An appraisal of clinical diagnosis and management of dementia patients in a public hospital

Abstract

Background: As of 2015, 46.8 million elderly people were living with dementia, with 4.6 million new cases diagnosed every year worldwide. Comprehensive evidence and practice-based management principles with practical strategies and interventions are necessary for adequate care to be rendered.
Objective: The purpose of this study was to examine clinical information, management, intervention principles and other relevant contents in the case note of dementia patients.
Methodology: A retrospective study in which 42 case notes of dementia patients seen in Federal Neuro-Psychiatric Hospital, Maiduguri in 2017 were retrieved based on the register kept by health records staff. The number of dementia cases from the register showed that one hundred and fifteen (115) cases were seen in 2017. Systematic sampling was used to select client case files to be studied from a list of 115 produced using medical health record register for dementia diagnosis in the year 2017. Information sorted out included socio-demographic data, clinical information, diagnosis, management, intervention principles and other relevant contents related mostly to first visit.
Results: Majority (N=27, 64.3%) were males, maximum age was 90yrs and minimum 56yrs. More than half (N=25, 59.5%) were married, a third widowed (N=15, 35.7%) and 13(31%) were unemployed. Main complaints were forgetfulness (N=36, 85.7%), irrational talks (N=29, 69%) and poor sleep (N=9, 21.4%). Information content in assessment was not comprehensive in 23 (54.8%) of case notes while 19(45.2%) were fair. Associated factors were not documented in many case notes, like smoking (N=40, 95.2%), alcohol use (N=41, 97.6%) and past psychiatric history (N=38, 90.5%). Management guidelines were sparsely used (N=24, 57.1%) or not used (N=18, 42.9%).
Conclusion: Care of dementia patients need to follow adequate assessment and management based on known guidelines for it to be beneficial. A national guideline with strategies for prevention, screening and intervention will encourage early involvement in treatment and delay deterioration