Celebrated World Day to Fight Alzheimer's

21 september (saturday)2019, Skopje, square "Macedonia"

Under the motto "Remember" by listening to music from the past and watching old movies on September 21 (Saturday) at Macedonia Square organized by Alzheimer's Institute and Neuroscience, organized by PHI Specialized Geriatric and Palliative Medicine "November 13" - Skopje, with the support of the First Lady of the State, Prof. Dr. Elizabeta Georgievska, marked World Alzheimer's Day, called the 21st Century Epidemic.

The first lady, the wife of the President of RSM, Elizabeta Gjorgievska said that dementia does not concern us all and starts quietly and unnoticeably, and lasts long.

‘’The more we encourage within ourselves the humanity, understanding and awareness of the disease, the more we contribute to creating humane living conditions and equal conditions for all. You need to help people who are searching for memories and do not recognize their lowest. Let us understand them and help them make their future happier. It is possible to live with dementia, but the most important thing is the person, not the disease’’.

Gabriella Novotny of the Alzheimer's Disease and Neuroscience Institute shared that this is one of the saddest diseases that robs us of all memories and memories, in a word all that we will earn in life. The idea of ​​organizing this event is the result of reminiscence therapy. It is reminder therapy. Alzheimer's disease steals memories that are last to be remembered. Old memories, the times of their youth will be gone, so listening to music from their youth and looking at photos, arouses very pleasant emotions and diminishes aggressiveness, says Novotny. Dr Novotny says this will save on the abuse of many prescription drugs and improve the quality of life through non-pharmacological treatment.

According to world statistics in our country should be about 20 thousand Alzheimer's disease, and only 20 percent are diagnosed and treated. Early recognition and treatment of Alzheimer's disease slows its course and improves quality of life.

Our institution, as a specialized hospital for geriatric health care, we sent a message about our contribution to the palliative treatment of Alzheimer's and dementia patients, who are usually in the terminal stage and need institutionalization.

These are patients with a severe clinical picture of dementia, incontinent, with no recognition of the blues around them with impaired cognitive and behavioral behavior and aggression.

The treatment of these patients is multidisciplinary, involving a specialist team of specialist physicians (neurologist, psychiatrist, internist, psychologist and social worker). But with the growing number of Alzheimer's and dementia patients, there is a growing need for capacity building.

In addition, within our specialist clinic, we have a cabinet for neurology and psychiatry, through which we monitor listed patients and make efforts to treat them on an outpatient basis or through a day hospital, so that institutionalization is the last step.

An interesting detail of the event was the presence of team representatives and beneficiaries of the Mother Teresa Elderly Home - Skopje, it is a social protection facility but is under the authority of our institution), presented with a stand of personal collaborations under the occupational therapy under the motto ’’ WE DEFY ALZHEIMER'S ’’.

The users housed there, have a variety of social activities, the most important of which is the above-mentioned occupational therapy.

Occupational therapy is a type of activity where people in a group mentored by a person in charge of them make a variety of subjects, pictures and craftsmanship of the most ordinary materials. Their inclusion allows them to engage, create, work, create and at the same time the user creates a sense of community benefit.

Definition, clinical picture and diagnosis

Alzheimer's disease is a chronic progressive degenerative brain disease and most commonly occurs after 65 years of life.

People with dementia are usually diagnosed when they are already at an advanced stage. Dementia symptoms usually begin 10 years earlier, during that period the person still has insight and realizes that something is wrong with his memory, orientation, inappropriate behavior, activity planning and so on.

Because of this they withdraw from the environment in order not to be criticized or embarrassed.

People with early-onset Alzheimer's, ie. 75 years ago they are developing a clinical picture of dementia, followed by numerous neurological deficits - alology, aphasia, agnosis, agraphy. While people with late onset, after 75 years they are characterized by more confusion and forgetfulness and less dramatic progression of symptoms.

Appropriate institution for the treatment of this type of patients are psychiatric outpatient clinics with psychological testing which will help to more precisely define the stage of the disease.

Neurological ambulances - CTM of brain and hippocampal volume (measurement of hippocampal volume) which is a direct indicator of Alzheimer's dementia.

Raising public awareness that forgetfulness is not inherent in old people - it's a disease. Early detection and treatment means prolonging exacerbation and improving the quality of life of these patients.

Day hospital plans for Alzheimer's and dementia patients

Recently, I as a director of the facility along with Dr. Maja Spirova, a specialist psychiatrist working in the facility, we were visiting the St. Ivan's Psychiatric Hospital in Zagreb, Croatia.

We had the opportunity to meet the manager of the day hospital Dr. specialist psychiatrist Paola Cutting.

She explained how the day hospital works and what type of staff they have and what type of patients they are treating.

The doctor explained that they are currently working from 8 to 16h, but plan to introduce 2 shifts. In the morning, patients are taken by relatives and taken in the afternoon when they return from work.

During this time, patients receive a complete work program. Patients work with occupational therapist, psychiatrist, nurses, a social worker as well as a person in charge of passive gymnastics in a seated position. There is also a kitchen and rest area.

The patents are animated all the time, and after a while, the benefits have become very great. From patients who could not function at home became functional, the deteriorating clinical picture of Alzheimer's and dementia became bearable.

As an institution, we plan this activity in our future growth and development plans. We think that this kind of day hospital is in demand in our country as well, and the benefits would be great. Patients could work at home with their loved ones instead of being institutionalized, thus reducing the rate of intra-hospital infections as well as the financial costs of the family and the state budget.