National Dementia Plans
Launch of the Action Plan for Dementia
In 2010, the four-year Action Plan for Dementia was launched and EUR 4 million was allocated to implement the plan. This figure is significantly lower than the amounts allocated for other disease action plans in Denmark. According to the Danish Alzheimer Society, the plan will not be sufficient to meet the challenge of a growing number of people with dementia in the next 10-30 years.
Anne Arndal, Chairperson of the Danish Alzheimer Association, comments on the Danish National Dementia Plan
The Danish National plan for dementia is now a reality. Representatives from the ministries involved and the regional and local authorities have, after consultation with various interested parties, developed a national dementia plan. It is mostly a recapitulation of what has been achieved in the dementia field over the last 10 years, in the medical field as well as in psycho-social care.
The plan “National Handlingsplan for demensindsatsen” makes 14 recommendations, the first three of which are centred around the question of timely diagnosis of dementia in all parts of the country as well as the quality of the diagnosis. The Danish Alzheimer Association has been pointing to problems securing the right diagnosis for some time.
There are recommendations for all the regions in Denmark (responsible for the hospital sector) to follow guidelines (to be made by the Danish Health Board) for a cross-sectional diagnostic procedure. Measures to improve communication between hospital, general practice and local authorities are also recommended. The aim is to avoid a loss of important information when a person with dementia moves from care in one sector to another. However, neither the regions nor the local authorities have been allocated more money to fund this. It has to be taken from the day to day budget.
On the other hand, we are pleased that a new (although temporary) allowance of DKK 8.8 mil lion (around EUR 1.2 million) has been secured to fund the National Centre for Knowledge on Dementia over the next three years. The centre plays an important role in the implementation of good quality diagnosis and of care, as well as being a driving force in research and education.
Eight recommendations focus on the care for people with dementia and their informal caregivers. Much of the new knowledge on how to implement activities to make everyday life better for people with dementia is obtained through temporary projects paid for by the government. This is problematic as the activity is started with “project” money and it can only continue on a permanent basis if the local authorities have money to continue the activity. Therefore, these activities will often have to stop with the result that what was learned from them is lost.
The National plan recommends establishing a way of sharing experience of “good practice in dementia care”, which we naturally welcome. However, how this is to be implemented is not quite clear. We also welcome the focus on new assistive technology in the coming years.
It is suggested that work should be done to inform people with dementia that they can carry out advanced care planning, providing guidelines for future caregivers. This is not very often done in Denmark at the moment.
Ongoing endeavours to minimise the use of restraint in the care of people with dementia should continue. The Danish Alzheimer Association had for some time been discussing the question of restraint in connection with treatment of a medical or surgical illness. Adhering to the present very strict rules can lead to situations of neglect. We are thus very happy that the group behind the report recommends looking into the possibility to create more “workable” rules.
Only one of the fourteen recommendations addresses the education of nurses, and of staff in general involved in caring for people with dementia. It is suggested to intensify in-service training for qualified staff. This is a responsibility for regional and local authorities. But, again, no extra money is coming forth from the government, as far as we can see.
The report does not address the problem of a growing number of people with dementia and a falling number of younger people to look after them. However, it does suggest to make better and a more systematic use of patient organisations and volunteers to create better daycare and relief facilities for people with dementia and there carers.
The last recommendation is to conduct a countrywide awareness campaign, as was last held in 2007 and 2008.
In conclusion, the National plan focuses more or less on the same problems as in other European Dementia plans: timely diagnosis, self-determination for the person with dementia, unbroken “care chain”, better possibilities for the relief of informal carers, balanced view on assistive technology, destigmatisation.
The plan is, unfortunately, not very well funded. About EUR 750,000 is allocated to be used each year over the next four years. This is on top of the money for the National Centre for Knowledge on Dementia.
This article first appeared in Dementia in Europe magazine, issue 7, March 2011
Last Updated: mercredi 18 juillet 2012