Daily Archives: 15/11/2016

Korsakoff’s syndrome treatment model (DDN feature)

korsakoff-syndromeToday I’m re-sharing from Alcohol Policy UK their feature post on Korsakoff syndrome (or Wernicke-Korsakoff syndrome).

This month’s Drink and Drugs News (DDN) includes a feature article exploring a new model helping Korsakoff’s syndrome sufferers back to community living. The article states:

Korsakoff’s syndrome belongs in a spectrum of disorders categorised as alcohol-related brain damage (ARBD). It is a severe memory disorder associated with excessive, long-term alcohol misuse, and results in the loss of specific brain functions due to the lack of vitamin B1 or thiamine. Post-mortem studies suggest that Korsakoff’s occurs in about 2 per cent of the population and 12.5 per cent of dependent drinkers.

However owing to limited resources and low level recognition of ARBDs, specialised service provision is particularly limited. The Arbennig Unit – part of Queen’s Court Residential Service in Conwy and run by care provider Potens – was set up in 2002 to support younger adults with alcohol-acquired brain injuries. The service aims to provide a people with Korsakoff’s opportunities for choice and independence, with the Arbennig clinical support model based on the idea that rehabilitation should aim towards a structured, alcohol-free life.

The feature says Korsakoff’s sufferers often have a chaotic lifestyle with little, if any, of the social support networks that many people take for granted. In response the Potens’ support model looks at involvement of key professionals, but does not underestimate the importance of family and friends. Korsakoff’s sufferers health has also often also been compromised by poor diet and underlying mental health issues can become more pronounced after a period of abstinence. 

However Glenn Barnett says Korsakoff patients are capable of new learning, particularly if they live in a calm and well structured environment and if new information is cued. Read the full article including case study here.

Specialised ARBD services: a rare find?

What with shrinking drug and alcohol treatment budgets, increased scope for specialist services is unlikely. Indeed a 2014 report by a collection of medical bodies called for clinical commissioning groups to support services that provide specialist care for patients with alcohol-related brain damage. It identified the scope for provision within four specialist contexts: alcohol treatment services, prisons, acute hospitals and pregnancy/fetal alcohol spectrum disorder (FASD).

In 2014 Alcohol Concern Wales also released a report warning ARBD is poorly understood by the public and many healthcare professionals, emphasising the need for early identification and treatment. Further training and clear care pathways for the diagnosis and treatment of ARBD were also recommended. However in the current context of growing populations and shrinking resources, specialist ARBD responses are likely to remain the exception rather than the rule.

I nursed many patients with this disease on the ward and even now in the community we are involved in the care of those with Korsakoff, known more colloquially as alcoholic dementia, where they sadly invariably end up on residential dementia units.