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Parallel Session P16 - National dementia strategies

Detailed Programme and abstracts

Saturday, 2 October – 14.00-15.30 (Green Room)

P16.1. The National Dementia Plan – where are we now?

Maija Juva

The Norwegian government launched the Dementia Plan 2015, Making the most of the good days in 2007. The plan focuses on three main areas: 1. Day-care programs for persons with dementia, 2. Living facilities that are adapted to patient needs, and 3. Increased knowledge and skills.

There have been some positive developments – new projects that promote day-care programs, increased education for professional carers, schools/courses for family carers, and economic incentives for local authorities to build/rebuild adequate living facilities. All in all, the results, however, seem to be rather modest. The hard reality in most municipalities is that the economic room to manoeuvre for developments in this area is limited, and when all is said and done, appropriations remain subject to political priorities.

We have been an active lobbyist at the national level and hope to see positive results from our efforts in the near future. We have been informed that the government is working for a change in legislation so that it will become mandatory for municipalities to provide adequate day-care programs for persons with dementia.

The main focus this year, however, has been on breaking barriers and raising the general knowledge of dementia in the Norwegian population. In February, the government launched a national advertising campaign to increase the general knowledge of dementia. The Norwegian Alzheimer Association has been actively involved in this campaign, by lobbying to get the government to decide upon this strategy, by generating informational materials, by printing tens of thousands of informational brochures, by increasing the workforce to man the dementia helpline, and by having our local dementia associations arrange informational meetings for the general public.

The complete presentation shows how the Norwegian Alzheimer Association and the government cooperate and how each party has its own clearly defined role in a joint effort leading to a common goal.

P16.2. Alzheimer’s Disease in Romania: the National Program for Prevention, Prediction, Personalized Treatment and Monitoring of Memory Diseases

Luiza Spiru, Ana Aslan International Academy of Aging, Bucharest – Romania, lsaslan@brainaging.ro

Background. The actual demographic changes induce, among other, a higher incidence of aging related chronic diseases, a higher degree of medical and social dependence and higher healthcare costs. Among the old-age chronic diseases, dementias and especially Alzheimer’s dementia are true challenges for medicine and for society. Alzheimer’s Crisis is a reality that requires sustained research, healthcare and economical strategies able to ease social and family burden, concomitantly with the improvement of life quality of people with dementia. The ubiquitous correlate of dementias, from the Mild Cognitive Impairment (MCI) to the most severe form of Alzheimer’s Disease (AD), are memory disturbances. Research and early detection of these disturbances are critical for the successful preventive, predictive and personalized medical and non medical interventions.

Methods. In accordance with the “Communication from the Commission COM(2009) 380/4 to the European Parliament and the Council on a European initiative on Alzheimer’s disease and other dementias”, launched in July 2009, and the imperatives stipulated by its section National dementia strategies , we initiated and submitted to the Romanian righteous governmental institutions the draft of a National Program for Prevention, Prediction, Personalized Treatment and Monitoring of Memory Diseases. We are presenting the main items of this draft tailored on the realities of memory diseases and their medico-social attempt in our country.

Results. The study “Alzheimer’s Disease in Romania” performed in 2005 by Pfizer and GfK Romania shows that only 88% of the 300,000 people with AD are under treatment, while 8% withdrawn the treatment and 4% were never treated. Caring for people with AD is usually a family task, since the number of specialized long-term care institutions and community services is dramatically low, covering only 10% of requests. Specific care workforce in Romania must be drastically improved. Sixty seven percents of specialists and 70% of general population consider that memory disturbances are a natural aspect of old age, resulting in the delayed presentation to the specialist. Ninety one percent of caregivers, however, consider AD as the most severe and costly illness. About 50% of caregivers benefit from public financial support; 78% of caregivers characterized themselves as extremely tired while 61% of them felt extremely stressed. Early diagnosis must also be drastically improved: only 56% of general practitioners use specific cognitive and functional tests and only 11% use computerized tomography.

The National Program for Prevention, Prediction, Personalized Treatment and Monitoring of Memory Diseases we proposed deals with measures able to amend all of the above plus other critical particularities of medical and social assistance of memory diseases in Romania, which are presented.

Conclusions. Despite the prolonged and ongoing political transition and despite the effects of worldwide financial crisis, Romania is striving to amend medical, social and economical problems related to the improvement of dementia care and to align the local health politics to European trends and to the best practices in the field. Our National Program for Prevention, Prediction, Personalized Treatment and Monitoring of Memory Diseases could be an important step forward in this respect.

