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Sunday, October 30, 2011

"The Value of Support Groups for Caregivers and Patients"

From Fronto-Temporal Dementia Support Group :

"For me, the most valuable thing I learned is :

0. Find happiness and purpose in life again.
a. Everyone has a right to happiness and purpose in life. 

1. Make subtle changes and adjustments in your routine to adjust to life with Dementia.
a. You need to learn to keep adapting to the changes made by dementia.

2. Learning to live with Dementia in a positive way.
a. You need to keep a positive attitude and work around all obstacles.

3. A sense of belonging.
a. You are a part of something and feel comfortable with the people and atmosphere.

4. Expressing our experiences to peers in an effort to minimize our problems.
a. Having others that can relate to your life and you to theres.

5. You learn you are not alone.
a. You might be lonely, but your not alone.

6. Learn you can function with your crazy ways.
a. No one is perfect. Live life and enjoy. Get over things fast and move on.

7. Life is not over, we can rebuild our lives.
a. You can have a full and wonderful life. Just different than before.

8. Awareness of Dementia.
a. Be aware and accept the a changes in your life. You can't be happy if you keep fighting for the life you had before Dementia. You need to be aware of yourself and your life to move forward.

9. Get a 2nd opinion, don't necessarily trust every doctor you see because they are a doctor. 
Listen to medical opinion, but don't disregard your instincts and don't think twice of seeing someone else when it comes to matters of health and wellness.

10. A friendly, supportive, understanding environment.
a. You can breathe and relax. Better and cheaper than a psychiatrist office.

11. We are like brother/sister.
a. You can develop new close relationships with others that understand you and you them.

12. Learn how to live, not how to die.
a. Get busy living, never give up.

13. Dementia is a not a mental illness. 
Medications for mental illnesses do not necessarily work with Dementia.

Saturday, October 29, 2011

Caregiver's distress and alternatives in India. (extract of article, DNA)

"Alzheimer’s-hit to get home soon"
Published: Monday, Sep 26, 2011,
By Kanchan Srivastava , Mumbai, DNA.

"Andheri resident Radha Sharma (name changed) is fed up with taking care of her mother Shanti for last five years without a break. Every morning she bathes her, dresses up and takes her for walk. Then she rushes to the school, where she teaches, after locking her mother in their flat. “She doesn’t even know who I am. I wish there was someone to take care of my mom. I am exhausted,” she says.


"But such patients can now enjoy a full-fledged home, first of its kind in Maharashtra, which will take shape in Lonavala. A brain child of Santa Cruz resident Bhavna Kodiyal, this AD home will start functioning from January 1. “Construction will start from Monday. Prabha Joshi (78), a widow, is donating her bungalow at Lonavala for this cause,” says Bhavna, who has been associated with AD campaigns for a year."


"The home would be free for needy people but rich ones will be charged. Lions Club is also providing financial aid for the project. According to Bhavna, “We will hire widows and lonely people to work with these patients.”

Read full article at :

Friday, October 28, 2011

The Health System in India : "a bundle of contradictions".

Comprehensive informations on slides,

 by Anup Soans.

"Health, far from being accepted as a basic right of the people, is now being shaped into a saleable commodity".

Sunday, October 23, 2011

Alzheimer's disease in India : Bibliography. (2)

Prince M, Bryce R, Ferri C. World Alzheimer Report 2011: “The benefits of early diagnosis and intervention”, Published by Alzheimer’s Disease International (ADI). UK; September 2011. 72 pages.

Shaji KS, Jotheeswaran AT, Girish N, Bharath S, Dias A, Pattabiraman M, Varghese M. The Dementia India Report 2010: “Prevalence, impact, costs and services for dementia”. Report published by the Alzheimer’s and Related Disorders Society of India, New Delhi; 2010. 92 pages.

Ageing in Asia Pacific and the world. Report 2011.

Collective. India addresses concerns of demographic Ageing. The Times of India. 2011 Janvier 31.

Lingiah H. Facing the challenge of an ageing population. Mauritian Abroad. 2008.

Kandarp. Role of Home-based patient monitoring to manage chronic diseases in developing countries. Center for Public Health Informatics, website of the Asian Institute of Public Health. 2011 Juillet 28.

Shaji KS. Dementia care in developing countries: The road ahead. Indian Journal of Psychiatry. 2009; 51:5-7.

Dias A, Patel V. Closing the treatment gap for dementia in India. Indian J Psychiatry; 2009; 51 (Supp 11): 93-97.

