 Good afternoon everyone once again. So our speaker has already joined us and therefore, without wasting much time, we will proceed with our webinar, today's afternoon's webinar. So on the counts of World Algebra Day, the Psychology Department has organized this webinar on the team. Let's talk about dementia. And today we have our resource person among our mates, Dr. Vaketu Leipnir, our senior medical officer from the State Mental Health Institute. So thank you, sir, for joining us in spite of your busy schedule. We are happy that you have accepted our request on this occasion of World Algebra Day. Thank you, sir. Thank you, sir. Thank you and welcome. So today, the order of the program is, we have, I'll be in the program, and as mentioned earlier, Dr. Vaketu Leipnir will be our resource person and the opening remarks will be delivered to us by Ms. Erwin Slo. And at the end of this session, we have a few minutes of questions and answers. So I request all the participants to raise any queries or questions during this given time. And I will be reading out this order of the program again, so I hope the participants will follow the resource person and the new remarks will follow this order of the program. Yes, sir. Yes, sir. Yes, sir. Can you hear me? Yes. Yes, sir. Yes, sir. Okay, okay. All right, sir. Yes, sir. Yeah. I think they think this is cool. Is it okay now? No, it's still there. Is it okay? Can you hear me clearly? Yes, sir. We can hear you clearly. Yes, sir. Okay, okay. I think that's a little better. Is it time for me now to take over? No, just a minute. Just a minute. Yeah, I understand. Now the time will be given for opening remarks. Yes, sir. So, on the go, we can take your time. on behalf of the college and the department of psychology. I think there's a little bit of an echo. Sir, if you don't mind audio for now. Audio. I'm sorry about that, I think it's because of that, it's been echoing. So Alzheimer's disease and other forms of dementia is a rapidly growing public health concern, especially in a country like India where we have a huge elderly population. Okay, so Alzheimer's disease and other forms of dementia is a rapidly growing public health concern, especially in a country like India where we have a huge elderly population. It is estimated that by this year, 4 million people, 14% of the world's elderly people are going to be living in India. And also there are 4 million people who currently have some form of dementia in India and it is only going to increase because the incidence rate is only going to increase and this issue needs to be addressed. So on account of this day, I was just reading up a few things on Alzheimer's disease. So I decided to look up Nagaland statistics also and I couldn't find any. So I actually contacted a senior doctor who works very closely with my community and I was told that from his 30 plus years of experience, he has only encountered very few cases of diagnosed Alzheimer's and there are only a handful of people who have been diagnosed yet. And this is not because there has been no incidence, but it is because of lack of knowledge and of care and treatment which can be availed. And most symptoms of Alzheimer's are actually being just labeled as signs of old age and being as nothing more. And it is very sad, but some elderly with Alzheimer's are also being labeled as mad in the rural areas, especially in our land. So the government of India has also put out a number of national health programs for elderly. So if preventive measures can be taken, if intervention can be made, if symptoms management can be applied, I think we should avail it because our elderly also deserve to live the end of their lives with dignity. And so that is why we are so delighted to have Dr. Viqueto Lepenu here today with us, the senior medical officer of State Mental Health Institute, Kohima, to share his experience and knowledge with us. He also teaches at the State Council of Educational Research and Training, which is the SERD. He works very closely with people who have mental health issues and substance abuse history. He is also a motivational speaker and his area of expertise is stress management. And I would also like to add that geriatric psychology and geriatric care is taking foreground. And many people, many young professionals are opting this as a career path. So with many of our elderly also investing heavily on retirement plans and later life health plans, which is why I believe that this talk is very timely to help us bring awareness and also start dialogues on intervention plans within our own community. I thank you, Dr. once again for coming, taking the time to come address our college and also all the participants who have joined, we are looking forward to learning from you. Can I switch on now? Yes, you can take it. Okay. Can I take over now? Yes, sir. Yes, sir. Okay. Okay. It's the 21st of September and 21st of September is commemorated as World Aljheimers Day. Aljheimers Day. The theme for this World Aljheimers Day is let's talk about dementia. Every year the 21st of September is always commemorated as World Aljheimers Day. And the aim of this day is to raise awareness and highlight the issue of dementia. Number one. Number two, this day is commemorated to create an opportunity for people and organization to understand how we can overcome this issue, break the stigma and help people live with dignity. And number three, the aim is to provide and enhance the quality of life for people living with dementia. All over the world, we have about roughly 50 million patients suffering from Alzheimer's disease. As you may be aware, Alzheimer's disease was first coined or discovered by a doctor by the name Alois Alzheimer back in 1906. So after the name of this physician, the disease was coined. Alzheimer's disease, as