P16.3. Integrated Dementia Care effective from a clients point of view

W.M. Werkman, Alzheimer Nederland, Netherlands, w.werkman@alzheimer-nederland.nl

In regions where the dementia care is well integrated, the care for people with dementia and their informal carers is delivered quickly and is well adapted to their individual needs. These are the results of a study amongst 434 healthcare professionals and informal carers, conducted by Alzheimer's Netherlands, the Dutch Patients & Consumers Federation (NPCF) and a consultancy firm (Deloitte) assigned by the Ministry of Health, Welfare and Sports.

The study revealed that purchasing integrated dementia care is effective from a clients perspective in a number of ways. First of all, persons with dementia and the informal carers value the help and support they get from the casemanager so that the care they receive is well adapted their individual needs. Furthermore, the demand-driven financing of integrated care leads to a wide variety of care. In this variety of care, the clients are mostly satisfied with the support and guidance they receive form a diversity of health care professionals, the medical treatment and the activities such as daycare and meeting centres. And finally, close cooperation between healthcare providers ensures that problems are noticed earlier and solved quickly and effectively.

Although integrated dementia care works well for people with dementia and their families, the study also shows that not all problems are solved. Dementia is not diagnosed earlier, despite improved training of health professionals. People with dementia stay unnoticed if they postpone a visit to the GP. Also, the household and personal care is not well adapted to their needs, due to changes of staff, irregular visiting hours and employees who are inexperienced in dealing with people with dementia. Homecare however is very important for people with dementia as it enables them to stay at home as long as possible. Finally, the study revealed that that a proper registration has not yet been realized. Information about the person with dementia is insufficiently shared between care providers, so patients and their family have to tell the same story over and over again.

The results of this study are promising. Alzheimer Nederland will further stimulate the development of integrated dementia care nationwide. Alzheimer Nederland is in close collaboration with key organizations in the healthcare to achieve and optimize integrated dementia care. Also, Alzheimer Nederland evaluates on a regular basis the needs of people with dementia and their relatives so the care is well adapted to their needs.

P16.4. Societal, pharmacotherapeutic and policy aspects of dementia care in the Maltese islands

Charles Scerri PhD, Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida MSD 2080, Malta

Dementia is a growing concern in countries facing an ever-increase in the elderly population. In Malta, the percentage of individuals at 65 years of age and over will double by the year 2050 reaching 28% of the general population. This will invariably lead to an increase in the number of people with dementia thus bringing about a significant and continuous demand on national health care services and the society in general as most care-giving is provided by close relatives living in the community. This paper will briefly discuss research recently conducted on perceptions and organization of dementia care in Malta, pharmacotherapeutic management and the need of policy development aimed at enhancing dementia management at all levels. The results obtained were instrumental in formulating a series of recommendations that form the basis of a document containing a national plan for dementia and recently presented to the local health authorities.

P16.5. Towards a dementia action plan in Greece

Paraskevi Sakka, Neurologist- Psychiatrist, Athens Association of Alzheimer’s Disease and Related Disorders, 2 Naiadon St.Athens 11634 Greece, vsakka@ath.forthnet.gr

There are currently 160.000 people with dementia in Greece and this number is set to rise rapidly as the population ages.

Dementia has a devastating impact on people who develop it and the families caring for them. In Greece, current status of Dementia services is rather disappointing. Alzheimer’s Association along with health professionals have been striving for a long time to activate policy makers and to make dementia a national priority.

Under pressure and constant reminding, recently a Working Group was formed under the auspices of the Greek Ministry of Health and Social Solidarity to develop a Dementia action plan. It comprised health professionals, representatives of the Greek Alzheimer’s Associations, carers and patients.

The Working Group outlined three steps to be taken. First, we need to raise awareness and remove the stigma surrounding Dementia. Second, we have to ensure that people with dementia are properly diagnosed and treated. Third, we must develop services for people with Dementia and their carers which will fully address their unmet needs.

So far the Working Group came out with a report based on surveys carried out by the Alzheimer’s Associations and focus group evidence from 1000 people. We are also planning to organize stakeholders events throughout Greece starting from October 2010.

We believe that our efforts will generate principles and services that will provide people with Dementia and their carers with the help and support they need throughout the course of the disease, helping them to live of the best quality possible.

 

 
 

Last Updated: mercredi 03 novembre 2010

 

 
 

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