Rise in Dementia Cases Provides a Challenge for Wales

By Sian Owen, Western Mail, walesonline.co.uk

May 11, 2009

United Kingdom 

We read many alarming health statistics on a daily basis – some of them reliable, others less so.

But there are some statistics that we cannot ignore including those from the Alzheimer’s Society that there are 37,000 people living with dementia in Wales. This figure is set to rise by 35% over the next 20 years. One in three people over 65 is expected to die with a form of dementia.

With this in mind, it is no surprise that the director of the Alzheimer’s Society in Wales, Ian Thomas, has called dementia “the health and social care challenge of the century”, and it is a challenge that we in Wales must meet.

Health Minister Edwina Hart, has given a group the job of developing a national dementia plan for Wales.

The decision has been widely welcomed. The Department of Health in England carried out a similar piece of work, published earlier this year, which outlined their steps towards better care for people with dementia.

The group set up here in Wales will look to provide solutions based on the Welsh health system – which is becoming increasingly different to the English NHS – but there are overarching principles in the English strategy that apply wherever you are in the world.

The first issue we must tackle is to raise awareness and understanding of dementia, so we can increase the number of people seeking help and achieving early diagnosis. Only a third of people with dementia receive a formal diagnosis at any time in their illness. Perhaps one reason for this is the stigma that many people still feel surrounds the issue.

There is also a training challenge to address with our GPs and health professionals. The department’s research unearthed a low priority being given to developing the necessary professional skills to care for people with dementia, and a widespread mis-attribution of symptoms to “old-age” among professionals.

The effect of these factors is that people wait up to three years before reporting symptoms of dementia to their doctor. When diagnoses are made, it is often too late for those suffering from the illness to make choices.

We need to overcome these barriers to early diagnosis, and use public awareness campaigns to encourage people to get to their GPs sooner rather than later.

What also becomes clear on reading the Department of Health’s strategy, is that once a diagnosis has been made, people with dementia need personalised care that encompasses all of their needs; not only their health needs, but also their personal and emotional needs as well.

For example, it may seem like a small thing, but many people were unhappy with the way the news of their diagnosis was broken to them by the health professional involved. The strategy outlines steps to make sure that the diagnosis is given sensitively by an appropriately qualified person, and backed up with sources of further support.

There are also actions outlined to help carers build up relationships with the people they care for, train more healthcare staff in dementia care, create peer support networks, and find ways to give family carers respite breaks.

Being able to create this kind of holistic care for patients requires close working between primary and secondary care, and social services. Patients do not separate their social and health needs, so neither should we as care-givers.

The current reorganisation of NHS services in Wales looks set to make our health services more integrated across primary and secondary care. The new local health boards will be determined to build on the good partnerships between health and local government, put in place by their predecessors.

The dementia plan being developed here in Wales will take into account the differences in healthcare systems between Wales and England. With an emphasis on closer working between the different parts of the health and social care system, patients will begin to feel the benefits of more seamless care.

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