RESEARCH PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Dementia is a challenging problem across the world, with over 5 million people with dementia in India. Multidisciplinary memory clinics (MCs) are the mainstay of care for people with dementia in many countries. There is limited information about the understanding of and attitudes towards MC among health and social care professionals in India. This study aimed to identify the perceived advantages and disadvantages of a multidisciplinary memory clinic model in the care of people with dementia, and to identify the facilitators and barriers in establishing and running multidisciplinary memory clinics, as perceived by a group of specialist doctors, psychologists, and social workers.

Methods:
A qualitative study using focus group discussions (FGDs) was conducted and the theoretical background of directed content analysis was applied for data analysis. The participants were from Kerala, a southern state in India, working in 13 different institutions involved in healthcare and social work. Purposive sampling was utilized for the FGD representative of a multidisciplinary team.

Results:
All participants agreed that a multidisciplinary memory clinic approach would improve patient care. Early detection, comprehensive, continuous, person-centered care and caregiver focus were perceived benefits that MCs could offer. Disadvantages include unclear role definition, disjointed care, complex team dynamics, and high costs. Awareness of dementia, close involvement of stakeholders, clarity in role definitions, elder-friendly settings, community involvement and access to finances were perceived to facilitate establishing memory clinics while lack of awareness, stigma, risk of duplication of functions, lack of outcome assessment and lack of funding were barriers.

Conclusions:
Multidisciplinary memory clinics potentially facilitate early diagnosis of dementia and comprehensive person-centered care. Caregivers stand to benefit as the team has more time and diversity in skills to educate and support them.

CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
There was no source of funding for this research.
ETHICAL APPROVAL AND INFORMED CONSENT
Ethical approval was obtained from the Institutional Ethics Committee of Rajagiri Institutional Ethics Committee (Approval number: RAJH/2020/002; Date: 15 February 2020). Participants provided informed consent.
DATA AVAILABILITY
The data supporting this research are available from the authors on reasonable request.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
REFERENCES (35)
1.
Prince MJ, Wimo A, Guerchet MM, Ali GC, Wu Y, Prina M. World Alzheimer Report 2015 - The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends. ADI; 2015. Accessed July 16, 2024. https://www.alzint.org/u/World...
 
2.
Alzheimer’s Disease International. Dementia Statistics. ADI; 2019. Accessed July 16, 2024. https: //www.alz.co.uk /research /statistics
 
3.
Kumar CTS, Shaji KS, Varghese M, Nair MKC. Dementia in India 2020. ARDSI; 2020. Accessed July 16, 2024. https://dementiacarenotes.in/d...
 
4.
Shaji KS, Jotheeswaran AT, Girish N, et al. Dementia India Report 2010: Prevalence, impact, costs and services for Dementia. ARDSI; 2010. Accessed July 16, 2024. https://www.mhinnovation.net/s...
 
5.
World Health Organization. Dementia: a public health priority. WHO; 2012. Accessed July 16, 2024. https://www.who.int/publicatio...
 
6.
World Health Organization. Global action plan on the public health response to dementia 2017 – 2025. WHO; 2017. Accessed July 16, 2024. https://www.who.int/publicatio....
 
7.
Jolley D, Benbow SM, Grizzell M. Memory clinics. Postgrad Med J. 2006;82(965):199-206. doi:10.1136/pgmj.2005.040592
 
8.
Second English National Memory Clinics Audit Report. Royal College of Psychiatrists; 2014. Accessed July 16, 2024. http://data.parliament.uk/Depo...
 
9.
Recent advances in psychogeriatrics 2. Psychological Medicine. 1992;16(3):105-116. doi:10.1017/S0033291700010552
 
10.
Wright N, Lindesay J. A survey of memory clinics in the British Isles. Int. J. Geriatr. Psychiatry. 1995;10(5):379–385. doi:10.1002/gps.930100506
 
11.
Katzman R. Editorial: The prevalence and malignancy of Alzheimer disease. A major killer. Arch Neurol. 1976;33(4):217-218. doi:10.1001/archneur.1976.00500040001001
 
12.
Ramakers IH, Verhey FR. Development of memory clinics in the Netherlands: 1998 to 2009. Aging Ment Health. 2011;15(1):34-39. doi:10.1080/13607863.2010.519321
 
13.
Cook L, Souris H, Isaacs, J. The 2019 national memory service audit. NHS England; 2020. Accessed July 16, 2024. https://www.england.nhs.uk/lon...
 
