A Service Model for Home-based Care in Late Stage Dementia: Scope, Scale and Policy Implications

Abstract

Dementia care as it exists today in India is threadbare. Quality of life of dementia sufferers needs much improvement. Considering the resource constraints, care models for chronic conditions like dementia will be sustainable only if they are cost effective. Community-based care, preferably at home with a health worker providing domiciliary support, would be ideal, and evidence in support of such care is accumulating. However, implementing such care in real world settings is a challenge even for the well-resourced health systems of high income countries, and most of the responsibilities will have to be entrusted to a low cost workforce with multidisciplinary skills. The author describes a putative model for home-based dementia care that horizontally integrates two programs which already function in Kerala — District Mental Health Program and Palliative Care Program.