It is indeed heart rending to witness the advancing symptoms of a disease that slowly but surely sucks the personality out of a person. A once bright, sharp-witted and sociable character is reduced, in the latter stages, to a blank, confused and totally dependent state.
This is what dementia does. It is literally the slow death of a brain, as cells die off, but also of a mind, of what once made a person who s/he was: memory, thinking, emotions, communication, behaviour. All these go through drastic changes over the years, rendering the individual not only unable to recognise the people s/he once held so dear but also unrecognisable. It is a painful, tragic experience for both close friends and family members.
In 15 years’ time, it is estimated that 10,000 Maltese people over 60 will be afflicted to varying degrees by this sad and terrible condition, up from the present 5,000-6,000. Hence, the need for a national dementia strategy, recently published for consultation. This is the result of a cross-administration initiative, having been set in motion under the previous government and brought to fruition by the present one.
It also stems from a recognition within the EU of the pressing need for action to tackle what is not only a growing financial burden on families and carers but also on the public purse in terms of medical costs. In this country, the total estimated expenditure on dementia is about €70 million and growing.
The stated aim of the strategy is to “enhance the quality of life of individuals with dementia, their caregivers and family members”. It outlines the measures that need to be taken, such as raising awareness and understanding of the condition, improving the quality and reach of information, ensuring early diagnosis and intervention, developing a specialised workforce, providing medication and other forms of treatment and improving both residential and community services.
The old adage, prevention is better than cure, does not quite apply fully to dementia because there is no cure, only the slowing of its progress, once it has set in.
The part about prevention certainly holds true, however. It is an aspect the strategy covers and which will go some way towards reducing the number of sufferers in early old age.
The message needs to reaches the general population: just as lifestyle changes can lower the risk of diabetes, obesity, heart disease and so on, the probability of getting certain forms of dementia is likewise reduced, or its onset delayed, with physical, mental and social activities and a healthy, balanced diet.
Comprehensive though the draft strategy is in proposing how society can become more dementia-friendly, one aspect it touches on requires closer study and urgent action. People with dementia are extremely vulnerable to neglect, manipulation and abuse by unscrupulous caregivers and others, whether in a family or institution.
Patients are likely to become confused if asked to sign a document; they may have no idea whether they have been washed the day before or how much money they are supposed to have in their wallet or bank account; they will probably not remember how that bruise appeared on their forehead.
This newspaper recently highlighted the growing problem of abuse of the elderly, with figures showing an increase in the number of reports.
Dementia, by its very nature, does not allow the sufferer to file a report, so one can only guess at the incidence of abuse in this particular population.
Ways must therefore urgently be found to combat it.