Brenner S, Chandra V, Pandav R, Ganguli M, Johnston J, Belle S, et al. Prevalence of AD and other dementias in rural India. Neurology. (April 1) 1999; 52:15-17.

Bose S, Shaji S, Verghese A. Prevalence of dementia in an urban population in Kerala, India. Br. J. Psychiatry. February (1) 2005; 186:136-140. 

Pankaj K. New definition of poverty line to exclude large number of needy from social welfare programs. Goindocal, people voice people choice Website. 2011 Octobre 3.

Gupta R,  Rowe N,  Pillai VK. Perceived Caregiver Burden in India: Implications for Social Services. Affilia. February 2009; 24: 69-79.

Pattanayaka RDJenaa R, Tripathib M, Khandelwala SK. Assessment of burden in caregivers of Alzheimer's disease from India. Asian Journal of Psychiatry. (3): 112-116.

Anthony K R. Who said doctors can’t be ethical and successful? The Hindu. 2011 Juillet 24.

Sinha K. MCI wants doc to spent at least 10 mins with each patient. The Times of India. 2011 September 01.

Dayal K. India doesn’t have even one hospital bed per 1,000 persons. The Times of India. 2011 October 10.

Tomita M, Sarang A, Lee KF, Schultz Lee K, Russ L, Noe M. Characteristics and Perceived Supports of Primary Caregivers of Home-Based Older Adults with Dementia in India, Taiwan, and the United States. Geriatric Rehabilitation. 2010; 26 (1):2-16. 

Tomita M, Sarang A, Lee KF, Schultz Lee K, Russ L, Noe M. Psychological Health of Primary Caregivers of Home-Based Older Adults with Dementia in India, Taiwan, and the United States. Geriatric Rehabilitation. 2010; 26 (1):17-31.

Planning Commission. Faster, Sustainable and Growth: “an approach to the 12th five year plan”, Draft. 2011 August.

Raju S. Voice of the elderly in India. Éds S. Siva Raju. B.R Publishing Corporation. Delhi, India. 2011. 206 pages.

Rao R, Khande P. Awareness on Alzheimer’s, crying need of the hour. DNA Speak up. 2011 Juillet 29.

Mukherjee N. Caregiving for the elderly is a challenge that needs to be addressed urgently. Moneylife. 2011, Septembre 16.

Kishore S. Applying available Dementia caregiving material to the Indian context. Swapnawrites Blog. 2010 Mai 13.

National Policy on Senior Citizens 2011 Draft. Review of NPOP 1999. HelpAge India report 2011.

Marriot A. Direct Health care by government best option, says World Bank Economist. 2010 Octobre. Reproduit sur Global Health Check website. 2011 Juillet 22.

The Lancet Series coll. India: “towards universal coverage”. The Lancet. 2001 January 11.

Tiwari AK. Retirement complexes gain ground. DNA. Mumbai. 2010 June 9.  

Manzoor S. Asian parents in care homes. The Guardian. 2011. February, 26.

Homes Not ‘Home’ for India’s Elderly. Agence France-Presse. September 21, 2011. India.

Lingiah H. Le vieillissement démographique mondial ou un exemple de prise en charge de la Maladie d’Alzheimer en Inde. Mémoire de Santé Publique et Développement. CNAM Paris. 2007/2008.
Bas du formu

"Healthcare in India - Vision 2020" by R. Srinivasan: 
Article available and Downloable on Scribd on PdF at :

"OECD (2012), Pensions at a Glance Asia/Pacific 2011", OECD Publishing. at:

Prinja S, Bahunga P, Pinto AD, Sharma A, Bharaj G, et al. (2012) The Cost of Universal Health Care in India: A model Based Estimate. PLoS ONE 7(1): e30362. doi: 10:1371/journal.pone.0030362.

Tiwari SC, Tripathi RK, Kumar A.  Applicability of the Mini-mental State Examination (MMSE) and the Hindi Mental State Examination (HMSE) to the urban elderly in India: A pilot study. Int Psychogeriatr 2009;21:123-8.

Indian Journal of GERONTOLOGY, a quarterly journal devoted to research on ageing, Vol. 26 No. 2, 2012, EDITOR, K.L. Sharma.

Brodaty H et Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry 2012; 169(9): 946-953. 1er Septembre Gitlin LN. Good News for Dementia Care: Caregiver Interventions Reduce Behavioral Symptoms in People With Dementia and Family Distress. Am J Psychiatry 2012; 169(9): 894-897. 1er Septembre 2012. 

