Objective: The public health care system in India does not provide appropriate responsive services for older people. Families who care at home receive no benefits and little support. Unsurprisingly, there is very little help seeking, and this is a barrier to developing a new community based service. Development of a user-friendly dementia care service in the community was our aim Design: Two studies were conducted at Thrissur, Southern India in order to identify the target population as well as to know the caregiver needs. A monthly dementia clinic was established at the local Primary Health Centre. Materials and Methods: We have trained women health workers to identify cases of dementia in the community. During our subsequent qualitative research ,we conducted in depth interviews of 17 caregivers of people with Alzheimer’s disease. Results: Upon evaluation by a psychiatrist, two-thirds of those nominated as cases by the trained health workers met DSM-IIIR criteria for dementia, and the other third had other mental conditions with considerable unmet need. The qualitative study identified the need to provide information and education to the caregivers and other family members. Caregivers need emotional support as well as advice regarding the management of distressing symptoms. Conclusion: After identifying the families looking after demented relatives at home, we offered them regular help and guidance at the newly established monthly dementia clinic .The focus is on providing support to the caregiver and to improve the quality of care provided at home. In addition to presenting data from the case identification study, and the caregiver qualitative research, we shall present an account of the first three years work of the new community-based service.
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