In a statement by the Parliamentary Secretariat for the Rights of Persons with Disability and Active Aging, back in April 2015, it was noted that there were an estimated 6,071 people suffering from dementia in Malta (1.5 per cent of the general population) and that, by 2050, this was projected to grow to 3.5 per cent (effectively more than doubling).

This statement coincided with the launch of a national strategy for dementia in the Maltese islands, a commendable initiative that would see the implementation of a work programme over a period of nine years. This would cover: awareness and understanding of dementia, timely diagnosis, workforce development, research and dementia management and care.

While I accept that only a year has passed since the launch, very little evidence of progress is visible at this stage. I say that from personal experience during my two-month stay in Malta when my wife and I visited her mother practically daily at both the home where she resides in Buġibba and at the Mater Dei Hospital, where she has unfortunately undergone two major operations over the last two months due to a fall and a resulting broken hip.

I am no expert in dementia care but I have read that flexible, culturally-appropriate care, close to home and the community should be the focus of any aged care service provision.

We have noted a number of things. The home in Buġibba has 100 residents, 65 per cent of whom suffer from dementia (their figures not mine). There are very few homes in Malta that have dedicated dementia wings. What this means is that most of the dementia residents are treated like any ordinary aged person. Anyone who has any experience with dementia would know that this is inappropriate.

Our mother was born and lived in Żabbar all her life. Her family and extended family live within a couple of kilometres of Żabbar. She was placed in a home in Buġibba last year just after the place was opened.

We should probably consider ourselves lucky that she has been allocated a place, however, even though distances in Malta are relatively short, there is no way any of her aging sisters or busy children and grandchildren can visit her often.

This is not active ageing. This is not living with dignity

Apart from the distance, there is the nightmare of finding a place to park. The result is that visits are few and far between or a major hassle.

She is illiterate (never attended school back in the 1930s and 1940s) and can only communicate in Maltese. Practically all her carers at the home are foreigners that speak no Maltese whatsoever. It is sad to see dementia patients who are trying to communicate basic requests being faced by ‘carers’ who can’t understand what their need is. Tragic!

There is no person-centred care or flexibility whatsoever either in the home or in the hospital. Our mother has to use nappies. They are changed for her a number of times a day on set routines. If you soil your nappy just after the change has been made, tough. You wait until the next nappy change time, which could be hours away. No wonder they get rashes and sores.

The meals served at both the home and the hospital are poor. I have noted a number of visitors bring meals for their loved ones. I’m not surprised.

Either the government/private care provider is not paying enough or the caterer is making a fortune off the back of patients who require special nutritional diets. There is also the issue of assistance provided to those who are not able to eat by themselves.

I could go on. There are many things that are just not right.

Why did our mother fall when she was in care? Why is there no incident report that explains how and why she fell and fractured her hip? How can we be sure this will not happen again?

Who is checking the private homes to make sure they meet the national minimum standards for care homes for older people? No point in having minimum standards if no one checks whether they are being met.

People with dementia suffer from loss of memory, confusion, language difficulties, inability to perform basic routine tasks as well as personality and mood changes.

It is obvious that most of the carers at the home and the nurses at the hospital do not have a basic level of understanding of what dementia is and what dementia patients might be going through.

It would appear we are starting from a very low level of understanding of this condition and that the ‘care’ being provided is woefully inappropriate.

I look at the residents and can’t help but feel that they are all ‘parked’ in this modern facility looking very sad and just waiting to die. This is not active ageing. This is not living with dignity.

We Maltese pride ourselves on our kindness, our generosity and our caring attitude. I suspect we treat our stray cats better than we treat our ageing parents.

There is a lot that can be done. We must allocate more resources now to ensure we bring the actual level of care to match the wonderful pictures and words that fill the activeageing.gov.mt website.

The gap is huge. The problem is big and getting bigger.

Albert Hili is chairman of a not-for-profit community services organisation in Australia.

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