we understand, it is a psychiatric condition, which is characterized by the following signs and symptoms. Firstly, there will be a decline in cognitive functions like memory laps, attention laps, and difficulty in reasoning, difficulty in thinking. Secondly, people who suffer from Alzheimer's will experience forgetfulness, absent-mindedness. Halfway through the talking, he will struggle to recollect words. They will experience memory impairment. They'll have difficulty in recalling past events. If you ask them, especially, this disease is seen only people who are above 75 to 80 years of age, not among young people. So they'll have difficulty in remembering past events, difficulty in recollecting friends, names of people whom they know earlier. And they will have difficulty in performing daily tasks, daily routines, where they need the help and support of family members. They will have difficulty in concentration. They will not be able to concentrate on a particular task. A lot of them will have difficulty in multitasking. Simple task only, when we are so much used to so many complex multitasking, when people who suffer from this ailment, they will have a problem multitasking. Some people will experience a loss of inhibition. They will take off their clothes without any sense of inhibition, without any sense of shame. Some people experience irritability and they've become aggressive. For no reason, they've become aggressive with family members, irritable all the time, getting angry with family members. For some people, they will experience poor judgment, inability to make good reasonable judgment. Some people will experience the inability to solve problems. Every day, simple tasks, simple problems, they will have difficulty in solving. They need somebody to help them solve problems for them. Then a lot of them will experience difficulty in keeping track of time and place and space. You ask them where they are. They will not be able to place it. You ask them what time is it? They will not be able to give you the right time. They will get lost. Then they will have trouble. They'll have problems understanding images. They'll have problem understanding words. Then they might misplace things and have difficulty in retracing their steps. They become so forgetful. And some of them will even experience change of mood and change of personality. Some of them might become socially withdrawn and even experience depression. So these are some of the signs that we need to be aware of, especially among the elderly. Now regarding the prevention. This particularly, this Alzheimer is a very difficult and progressive disease. They don't get cured completely. It is a part of the inevitable process of aging. We all have to go through it as we grow old. Of course, not everybody suffers from Alzheimer, but some people are a little more prone to, more vulnerable to, because of genetic factors, maybe, because of dietary factors, maybe, maybe because of unhealthy lifestyle, maybe because of some unhealthy abuse like alcohol, chronic alcohol abuse, unhealthy lifestyle, like poor exercise, poor diet, and people who don't mingle well with the society, with poor social life, they are usually a little more and people who are not so well educated. This is seen more among people who are a little less educated. So many factors are there that makes you vulnerable to develop Alzheimer. Now there are some advice that we can give to our patients to enjoy a healthy elderly life into your 80s and 90s. If you practice a few things like having good sleep, for example, if you have good sleep and a balanced work and balanced rest and balanced sleep, you can experience a healthy mental life well into your advanced age. If you maintain good health, people who are, I want to say people who have physical ailments like blood pressure, heart disease, diabetes and say cardiovascular diseases, they are a little more vulnerable to develop Alzheimer. So it is good and necessary for us to maintain a healthy body and fitness so that we can overcome Alzheimer. Now we also encourage healthy physical life like exercising every day, at least half an hour to one hour every day, morning, evening, because it is seen that having a poor healthy lifestyle also contributes to the development of Alzheimer. So we encourage healthy physical activity. People who do exercise daily, they are less prone to develop Alzheimer. Then regarding diet, we encourage, especially when you become older, well into your 60s and 70s, we advise people to eat more of fruits, vegetables, more of fish and less red meat. And we encourage people to take curcumin. Curcumin is that active ingredient found in our healthy, that masala, healthy masala. It has been proven fact that people who eat regularly, they suffer less from Alzheimer. Then we also encourage a healthy social life. You know, when you are all the time to yourself, when you're all the time staying alone, lonely, aloof, there's a chance of developing many mental health issues. So we encourage people to enjoy and to stay as much as possible, socially active life that keeps the brain active and keeps the brain healthy and strong. Then we also encourage people, elderly people especially, to learn new skills every day. It helps the brain to maintain its plasticity, like for instance, reading every day or being intellectually active, in active discussion with people, with other people, so that it helps keeps the brain plasticity strong. And we also advise people to avoid alcohol and drugs as much as possible because it is seen that alcohol also causes contributes to dementia. And we also advise people to manage their stress well. Too much stress can cause all sorts of mental illness that includes Alzheimer disease or so. So learn to handle your stress well. Now regarding the treatment, we