Empowering change : a national strategy for dementia in the Maltese islands 2015-2023

Abstract

Dementia is a term describing a number of conditions characterised by progressive deterioration in mental functions including memory, judgement, communication skills and behavioural changes serious enough to interfere with daily life. Although dementia becomes increasingly more prevalent in the senior adult population, early onset dementia may occur and is frequently misdiagnosed. In the Maltese Islands, 6,071 individuals will have dementia in 2015, a figure equivalent to approximately 1.5 per cent of the general population. As the population ages, the number of individuals with dementia will increase significantly such that by the year 2030, it is projected that 9,883 individuals will be affected. It is well recognised that dementia presents a psychological and financial challenge both to those with the condition as well as their caregivers and family members. This strategy aims to implement a number of measures in the various areas of dementia management and care with the overarching aim of: Enhancing the quality of life for individuals with dementia, their caregivers and family members. This strategy is a continuation of previous work carried out by the Malta Dementia Strategy Group on recommendations for a dementia strategy in the Maltese Islands presented to the authorities of Health in January 2010. It is also a reflection of the latest developments in the field of dementia management and care. The key objectives presented in this strategy include: Increasing awareness and understanding of dementia. One fundamental aspect of this strategy is that of increasing awareness and understanding of dementia among the general public and healthcare professionals in order to reduce stigma and misconceptions about the condition. Information campaigns will be launched that will seek to provide information about dementia, measures that aid prevention, the importance of timely diagnosis and services that are available in the community and elsewhere. It also aims to provide adequate knowledge on dementia to non-professional sectors of the population including service providers that come into direct contact with individuals with dementia: Timely diagnosis and intervention. Early symptom recognition and interventions through appropriate referral pathways together with the necessary pharmacological and psychosocial support offer the best possible management and care for individuals with dementia. This strategy also encourages the development of advanced care directives. Workforce development: Good quality care will be ensured through the provision of training and educational programmes for staff working with individuals with dementia, giving particular importance to challenging behaviour and palliative care. Caregivers and family members who are responsible for the daily care of individuals with dementia will also be provided with adequate training in order to offer the best quality care and help them cope with new challenges. Improving dementia management and care: A holistic approach in service provision for individuals with dementia, their caregivers and family members will be adopted. Apart from providing all pharmacotherapeutic options to Alzheimer’s disease patients, individuals receiving a diagnosis of dementia will have care plans developed by a multidisciplinary team specialised in dementia management and care. These will address activities that maximise independent living, adapt and develop skills, and minimise the need for support. This, together with a rehabilitation service for those with other comorbidities, will seek to better equip the patient to return to the community. The strategy also aims to strengthen community care for individuals with dementia and their families so that services are closer to the people who need them. The individual with dementia as well as the caregiver and family members need to be viewed as a single unit requiring appropriate care and support. The proposed creation of a Dementia Intervention Team will serve as a single point of referral for individuals with dementia and their caregivers and will help in providing the most appropriate support according to the family’s needs. Provision of different forms of respite services and the availability of outreach support are being seen as central in achieving quality care in the community. The following strategy also aims to create extra dementia units in community care homes. Regular monitoring of homes in order to ensure high standards of care and the gradual incorporation of dementia-friendly measures are also addressed. Ethical approach to dementia management and care: This strategy aims to promote an ethical approach to dementia management and care and provide individuals with dementia and their caregivers with the necessary psychological support needed in making important decisions regarding their health and welfare.