"Caregiver's Burden in India"

Assessment of burden in caregivers of Alzheimer's disease from India

Haut du formulaire
Bas du formulaire
Asian Journal of Psychiatry
Volume 3, Issue 3 , Pages 112-116, September 2010



Most of existing literature on dementia caregiving comes from Western countries but the caregiving experience appears to vary in different societies. The cultural norms and socioeconomic resources of India are in stark contrast to western societies, however the dementia caregiver burden remains understudied in Indian context.

We aim to assess the burden in relation to key variables and explore its predictors in caregivers of Alzheimer's disease.

Thirty-two patient-caregiver dyads were selected. The dementia characteristics were assessed with Hindi Mental State Examination and Clinical Dementia Rating; burden was evaluated using Burden Assessment Schedule.

The caregiver sample had an overall moderate degree of burden. The burden in patient's behavior and external support area increased with the degree of cognitive impairment. Caregivers for male patients were found to have a higher burden. The female caregivers perceived higher burden in physical and mental health, spouse related and caregiver's routine. The burden in caregivers from joint families did not differ from nuclear families except for a lower burden in external support area. On stepwise multiple regression, spousal relation, HMSE score and male patient emerged as significant predictors of total burden.


There is a need to devote more research attention towards dementia caregivers from developing countries and to understand the culture-specific impact of caregiving.

Perceived Caregiver Burden in India, Implications for Social Services. 


The study presented here explores the influences of selected social and social psychological factors that are associated with perceived caregiver burden in a sample of 263 primary caregivers of the elderly in Allahabad City in northern India. The results indicate that although male caregivers' perceived burden depends only on the size of the role overload, female caregivers' perceived burden depends on the interrelationship between the size of the role overload and adherence to Asian cultural norms. Implications of the findings for social work are discussed.

doi: 10.1177/0886109908326998 
Affilia February 2009 vol. 24 no. 169-79

India: Towards Universal Health Coverage. The Lancet Series.

India: Towards Universal Health Coverage. The Lancet Series. 2011 January 11.

Executive summary :

"This Series of papers on India’s path to full health coverage reveals that a failing health system is perhaps India’s greatest predicament. 

The papers in this Series reveal the full extent of opportunities and difficulties in Indian healthcare, by examining infectious and chronic diseases, availability of treatments and doctors, and the infrastructure to bring about universal health care by 2020. 

The Series brings together a rapidly growing body of evidence to show that Indian health is in crisis. As the country with the largest democracy in the world, India is well positioned to put health high on the political agenda." 

Pam Das summarises the Series and explains its background and context.

Download her summary on the Podcast available at

Health Care Industry In India, some figures.

"The rate of growth of the health care industry in India is moving ahead neck to neck with the pharmaceutical industry and the software industry of the country. Much has been said and done in the health care sector for bringing about improvement. Till date, approximately 12% of the scope offered by the health care industry in India has been tapped. The health care industry in India is reckoned to be the engine of the economy in the years to come. Health care industry in India is worth $17 billion and is anticipated to grow by 13% every year. The health care sector encompasses health care instruments, health care in the retail market, hospitals enrolled to the hospital networks etc

Health care industry in India and the GDP or gross domestic product:
Expenses incurred by the Indian Government on health care is the highest amongst developing countries. India's expenses on health care sector comprises 5.25% of the GDP. Chances are that the health care market could experience a hike and attain a figure ranging between $53 to $73 billion five years from now. This in turn will reflect an increase in the gross domestic product to 6.2% GDP. The health care industry in India earns revenues accounting for 5.2% of gross domestic product.

Employment opportunities are provided to as many as 4 million people in the health care segment or other related sectors catering to the health care industry in India in some way or the other. Owing to the vast differences in medical expenses in western countries and that of India, India has become one of the favorites for health care treatments."

Although the total spend is ~6% of GDP but government spend is only ~1% of GDP.

"A growing healthcare sector" 

Healthcare is one of India’s largest sectors in terms of revenue and employment and the sector is expanding rapidly. During the 1990s, Indian healthcare grew at a compound annual rate of 16%. Today the total value of the sector is more than $34 billion. This translates to $34 per capita, or roughly 6% of GDP. 

By 2012, India’s healthcare sector is projected to grow to nearly $40 billion. The private sector accounts for more than 80% of total healthcare spending in India. Unless there is a decline in the combined federal and state government deficit which currently stands at roughly 9%, the opportunity for significantly higher public health spending will be limited."

Full report available on Pdf version at :