have a medical treatment that we all know and that is confined to doctors in the mental hospital. We have a few mental medication that can improve. But let me tell you, this Alzheimer disease is not 100% curable. It is a progressive disease. Despite medication, people will progress deeper and deeper into the effect of the disease. So the chances of recovery is not so good. So however, we try to provide as much as possible a good family support so that the patient can enjoy good quality of life. The aim of our treatment is that. Besides medication, we have something known as psychosocial care. The aim of this treatment is to integrate them into the family system and to make them as useful as possible. Integrate them and make them as useful as possible and help them to enjoy good quality of life before they die. So this is the aim of our treatment, not to reverse. It is impossible to reverse the whole process back to normal. You can't reverse an 80 year old, 90 year old man back to a young man. So we have to accept the inevitability. Now, part of the psychosocial care includes educating the family members about the disease. Very, very important. Many people who don't understand, they say, how to manage, how to go above, we don't know. And because of ignorance, because of poor understanding about the disease, the patient becomes unattended, ignored and neglected, which makes the disease worse. Because of that, we need to educate the family members very, very important, especially for those of them who are the main caregivers, the nearest family members who are attending to this case. They need to be well-versed, well-educated regarding the nature of the illness, the progress of the illness, the treatment, how to talk to them, how to manage their life, how to provide for all their needs. It happens so, bhabhara, sumjaiti will again. This we call it psychoeducation, which is very important for the caregivers. Then the next is the medication that will be prescribed by the treating doctor, wherever the psychiatrist is. So he will provide some medication for them. And the responsibility of the caregiver is to ensure that he gets his medication on time and regularly. Because on their own, they will forget. On their own, they cannot be held responsible. Sometimes they miss out on their dose, they forget, they refuse to take. So we have to ensure the caregivers that all these things are taken care of. Then another very important factor in providing psychosocial care is providing a conducive positive environment. Here I mean an environment where there is love, where they're wanted and accepted and cared for. This is the main core essence of providing psychosocial care. If a patient is made to live in such a warm environment where there's love, where there's acceptance, where they're wanted and loved and cared for, he will improve, he will enjoy his life. But if the environment is negative, here I mean he's not loved, he's not accepted, he's not wanted and nobody wants to take care of him maybe because of family problems, because of financial problems. In a situation like this, the progress of the disease might worsen, it might aggravate. And that's that prognosis for the patient. So providing the right conducive environment for the patient is very, very important. And another psychosocial care is to make them feel useful by keeping them connected socially, by keeping them engaged mentally. So making them useful, making them wanted in the family. This is going to be a very, very important thing for them. Remember our clients, our patients, they all have feelings, okay? Pagala hojye akuna jahaniye inakano kheide, hoi. Mental thinking process has deteriorated. It's not like those days. But they have feelings. They have feelings, they feel good when you love them, when you care for them. They feel low on the self-esteem. When you don't take care of them, when you neglect them, when you ignore them. When you say harsh words, when you say bad words, you know, and when you ignore them and when you don't attend to them, the feeling becomes very, very low. That self-esteem goes down and many of them will suffer from depression also, associated complication along with Alzheimer. And of course, make sure that the psychosocial care also covers providing for all their physical needs like fooding, clothing, maybe personal hygiene. Some of them cannot even clean themselves properly after going to the toilet and back. So we need to provide for all the foodings, clothing, personal hygiene and spending time with them. This is also important. Many elderly people, many people don't want to stay with elderly people. They feel very, very neglected. elderly people, nobody wants to talk to them. Children don't want to talk to them. They feel very unwanted, they feel very neglected. This can aggravate their condition. And as a caregiver, also you have to ensure that they provide, they get some exercise as far as possible, physical exercise. And of course, the caregiver also needs to exercise a lot of patients, very, very important. This is a very exhausting problem. It's a very, it does not get cured within a few weeks, within a few months. It's going to go for as long as the patient needs. So with the caregiver needs to have a lot of patients with them. So sometimes the caregiver can also experience exhaustion and burnout. And of course, another way of providing psychosocial care is to get them connected with support networks like the Alzheimer's Association, sharing with them, getting, joining the movement and helping them to break the silence, break the stigma. So this is, in short, a few things that we can do to improve the quality of life so that they can have a good time before they die. Eventually we will all die, but this is something that we can do. Medication alone is not