An article in the Wall Street Journal on 17 October 2012 is headlined “France Seeks New Ways to Manage Alzheimer’s Care” and goes on to describe the recent initiative that is funded to the tune of US$2 billion that includes an emphasis on psychosocial care, training of doctors and nurses, supporting families, creating memory clinics and tracking progress to determine the most effective strategies.
Sounds like a good plan from France. Interesting how unaware the author (Shirley S. Wang) is of Australia’s current national response and history of national plans over nearly 20 years. As much as we have problems with our situation it is light years ahead of many countries, particularly with respect to the existence of well established health structures such as memory clinics, respite and transitional care programs, accreditation standards, national government funding and a growing community care sector which does not even exist or exists in a very rudimentary and privately funded manner in many European countries.
I was at the International Implementation Group Meeting of Dementia Care Mapping in Singapore last week. Thirteen countries sat around the table and each reviewed their situation. Many lack community care or much of a focus on psychosocial care. Some are as advanced as we are. One of our benefits is having a national scheme. The US has 52 schemes with most aged care and more specifically dementia care state based and regulated. Try pulling that together. Some US states do not even have any training required of care staff before they get a job in aged care. Proprietors can commence providing care in a private house without regulation in some states. Many European countries rely on church based or private philanthropic organizations to provide dementia care resulting in regional or town based solutions at best.
Following our meeting we were all guests of the Alzheimer’s Disease Association of Singapore to present at a Symposium on person centred care to 300 participants. They and the other international representatives shared struggles with problems in dementia care and culture change that are universal. How do you get a group to embrace a “restraint free” approach, how enlist the cooperation of all staff in improving care quality, how provide for all people including those living at home. How best communicate with someone with dementia? What does quality of life look like in an older person with dementia? How deal with the growing “grey tsunami” of older people?
We are about to move to the next solution that will be based on the work of the Productivity Commission. This will no doubt throw up challenges but then we can draw on a history of progress and national development that will assist us to make the next steps. We certainly have problems in our model of care in Australia but it is far better than many countries.