Below are some frequently asked questions regarding KorCare, our services and the client care we provide. Please select the question below for it’s answer. If you have other questions not featured here please do contact us.
How is Korsakoff's disorder diagnosed and what is the treatment?
Korsakoff’s Disorder generally follows on from an episode of Wernicke’s Encephalopathy – a life threatening condition resulting from thiamine deficiency most commonly caused by long-term alcohol abuse. This results in slow bleeds into the brain which can cause irreversible brain damage leading to memory loss.
Some other causes of Wernicke’s Encephalopathy could be anorexia AIDS hyperemesis gravidarum cancers that have spread through the body or gastric disturbances.
Wernicke’s Encephalopathy may be initially mistaken for being under the influence of alcohol. Signs include abnormal eye movements (nystagmus) difficulty in co-ordinating body movements (ataxia) peripheral neuropathy (numbness or tingling in the hands or feet) and disturbances of consciousness including confusion disorientation and in severe cases acute coma. Immediate treatment with parenteral thiamine is required with additional ‘B’ vitamins.
These symptoms may develop quickly but it may be some days before a full diagnosis may be made.
Korsakoff’s Disorder is characterised by short-term memory loss – in severe cases the person may not be able to recall events that have happened a few moments previously.
The long-term memory may be relatively intact and the person may be able to remember events that happened in the past with ease.
Memories may be jumbled with recent events being confused with those from the past and there may be a large gap in memory prior to the syndrome developing. Insight into memory loss is poor with the person confabulating – trying to fill in the gaps with false memories but genuinely believing that they are true.
The personality of a person with Korsakoff’s Disorder may dramatically change from the person that they were before – self-neglect is common and there may be little interest or motivation in occupation. It is unusual for a person with Korsakoff’s Disorder to have any insight into their condition.
Many – although not all – show no interest in alcohol but would probably drink if it was offered without thinking about any further harm it may cause.
Risk Assessment and Safety
Due to the nature of Korsakoff’s Disorder careful Risk Assessment is essential – people are extremely vulnerable and open to abuse due to their confusion difficulty in communication and poor memory.
Risk assessment should include:
- – Orientation/Mobility
- – Personal Safety
- – Health
- – Self-care
- – Challenging behaviour – physical/verbal aggression; sexual awareness/inappropriate behaviour/disinihibition
- – Any forensic risk
- – Danger to self or others
What is the Prognosis?
It is extremely important that people abstain from alcohol and eat a healthy diet in order to halt any further damage. Gradual improvement in short term memory and other cognitive functions may occur during 1-2 years after diagnosis but further improvement after that time is thought to be unlikely.
Prognosis is often poor for people over 45 years who have developed the condition suddenly and show the severest impairment of short-term memory.
What are the prospects of recovery and rehabilitation?
Complete recovery is possible in some cases and approximately 25% may improve to resume a normal life-style providing that they abstain from alcohol.
A significant recovery may occur in approximately 25% and these people may be able to live independently perhaps with a community support network to prevent isolation.
25% may have a slight recovery but in order to return home require a high level of structured support both socially and in activities of daily living. Rehabilitation requires the re-learning of lost skills and structure in order to give shape and order to the day.
The remaining 25% show very little recovery and require 24 hour care – this may mean living in a nursing or care home. Their cognitive impairment is such that they require prompting for most or all activities of daily living and close supervision to maintain their safety. A structured environment helps to reduce confusion and disorientation and maintain stability. For this group rehabilitation into the wider community may not be possible.
My relative/friend has been diagnosed with Korsakoff's disorder. he is in hospital and they want to discharge him from hospital as he is medically fit. He is not able to look after himself and I am unable to care for him How can I help?
Be very clear about the level of input – if any – that you are able to give.
If you are able to give some time try to attend as many meetings as possible in order to keep informed about the Discharge Process and represent your relative/friend’s interest as they may not be in a position to make any decisions at this point. Issues regarding Capacity may be discussed and an Independent Mental Capacity Advocate may be appointed.
The Hospital Discharge Process should include:
An assessment of the persons needs – their current living environment and support network; a comprehensive Risk Assessment; an OT assessment; psychiatric assessment/diagnosis; a Nursing Needs assessment; a Care Plan which identifies the areas of need which should be addressed.
A care co-ordinator or key worker will be allocated to ensure that all those involved your relative/friend’s care is kept informed and up-to date with progressin finding the right care package.
Where does the funding come from to pay for the care that is required?
Funding may be accessed from a PCT (Health Authority) Local Authority or combination of both.
As part of the Hospital Discharge Assessment eligibility for NHS Continuing Care Funding may be considered by comparing Health Needs with the Health Authority’s eligibility criteria. In most cases only people with high care needs or people who need specialist treatment will be eligible for care paid entirely by the NHS.
If the Assessment concludes that the person is not eligible for NHS Continuing Care or for Rehabilitation the Local Authority will assess their needs. Services may be provided in order to support the person in their own home or it may be decided that the person requires services provided by a Care Home. Services provided by a Local Authority are not free of charge and the person will have to contribute toward the cost. The Local Authority will complete a Financial Assessment which will take income benefits and any assets into consideration when deciding the contribution.
Further information with regard to funding and other issues may be found at:
THE ALZHEIMER’S SOCIETY
Alzheimer’s Helpline: 0845 300 0336
(Mon-Fri 8.30am – 6.30pm)
Information Line: 0800 00 99 66
(Everyday 8.00am – 7.00pm)
HELP THE AGED
Information Resources Team: 020 7278 114
Information leaflets – Care Homes – Paying for your Care Home; Problems with Local Authority Funding; Community Care: Legislation, Guidance and Case Law can be downloaded from the website or ordered over the phone.