14.
Stephan A, Bieber A, Hopper L, et al. Barriers and facilitators to the access to and use of formal dementia care: findings of a focus group study with people with dementia, informal carers and health and social care professionals in eight European countries. BMC Geriatr. 2018;18(1):131. doi:10.1186/s12877-018-0816-1
 
15.
Morgan D, Kosteniuk J, O'Connell ME, et al. Barriers and facilitators to development and implementation of a rural primary health care intervention for dementia: a process evaluation. BMC Health Serv Res. 2019;19(1):709. doi:10.1186/s12913-019-4548-5
 
16.
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-1288. doi:10.1177/1049732305276687
 
17.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-112. doi:10.1016/j.nedt.2003.10.001
 
18.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357. doi:10.1093/intqhc/mzm042
 
19.
Kumar CTS. ARDSI guidelines for establishing Memory clinics. 2015. Accessed July 16, 2024. https://ardsikottayam.wordpres...
 
20.
Lee L, Hillier LM, Lumley-Leger K, et al. Key lessons learned in the strategic implementation of the primary care collaborative memory clinic model: a tale of two regions. World Health Popul. 2019;18(1):68-81. doi:10.12927/whp.2019.26057
 
21.
Gauthier S, Rosa-Neto P, Morais JA, Webster C. World Alzheimer Report 2021, Abridged version: Journey through the diagnosis of dementia. ADI; 2021. Accessed July 16, 2024. https://www.alzint.org/u/World...
 
22.
Deudon A, Maubourguet N, Gervais X, et al. Non-pharmacological management of behavioural symptoms in nursing homes. Int J Geriatr Psychiatry 2009;24(12):1386–1413. doi:10.1002/gps.2275
 
23.
Teri L, Larson EB, Reifler BV. Behavioral disturbance in dementia of the Alzheimer's type. J Am Geriatr Soc. 1998;36(1):1-6. doi:10.1111/j.1532-5415.1988.tb03426.x
 
24.
Cohen-Mansfield J. Nonpharmacologic interventions for inappropriate behaviors in dementia: a review, summary, and critique. Am J Geriatr Psychiatry. 2001;9(4):361-381. doi:10.1097/00019442-200111000-00005
 
25.
Turner S. Behavioural symptoms of dementia in residential settings: a selective review of non-pharmacological interventions. Aging Ment Health. 2005;9(2):93-104. doi:10.1080/13607860512331339090
 
26.
Talerico KA, O'Brien JA, Swafford KL. Person-centered care. An important approach for 21st century health care. J Psychosoc Nurs Ment Health Serv. 2003;41(11):12-16. doi:10.3928/0279-3695-20031101-10
 
27.
Chenoweth L, King MT, Jeon YH, et al. Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurol. 2009;8(4):317-325. doi:10.1016/S1474-4422(09)70045-6
 
28.
Crooks EA, Geldmacher DS. Interdisciplinary approaches to Alzheimer's disease management. Clin Geriatr Med. 2004;20(1):121-139. doi:10.1016/j.cger.2003.11.004
 
29.
Colerick EJ, George LK. Predictors of institutionalization among caregivers of patients with Alzheimer's disease. J Am Geriatr Soc. 1986;34(7):493-498. doi:10.1111/j.1532-5415.1986.tb04239.x
 
30.
Gaugler JE, Kane RL, Kane RA, Newcomer R. Early community-based service utilization and its effects on institutionalization in dementia caregiving. Gerontologist. 2005;45(2):177-185. doi:10.1093/geront/45.2.177
 
31.
Caron CD, Ducharme F, Griffith J. Deciding on institutionalization for a relative with dementia: the most difficult decision for caregivers. Can J Aging. 2006;25(2):193-205. doi:10.1353/cja.2006.0033
 
32.
World Health Organization. Measuring the age-friendliness of cities: a guide to using core indicators. WHO; 2015. Accessed July 16, 2024 https://www.who.int/publicatio...
 
33.
Kumar CTS, George S, Kallivayalil RA. Towards a dementia-friendly India. Indian J. Psychol. Med. 2019;41(5):476–481.
 
34.
McKnight J, Block P. The Abundant Community: Awakening the Power of Families and Neighborhoods. San Francisco, CA: Berrett-Koehler; 2010.
 
35.
Mathie A, Cameron J, Gibson K. Asset-based and citizen-led development: using a diffracted power lens to analyze the possibilities and challenges. Prog. Dev. Stud. 2017;17(1):54–66.
 
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