Dementia is not an inevitable consequence of ageing. Photo: Darrin Zammit Lupi

Stamping out the taboo of dementia, as well as the false belief that this disorder is an inevitable consequence of ageing and “nothing can be done” in terms of healthcare and support, lie at the core of the draft National Dementia Strategy.

Released by the government yesterday, the document strives to boost awareness, training, research and services offered for the ever-increasing number of de-mentia sufferers.

The document, which is being submitted for public feedback before it is finalised in October, will make Malta the 16th country to adopt such a strategy. It will span nine years from 2015 to 2023.

Active Ageing Parliamentary Secretary Franco Mercieca said the strategy was first drafted in 2010 under the previous administration but had been shelved due to lack of investment.

Malta Dementia Society co-founder Charles Scerri, who had penned the original document, was tasked with updating the strategy.

Dementia is an umbrella term that refers to a progressive decline in mental abilities that interfere with daily life, such as memory loss and deterioration in planning and organisational skills, accompanied by personality change.

The most common is Alzheimer’s disease. Although dementia is far more common in the geriatric population, an elderly person does not automatically develop it.

The document places heavy emphasis on early intervention and timely diagnosis

In 2010, there were some 5,200 people with dementia. This figure is expected to mushroom to 10,000 by 2030 and 14,000 by 2060.

However, the figures were misleading, Dr Scerri explained, as dementia impacted many more people, including relatives and caregivers.

The document places heavy emphasis on early intervention and timely diagnosis, not only because the patient’s level of function will be preserved for a longer period, but also because it helps patients and caregivers better cope within their communities.

People with dementia who keep living in their own residences with a caregiver incur less societal costs than those who need to be moved to elderly care homes.

The document proposes setting up a dementia intervention team – a multidisciplinary group of professionals who would help people with dementia and their relatives by providing information and care coordination (including psychological counselling) throughout the whole process.

They would also visit private residences and suggest any infrastructural modifications which would ease the life of a person with dementia.

The government is aiming to provide such services for free, Mr Mercieca confirmed.

The majority of individuals with dementia in Malta live within the community and most are willing to continue doing so for as long as possible.

With the right support, they can remain active, especially in the early stages of the condition.

The strategy therefore proposes an increase in the number of day centres specialising in dementia management and care, where family caregivers can leave their dementia-stricken relatives and take some temporary, but much needed, respite from the exhausting task of caring.

Currently, respite care is only offered at the day centre located at St Vincent de Paul. However, the service is too small to meet the demand.

Other suggestions include outreach support programmes that comprise both specialised home help for individuals with dementia, as well as respite service in the community.

Appropriate training is at the core of the strategy. Family caregivers who are responsible for the daily care of dementia sufferers need to know how to deal with symptoms like memory loss, difficulties in activities of daily living and challenging behaviour.

On a professional level there is growing evidence that, even among professionals working in specialist dementia services, the proportion of staff receiving dementia care training is low.

According to the document, coverage of dementia at undergraduate level is variable and fragmented. Modules on dementia care do not form an integral part of training for doctors, nurses and other health and social care staff who will come in contact with dementia patients.

Although a number of faculties at the University of Malta already offer courses in dementia, the person-centred model of care is rarely adopted.

The draft strategy proposes developing a number of undergraduate level study units on the medical, social, psychological and economic aspects of dementia for all health and social care students.

It also proposes that all approved medications for the symptomatic treatment of Alzheimer’s are added to the government formulary list.

The document suggests financial assistance to purchase or rent new assistive technology, and for infrastructural modifications that may be necessary within a patient’s residence.

It stresses that support should be provided to caregivers to continue working while providing care. The caregiver pension should also reflect the specific and significant financial needs of dementia care.

The document can be accessed on www.activeageing.gov.mt. Feedback can be submitted up to the end of May on dementia.mfss@gov.mt.