Dementia poses a significant challenge to modern healthcare systems and society, impacting millions of lives globally. According to data from the World Health Organization (WHO), over 55 million individuals are currently living with dementia, with an alarming increase of nearly 10 million new diagnoses annually. Projections estimate that by 2050, this figure could surge to 153 million people.

However, behind these stark figures lies a deeply human reality, often invisible: the emotional and social toll of the disease. A mother may no longer recognize her child, a grandfather may get lost on a familiar street, and an entire family’s life is reconfigured to provide care for a loved one. Statistics fail to capture the frustration, tears, and emotional exhaustion experienced by those involved.

In the Republic of Moldova, where over 25% of the population is over 60, official data indicate just over 4,000 cases of dementia. Nevertheless, experts believe the actual number is significantly higher, as many patients do not seek medical attention, and symptoms are frequently mistaken for “normal aging.” This discrepancy leaves thousands of families to navigate this immense challenge alone.

Dementia fundamentally alters family dynamics: children assume the role of caregivers, spouses become permanent assistants, and daily life becomes a struggle for survival. The psychological and financial burden, though absent from statistical tables, is profoundly felt in the households of those affected. Furthermore, families often conceal the diagnosis out of shame or fear of judgment, leading to social isolation that exacerbates the cognitive and emotional decline of the patient.

Dementia: causes, symptoms, and stages of evolution

Dementia is not a single disease but a complex clinical syndrome resulting from various neurodegenerative conditions. Its primary characteristic is the progressive decline of cognitive functions, including memory, abstract thinking, judgment, and spatial orientation. Of all forms of dementia, Alzheimer’s disease is the most prevalent, accounting for approximately 60-70% of cases. Other common etiologies include vascular dementia, Lewy body dementia, and frontotemporal dementia.

The disease’s clinical progression unfolds in three distinct stages. The initial phase is defined by subtle symptoms, such as recent memory loss or difficulty in word-finding.

In the intermediate phase, symptoms worsen considerably. Individuals may lose the ability to recognize close family members, require assistance with basic activities of daily living, and may exhibit significant behavioral changes.

The advanced phase is marked by a complete loss of independence and communication ability, with severe motor function impairment that increases the risk of medical complications such as malnutrition or infections.

Socio-medical services for dementia patients: the “CASMED” NGO experience

Effective management of dementia necessitates a holistic approach that integrates medical and social services delivered directly to the patient’s home. This internationally validated model addresses the complex, interconnected needs of individuals with the disease. The Public Association “CASMED” has been instrumental in successfully developing and implementing such an integrated care model, which is based on scientific evidence and recognized nationally. Through this model, the organization has assisted over 10,000 elderly individuals in more than 150 localities, conducting over 100,000 home visits.

The services provided by AO “CASMED” comprise two synergistic categories. Nursing services ensure that patients receive essential treatments in the comfort of their own homes. These include monitoring vital signs, administering medication, preventing and treating pressure ulcers, and restoring motor functions through physical therapy. Such a program mitigates the risk of unnecessary hospitalizations and ensures continuity of care.

Conversely, homecare services focus on daily support and maintaining a predictable routine, which is crucial for individuals with dementia. Social caregivers assist with personal hygiene, preparing nutritious meals, paying bills, and managing household chores. They also provide companionship and emotional support, facilitating family contact and reducing feelings of isolation. This integrated model ensures that a single provider coordinates both medical and social care, thereby minimizing confusion and the risk of errors.

Guidance for family caregivers

Caring for a family member with dementia is an emotionally and physically demanding endeavor. To facilitate this process and maintain balance, a number of practical strategies are recommended.

It is advisable to establish a predictable daily routine, as individuals with dementia feel more secure and less agitated with a consistent schedule. It is equally important to simplify the home environment, ensuring it is safe and easy to navigate. This involves removing tripping hazards, installing handrails, and ensuring adequate lighting to prevent falls. When communicating, adapt your style: speak slowly and clearly, using simple sentences. When the person makes an incorrect statement, avoid direct contradiction and calmly redirect the conversation. Engaging in simple stimulating activities, such as listening to music or looking at old photos, can improve mood and help maintain remaining cognitive functions. Finally, it is crucial to prioritize your own health. Emotional support and rest are vital in preventing burnout; therefore, seeking out support groups or respite care services can provide a much-needed break for caregivers.

“CASMED” NGO: our mission and impact

The Public Association “CASMED” is a non-governmental organization in the Republic of Moldova, recognized for its pioneering role in developing and implementing integrated socio-medical home care services. Its core mission is to enhance the quality of life for the elderly, those with chronic illnesses, and individuals with special needs by providing comprehensive and personalized support.

Through the provision of medical and social support directly at the patient’s home, individuals are not forced to leave their familiar environment, which offers a sense of security and comfort. This approach restores their dignity and affirms that every life is valuable and deserves unwavering support, even in the face of the greatest challenges.