Patient Info

What is the procedure to register for a OPD (out-patient) visit?

New patients are seen on all days (except Sunday and days when whole OPD is closed) in Gate 1 room No. Geriatric First Contact OPD (Rooms No 903, 904, 905). Registration happens in screening/ registration block from 8 am to 11 am and costs INR 20.

 

How long does it take for first consultation?

The whole process of first visit may take up to  2 to 3 hours and screening runs until 3 pm approximately. It all depends on how many patient is in queue before you. The duration may increase in the following circumstances-

*If you have to get a referral to another specialty within Nimhans
*If some investigations (blood tests, brain scan etc) has to be get done on the same day
If your/ your relative’s case has to be discussed with a senior consultant.

What should we bring with us when coming for consultation?

Please bring all the previous medical records and tests done with you. Please bring all the medications that patient is taking daily (empty or filled strips of them)

Should the patient come empty stomach?

We suggest that the older adult/ patient comes after having breakfast and morning medications. Any investigation required to be conducted empty stomach can be done at the later date. Please also get water and something to eat along with afternoon medications in case it gets prolonged.

Can somebody come alone?

Yes. One can come alone but it would be better if someone who can be trusted and has idea about the patient comes along with the patient.

Who should come with patient?

We can provide you best services if the person who stays with patient or knows the patient most accompanies to give maximum information.

Can a visit be made without the patient?

Yes, the visit can be made without patient and just with records and information. But, our recommendations and suggestions would be made only after the patient’s visit.

What happens at the end of first visit?

At the end of first visit, a tentative diagnosis is made based on which treatment is planned including medications and investigations.

We also give the Appointment date for next visit which may be either the follow up of review effect of today’s plan or work-up is planned to see your case in more detail.

Sometimes, referral to other departments or General hospital or referral to emergency department may be given.

In few cases, we may advise admission for in-patient care directly.

How to come for follow-up?

Registration for a follow-up visit happens between 9am to 1 pm at Gate 2 G13/ G15 and costs INR 10.

This and all subsequent visits would be scheduled on one among following days (every Tuesday, Wednesday and Saturday except second Saturday). For these visits, you need to come to G13/G15 with procedure same as for 2nd visit.

From 2nd visit onwards, patient coming with appointment would be given preference. You need to come within in half an hour before the scheduled appointment. If you need to change the date/ time of appointment, please call the number provided to you at the time of appointment.

Currently, we don’t have facility to book appointment through phone or online. Once it is available, it would be updated.

What happens in follow-up visit?

As indicated earlier, you may be called for

  • Regular follow up: It may get over in an hour; usually Tuesday, Wednesday or Saturday
  • Detailed Evaluation: It may take 2-3 hours as after taking detailed information, it would be discussed with senior doctor; usually Tuesday or Saturday

Is there any preparation required from our side when we are called for Detailed Evaluation?

Please bring the screening slip and all other medical records (doctors’ consultation, prescription, tests reports, records of any in-patient stay if any) with you for work-up. Even if you had shown these documents in 1st visit, you still need to bring them once more. It is recommended that the person who stays with patient the most or knows most about the patient should come along.

Reports of any blood tests or scans advised must be brought with you. If blood tests and scans are done in NIMHANS, we can see the reports in our computer. But ECG when done in NIMHANS, will be given in your hand. So, please bring it with you.

If a referral to other specialty within or outside NIMHANS was asked, please get records of that visit as well.

If a file is made, please bring the card bearing your file number with you for accessing your file from our records section.

Can I show to a particular doctor of my choice in first or subsequent visits?

Please express your wish if you have so. We would try to get you shown by doctor of your desire. But it depends upon the availability of that doctor on a particular day. Nonetheless, we would make sure that the continuity of treatment is maintained for you/ your relative and you get the best consultation.

Is there any concession for those who have BPL card?

If you have a BPL card from Karnataka, you can avail BPL concessions in investigations and some free medications. For this, a file needs to be opened in your name. This is done in G6 of OPD after the doctor writes the instructions. Please bring original and 2 xerox copies with you and show in G6 counter at the time of file opening.

What are the places inside NIMHANS where the elderly patient be referred to?

They are as follows*

  • Admission counter G6 in. OPD for file opening, BPL seal and admission
  • Blood sample collection and Injections G1 in Gate 2 OPD
  • Cash counter G4 in OPD
  • ECG – B- Block Psychiatry ground floor
  • Imaging investigations – G21 in Neuro-centre
  • Neurocasualty – Main Emergency
  • Neurology referral: F1 in gate 2 OPD (first visit to neurology)
  • Neurology review: F2 in Gate 2 OPD (subsequent visits to Neurology on the respective unit follow-up days)
  • Neurosurgery referral: Gate 3
  • Neuropsychology test/ referral: Neuropsychology Room in Ashwini Block
  • Psychiatric emergency – Psychiatry Short Stay Ward (Inside POGW Building and beside Main Emergency)
  • Speech pathology and audiology for hearing, speech and swallowing assessment – G14 Gate 2 OPD

*Some places might have changed secondary to Covid-19 situation

What if I don’t bring my screening slip, and other consultation records of Nimhans when I come for subsequent visit?