enough that cannot reverse the process but providing some important psychosocial care like this can help ease the suffering, alleviate their misery and make them feel wanted and loved till they die. So this is, in short, a small talk on World Alzheimer's Day. I hope you have understood the basic concept of Alzheimer's and I hope you have understood how to prevent, I hope you have also understood a little bit how to take care of them. So the time is now given to you to, you know, ask questions, see if there's any. Hello. Yeah. Okay, so now we have a question and a session. So if you have any queries or questions we should like to clarify into this time. Can I say something before that? Yes. Regarding the point made out by the second speaker, the lady, she said something about the MAGA context. Okay, Alzheimer. She asked a doctor about the incidence of Alzheimer in Nagaland. No, you remember your second speaker. So I want to mention something about that in our context. Hello, are you with me? Yes. So, Alzheimer in Nagaland. I just want to make some notes on that. Alzheimer is very common among the Western society. White men are a little more vulnerable. There's still a study, a lot of studies going on as to why, why white people are a little more vulnerable to Alzheimer than Asian race. In India also we have, we do have, but not as much as compared to the white men's race. And close the home in Nagaland. My personal experience is that we do have a lot of them present in our OPD as loss of memory, forgetfulness, absent-mindedness, memory impairment, inability to perform, this we get quite often. But what I have seen is it is not so common as it is, we do have this and we do get complaints in the villages especially. Papa, I think it's a bit of a problem. I think it's a bit of a problem. I think it's a bit of a problem. I think it's a bit of a problem. I think it's a bit of a problem. No, it's quite a common complaint that we normally hear from our fellow villagers. But I have noticed that a lot of these people don't come to our hospital for clinical examination. So many people assume that to be a normal process of aging. So this is how they don't bring to the hospital and this is how we miss out the cases. But overall, I think this is still too less compared to the Western society. So I used to wonder why. But there's some reason why we probably have less case. One reason could be we enjoy a lot of social support. When somebody is socially engaged and socially involved all throughout his life, the chances of developing Alzheimer's less. And maybe because we have a very active physical life, especially in the villages, a lot of people are active. Even when they are 70, 80, they go to the field and come back. So a highly active physical life, a highly active social life, they all contribute to mental well-being. Even right into the right old age of 80 and 90. Probably that explains why we have less case. And our diet is quite healthy. So probably these are some factors. And especially in the village, a lot of people are quite healthy. They don't have high blood pressure problem. They don't have blood sugar problem. So that makes them less vulnerable to develop Alzheimer's. So probably this explains why this case of incidence of Alzheimer's less in the villages. Yeah. Back to you. Thank you. All right. So we have a question. Yeah. Please read out the question once again. All right. This is a question for my mother. She's asking. Can we also hear about health programs by the government for the elderly? As such, I don't think we have a real health program for the elderly. Exclusively. We have our health centers all over the districts, primary health centers, community health centers where anybody, regardless of age, elderly people, adults, gentlemen, they can all have access. But as such exclusive mental health program for elderly, I don't think we have that yet. We should have. Thank you, sir. Thank you, sir. Any questions from the participants, students? Read out the question once again. Okay. This is a question from my mother. She wanted to know the issues of mental health is often considered a stigma in our society. So what can we do to create awareness? The best example is like today, World Alzheimer's Day. I told you in the first talk, this basic idea is to create awareness, highlight on this issue. So if we can have all kinds of activities that can create awareness and highlight this mental health issues and break the silence and help people understand how to cope with this, we can go a long way in overcoming stigma and discrimination. One big problem with mental health issues is stigma and discrimination because of that many people hesitate to come forward to come for treatment. This is probably also another reason why people don't want to come to mental hospital for treatment. So creating awareness like this, like this talk today, helping create awareness on mental health issues and educating the public, they all go a long way in reducing stigma and helping people to come forward. Thank you. Thank you. Did it suffice? I hope that satisfies you. Yes, students, you can take your time. Yes, students, you can take your time. Yeah, yeah, free. Okay, I think the students have all understood and they don't have any questions. Yes, so on that note, I would like to thank you once again for your insightful session, session on the topic how to deal with e, the meaning of e-generous, and also for delivering on psychosocial care, like how a family should deal about it, and how as a caregiver or in e, one happens to have e-generous to take care of them. So thank you very much once again for your insightful topic and for your deliverance. Yes, thank you. Yes, so on that note, we will conclude our webinar. Thank you all the participants for joining us. Thank you.