance of this disease and that there is help available,” said Dr Salie.

Should you suspect that a family member or loved one is possibly struggling, reach out to your nearest healthcare facility and speak to a health care worker.

For more information on Alzheimer’s disease and assistance, visit the Western Cape Government Health website at https://www.westerncape.gov.za/general-publication/alzheimers-disease-and-dementia or Alzheimers South Africa at https://alzheimers.org.za/western-cape/ or call their National Hotline on 0860 102 681.