A Guide To Dementia Day Care Centres

Dementia can be a challenging condition to manage, not only for the person affected but also for caregivers. Dementia daycare centres designed specifically for persons with dementia can provide much-needed respite and offer specialized care and attention for persons with dementia in a safe and stimulating environment that can help maintain their cognitive and physical abilities. Here’s a complete guide:

For many caregivers of persons with dementia, the challenge occurs in balancing their personal needs, such as a job or childcare while caring for the person with Dementia. Very often, the person with Dementia may also be in an environment without any interaction or stimulation or a sense of community not available at home.

While there are Dementia daycare centres and other similar services offered in India, their numbers are few and the information about them is sparse. Often caregivers feel they aren't doing their "duty" if they send the loved one to a daycare. Here's a complete expert guide on how Dementia Day Care Centres help and where can you find them.

Why are Dementia Daycare Centres Important?

Nilanjana Maulik, Secretary General of ARDSI – the Alzheimer’s and Related Disorders Society of India, Calcutta Chapter says that ideally there should be dementia daycare centres in each locality of every city. "Right now in our Kolkata centre, people come from far away to attend our daycare program and they are unable to attend every day because of the distance. That's why we need more centres. Daycare centres highlight the essence of meaningful engagement. At the centre, people living with dementia stay meaningfully engaged. They start the day with a purpose and have a lot of interactions and the emotional and social aspects of their life are addressed here. Their caregivers get respite and an opportunity to live their life well. Daycare centres also offer their loved ones a chance to live their lives well." 

Dementia daycare programs can provide valuable support to both individuals with dementia and their caregivers, agrees Dr Radha S Murthy, co-founder and managing trustee of Nightingales Medical Trust (NMT). NMT has been running a daycare for people with dementia (PwD) since 2005.

What To Look Out For When Selecting a Care Centre

Ms Maulik says people should keep in mind the distance from home and the ambience of the centre in terms of its physical and social environment, safety factors, hygiene, activities structure, staff, training, and compassion. Whether the centre looks into individual preferences such as in terms of food or offers a timing that suits the caregivers is important. Two other biggies to watch out for are how they deal with emergencies and the cost factor. "Doctors should be recommending daycare centres in their prescription and let family caregivers know how dementia daycare centres are beneficial and encourage them to try it out.

"Seeking guidance from healthcare experts, dementia support groups, and social workers can aid in identifying appropriate choices and successfully navigating the journey to access dementia care services," Dr Murthy adds.

Here's a handy checklist for a good dementia care centre:

- Secure entrances and exits to prevent wandering, with adequate lighting to reduce confusion and falls, and electronic monitoring for residents' safety.

- Handrails and non-slip flooring in common areas and bathrooms.

- Clear policies for handling challenging behaviours and emergencies.

- Transparent communication with families about policies and procedures.

- Regular evaluations and quality assurance measures to maintain high standards of care.

- Skilled and trained staff, including nurses and caregivers, experienced in dementia care.

- A low staff-to-resident ratio to provide personalized attention.

- Regular staff training in dementia-specific care techniques and communication.

- Structured day-to-day routine to lessen disorientation and anxiety, as well as activities to engage residents both physically and mentally.

- Enclosed outdoor areas or sensory gardens where residents can enjoy fresh air safely.

- Group activities like music therapy, art therapy, and cognitive stimulation activities.

- Opportunities for social interaction with peers.

- Sensory rooms with calming sensory stimuli like soothing music, aromatherapy, or tactile objects.

- Dementia-friendly design with visual cues to aid navigation, and circular or looped layouts to prevent residents from getting lost.

- Quiet areas for relaxation and reflection. Familiar, homelike decor with reminiscence aids, such as old photos and mementoes.

- Support with bathing, dressing, grooming, and meal preparation.

- Adaptive equipment and devices to aid with mobility and self-care.

- Access to medical professionals for regular check-ups and management of health conditions.