It’s preferable to bring the screening slip. Otherwise old prescription might contain your Unique ID (UHID) which will help us to trace some details which are stored electronically. If none are available, you might have to make a new slip. After 1st or later visits, your NIMHANS record would be stored in a file with Unique registration Number. This is mentioned in a Card, which is called NIMHANS Registration Card. Keep it safely and you may laminate it. Please keep the details of that card with you for eg as taking its picture. This can help us to retrieve your medical record details even if you have lost the card. If you have any other medical record from NIMHANS such as prescription slip, investigation slip, or discharge summary.

What is the benefit of providing the mobile number details?

It is very important to register your correct mobile number when screening slip is registered. If in future, you change your number, please inform our treating team. The correct mobile number helps us to contact you for telepsychiatry services, send you messages about appointment and other details and also can be helpful to retrieve your medical records.

What to do if we miss the given follow-up date of appointment?

If you are aware in advance that you would not be able to visit on the scheduled appointment, please call at the contact number provided at the time of appointment to reschedule it. If you miss the follow-up date due to the other reason, please contact at the earliest to reschedule the missed appointment. If you cannot reschedule it, visit us on the next closest OPD day as walk-in appointment, In any case, continue the medications until your next visit.

What to do if there are side-effects with medications?

The most common side-effects with medication will be explained to you when medication is started. If an unexpected effect happens after starting medication, please visit us in OPD at the earliest. If you cannot wait till then, then either come to Psychiatry emergency (Short stay ward, SSW) or visit your nearest physician/ psychiatrist.

When will a patient be admitted in NIMHANS under Geriatric Unit?

“There can be many reasons for admission as stated below. Your treating doctor in First Contact OPD or at G13/G15 takes the final call on admission based on his/ her observation of the patient, information given by accompanied caregiver and available medical records. Please check with the doctor about the reason for admission in your case.

  • Suicidal tendencies
  • Aggression
  • To clarify the diagnosis or the cause
  • Unmanageability at home
  • Not getting better with OPD based treatment

Where will a patient be admitted?

We have ICU, general wards, special wards with 6 bedded, 4 bedded, 2 bedded and single rooms for in-patient care. Patient can be admitted in any of the above stated wards depending on the availability, affordability and need of close supervision

Do I need to initiate some process to avail any kind of rooms?

Currently, there is no waiting process for any kind of room. It is filled based on the availability. The treating team will try to coordinate with their best efforts if no bed is vacant when admission is required in your case. For single rooms, there is a procedure for applying and availing it when it is vacant. Details would be informed to you when admission is warranted in your case. Currently, there is extra need of Covid testing before admission due to Covid-19 pandemic situation.

How long does an admission last?

Average in-patient duration under Geriatric Unit is 2-3 weeks but can vary depending on the condition of patient and reason for in-patient care.

Can anybody stay with patient?

A family member must stay with the patient 24 hours and will be responsible for the patient’s whereabouts, security and informing nursing staff and treating team in case of clinical downfall. The relative is provided with a separate cot in all kinds of rooms. The visitors cam visit in specified time, which s now restricted due to Covid pandemic. Sometimes, some specific family member would be called by the doctor to get particular information about patient’s illness.

Can anybody stay with patient?

A family member must stay with the patient 24 hours and will be responsible for the patient’s whereabouts, security and informing nursing staff and treating team in case of clinical downfall. The relative is provided with a separate cot in all kinds of rooms. The visitors cam visit in specified time, which s now restricted due to Covid pandemic. Sometimes, some specific family member would be called by the doctor to get particular information about patient’s illness.

Will the food be provided?

Hospital food is available for free for BPL patients and paid patients can opt for it.

What are the benefits available for a BPL patient?

BPL patients get food, medication and some tests for free. Other tests, bed cost is charged at subsidised rates. To avail the benefits of Aayushman Bharat or Karnataka Aarogya Card, please inform the doctor at the time of admission itself.

How frequently does a doctor see a patient during admission?

One doctor is assigned to the case comes and sees the patient at least once every day. He is further supervised by one or two doctors who takes update from hm and sees the patient at least once a week. Besides, other mental health professionals also gets involved in the treatment and sees the patient according to their role.

What are psychiatric emergency services?

Psychiatric emergency services are the clinical services which is available 24 hours a day and 365 days a year to handle the clinical psychiatry issues requiring urgent intervention and cannot wait for the regular opening of OPD services. This service runs in Psychiatric Short Stay Ward (SSW).

What is the procedure to come to emergency?

For any psychiatric emergency, you need to come to Main Casualty of Nimhans and informed the concerned doctor about psychiatry emergency needs. From there, you will be directed to Psychiatric SSW. If you are already showing to any department in Nimhans, please bring your related medical records including Nimhans registration card.

What kind of emergencies are treated here?

Psychiatric emergencies like suicidal attempt, aggression, agitation, unmanageability at home, significantly reduction in food and water intake are handled here In case of head injury, stroke, seizures or any neurological emergencies, the patient would be seen by doctors under neurology or neurosurgery department emergency services in main casualty. Non-neurological medical emergencies are better handled in general hospitals.

