Dementia is a national challenge

The International Day of the Elderly was marked yesterday. Undoubtedly, focusing at least for a day on a growing sector of the population whose needs are also constantly increasing is not a waste of time. Thirteen per cent of the population is 65 years and over. By 2050, this percentage will rise to 28 per cent. Is this is merely a game of numbers? It certainly is not. Numbers have a meaning.

It is a known fact that, thanks to the advancement of medicine and a general improvement in the quality of life, people are living longer. However, this also implies that the needs of this particular segment of the population are bound to increase as people grow older. The nature of these needs is varied, however, I am restricting myself to focusing on a particular condition, which may accompany old age and is fast becoming a global issue: dementia.

Dementia is a condition characterised by a progressive decline of mental abilities accompanied by changes in personality and behaviour. There is commonly a loss of memory and skills that are needed to carry out everyday activities. As the condition progresses, these persons become more fragile and dependent on those who care for them. A sufferer may even live up to 10 years with this condition. The challenge of retaining such persons in the community, which means living on their own, becomes quite daunting. On the other hand, family members who take it upon themselves to take care of a relative suffering from dementia end up burnt out.

The impact of dementia is significant both on the people that develop it and the families who care for them. A report by the World Health Organisation points out that disability from dementia was accorded a higher weight than that for almost any other condition.

Dementia contributed 11.2 per cent of all years lived with disability among people aged 60 and over; more than stroke, musculosketal disorders, cardiovascular disease and all forms of cancer. It is estimated that over six million people in EU member states have dementia. In Malta, the figure exceeds 4,500 individuals and that is expected to double in the next 25 years.

At a European level there is much concern about this disease. Countries like the UK, France, Norway and Germany are working hard to make dementia the number one health priority. This disease rips the socio-economic fabric of individuals and the relatives. Moreover, it is bound to cost the country more than cancer, heart disease and stroke put together.

This is why I feel we should make dementia a national priority. The setting up by the government of a National Dementia Strategy Group with the aim of making recommendations as to how we, as a nation, will be providing care both to sufferers and to the relatives who support them in the years to come. Preliminary results of a survey carried out by the group, led by Charles Scerri, point to a lack of awareness of the disease, how it can be treated and the services aimed at persons with dementia and their carers.

There is a lot of stigma associated with this condition, which adds to the misery of sufferers and, particularly, of relatives. The strategy group will now be consulting stakeholders.

Unfortunately, available data points to a general lack of awareness of this condition in Malta. This has often led to a late detection of the condition. It is also evident that there is a shortage of local experts in this field, which we need to address quite urgently. The same data is showing that there is a shortage of specialised centres where sufferers could get the necessary treatment. Although as a country we have invested heavily in health and elderly care for the last 25 years, we have still a long way to go. The homes for the elderly, which the government built in the 1980s and 1990s mainly for independent older persons, need to be adapted to the needs of a growing number of dependent people who are mostly in their late 80s and 90s.

Facilities being built now are taking dementia into consideration. A few days ago I had the opportunity to visit a new wing at St Vincent de Paul Residence. This new wing was specifically designed to cater for residents suffering from dementia, and which uses the colour and photo concept that is today widely used in the care of dementia older persons. The private sector is also investing in this sector. CareMalta will be opening a new home for the elderly in Attard next year, part of which will consist of a special care unit for dementia sufferers. It will complement a similar unit the company operates in Rabat.

Available data shows very clearly that families of elderly persons with dementia suffer a lot. Those who decide to take upon their shoulders the care of their relatives end up caring for their loved ones 24/7. About 60 per cent of these informal carers end up suffering from a form of depression or breakdown. Very often these families have to pay hefty prices for medicine that slows the onset of the disease. Unfortunately, this type of medicine is still not given out as part of the Schedule V scheme, so the financial burden has to be carried by the elderly or their relatives. The total expenditure can add up to €160 a month, a substantial part of the pension received by many of those affected by the disease, who also, very often, have to buy other medicines for other medical conditions.

I look forward to a discussion of a national dementia plan sometime in this legislature. Undoubtedly, Malta has established a good reputation in the elderly sector in the last quarter of a century, so much so that the United Nations opened an International Institute on Aging in Malta in 1988. The number of services introduced in the same period is impressive. Now we need to gear up for the challenges ahead. We cannot afford to fragment the available resources. The government, the Church and the private sector and the elderly and the families themselves need to be roped in a national effort to ensure that Malta becomes a centre of excellence for care in dementia. We should also involve NGOs who have been working in this sector for a number of years, particularly the Malta Dementia Society, which has been doing sterling work in providing information on this condition to the public, to professionals, to the relatives and to the elderly themselves.

Charlo.bonnici@gov.mt

Mr Bonnici is a Nationalist member of Parliament.