(Checklist: Nightingales Medical Trust)

When Is The Right Time to Find A Centre for your Loved One

Ideally from the early to moderate stage, says Maulik. "But a daycare that mixes both is a tough scenario. Lots of people in the early stages such as people with Mild Cognitive Impairment (MCI) don’t want to be part of it. So what we do at the Kolkata centre is that they don’t come as someone who has to be looked after. They come as volunteers to take care of the other people who need help and this way they feel that they are doing something useful."

Different Types of Dementia Care Centres

Memory Clinic for Assessment and Diagnosis: Memory care units are often designed to address the needs of individuals in various stages of dementia.

Daycare: Often designed to cater to the needs of the individual based on their abilities and interests, focuses only on mild and moderate stages.

Home health care services: To facilitate individuals help monitor symptoms, perform check-ins, and provide frequent communication to reduce avoidable hospital readmissions. Focuses on all the stages of dementia.

Residential care: To facilitate those with different stages of dementia with a personalized care plan, for continuous care support, a safe and supportive environment, and Respite care.

Palliative care: To provide compassionate end-of-life care, focusing on comfort, dignity, and quality of life.

Support groups: Families receive education, counselling, and support to help them understand and cope with the challenges across all stages of dementia. (Information: Nightingales Medical Trust)

There are also residential dementia care homes available in India. A care home is essentially a place where someone moves into (or when someone moves their loved one) when they need help and support for their day-to-day care, says geriatric psychiatrist Dr Soumya Hegde. It is a familiar concept in the West, and placement in these places is generally covered by insurance policies or the government. This is not the case in India where families have to fund their care. "When a loved one is affected with Dementia, the decision to move them to a care facility is made only when the behaviour challenges make it difficult to continue providing care at home or when there is no family member available to supervise care," she adds.

Read more on this here: All You Need To Know About A Dementia Care Home 

Financial Support and Options Available for Dementia Care Services

Taking care of elderly people in India can be a big financial burden due to the high healthcare costs and the absence of social security. Geriatric care is an unpredictable and indefinite process that requires a significant amount of financial resources. The most reliable care facilities are usually quite expensive. For example, caring for someone with Dementia at some facilities can cost around Rs 1,500 to 2,000 per day. Here are some sample costs but do check for any changes.

The cost of the dementia day care centre at Nightingales Medical Trust is Rs 500/daily and Rs 12,000/month. At ARDSI Kolkata, daycare charges are Rs 700/day. Dementia day care centre at A.S.H.A Delhi is Rs 15,000/month.

According to Dr Murthy, families looking for financial aid with dementia care services in India may be able to access aid with the associated costs, though the availability and eligibility criteria for these options can vary. Here are some potential sources of financial support:

- Government Health Programs

- Insurance Coverage

- Central Government Health Scheme (CGHS)

- State Government Health Schemes

- Senior Citizens' Savings Scheme (SCSS)

- Non-Governmental Organizations (NGOs)

- Financial Aid for Economically Weaker Sections (EWS)

- Medicines and Treatment Assistance

- Tax Benefits

Home or Dementia Day Care: What works better?

"One could provide stimulation at home too but sometimes it can be difficult. Setting up a structured environment in a home may be tougher. Daycares provide a better structure with a variety of people coming in-- from students to interns and volunteers from various backgrounds. The person with dementia is exposed to a variety of stimulation whether cognitive, social or physical. Given that family members are working these days, at a daycare center, safety is taken care of vs. a house where a single caregiver may be trying to manage other household chores too. Besides care at home is provided on a one-on-one basis compared to daycare where care is in a group and activities are done among the group. Of course, all this is applicable if the person with dementia enjoys the daycare centre and wants to be engaged in a group. If not then home is a better environment." -- Nilanjana Maulik

For a list of Dementia daycare centres, Residential care centres, Helplines, and other support systems, please click below.

Dementia Resources Across India

— With inputs from Reshmi Chakraborty

Cover image: A fun session at ARDSI Kolkata