What counselling/ psychotherapy services are available?

Some patients might require psychotherapy with or without medications for their psychiatric issues. We have Behaviour therapy unit and Family therapy Unit available, which provide psychotherapy to the patient and the whole family respectively. Some patients might be given appointment for psychotherapy by treating doctors themselves or the mental health professionals outside the above mentioned therapy units. Psychotherapy occurs both during in-patient care and on outpatient basis. OPD based psychotherapy usually happens once a week with the date and time convenient for both patient and psychotherapist. A psychotherapy session usually lasts for 45-60 minutes and patient should come just 5 minutes prior to the scheduled appointment. The psychotherapy lasts for an average of 12- 15 sessions. The number and frequency of therapy sessions would be decided by the therapist after discussion with you. As stated in VayoManasa Sanjeevani, online psychotherapy sessions have been initiated for these psychotherapy services in some cases.

What are Tele-After Care (TAC) Services? How to avail them?

NIMHANS has a tele-medicine Centre which offers Tele-After Care Services. Any patient who has been evaluated in detail by our team if eligible will be offered TAC services. Under these services, patients will be followed up by their respective doctors by video conference and prescription is sent by email. To be eligible for this service, patient or family members must be from distant places with difficulty commuting to NIMHANS regularly, have a working internet connection, a smart phone or tablet or laptop and be able to follow directions given by our team to establish a connection when required. Patients with coexisting medical and neurological issues might have to be examined physically regularly and might not benefit from TAC services. Considering the current Covid- 19 situations, we have initiated telephonic and video consultation follow-up services for regur patients as well. Please ask about this to your doctor during the 1st or later visits to geriatric clinic.

What are Neuropsychology services? How to get detailed memory assessment done?

The neuropsychology services pertain to the detailed assessment of memory and other cognitive functions , one of the reasons for which is dementia. The need for memory and other tests would be decided by the treating doctor. Then the patient would be referred to the Neuropsychology team at their office, Ashwini Block. There, the patient would be given appointment date for the testing. Based on the waiting list, the appointment date may get delayed to few weeks. On the appointment date, the patient should come at the scheduled time. The testing may take 1-2 hours. He may be given a break of few mines in between if required. The formal report takes some more days to come. Based on the report, the patient may be advised memory and cognitive training after discussing with treating doctor. Currently, the assessments are on hold due to Covid-19 situation.

What rehabilitation services are available in NIMHANS for elderly patients?

Occupational rehabilitation is available for in-patients in DPNR building. Various sections are available for patients to choose from as per their interests to spend for an hour every day. In addition, Neuropsychology team, Psychiatry rehabilitation team and Psychiatry Social Work team provide guidance for cognitive rehabilitation and daily activities, particularly during in-patient stay. In addition, Library is open from 10 am to 5 pm for patients in Psychiatry department

Are there physiotherapy services? How to avail them?

Physiotherapy department, DPNR Buidling offers physiotherapy services for chronic pain, gait and balance training. It’s done on appointment basis. Neurorehabilitation services offers rehabilitation for post stroke deficits, evaluation of lack of control of bladder and bladder training services. You can discuss with your treating doctor, who can refer to you to the suitable department.

Is yoga training available? What are the complimentary medicine services available?

NIMHANS Integrated centre for Yoga offers yoga training for in-patients on daily basis for an hour per day for older adults. In addition, we have the department of Complimentary Medicine, which offers the services for yoga through NIMHANS Integrated centre for Yoga and Ayurveda services in OPD as well as in-patient. Their OPD runs now for 3 days a week (Monday, Thursday and Friday) in G-13, OPD Block.

What are Brain Stimulation services?

We offer various brain stimulation services for patients as a part of treatment. The available services include Electroconvulsive therapy (ECT), repeated Transcranial Magnetic Stimulation (rTMS) and Transcranial Direct Current Stimulation (tDCS). Electroconvulsive therapy services occur 6 days a week and is provided by a multidisciplinary team consisting of Anaesthetists, psychiatrists and nursing staff.

Transcranial Magnetic Stimulation (rTMS) and Transcranial Direct Current Stimulation (tDCS) services are Non-invasive brain stimulation services that are given as add-on to medication for some patients for mood and memory issues. Based on the clinical need, these services would be offered to the patient. Or else, you can enquire further details about them to your treating doctor.

Does NIMHANS accept Brain donation?

Neuropathology department of NIMHANS welcomes brain donations from patients and healthy volunteers post-mortem. Kindly consult your doctor or visit Human Brain Bank, Nimhans.

Will all the medical needs of an older adult be handled at NIMHANS?

NIMHANS has Psychiatry, Neurology and Neurosurgery services available. For general medical conditions patients need to consult the respective doctors.

What to do if patient needs to visit a different doctor for other problems?

Except for a few medications, most of the medicines we prescribe can be safely taken with other medicines. We would also discuss with you the other medications you are taking concurrently. Kindly inform about all medications and nutrition supplements being taken by the patient. To be safe, it is also recommended to show the physician our prescription.