Downsizing dementia’s demands
BY JADE MORELLINI
Dementia Australia has embraced the introduction of new guidelines which aim to personalise and reduce treatments for each individual suffering from dementia.
Evidence has indicated that people with dementia have multiple health conditions and this has led to a number of medications being prescribed which may in fact be causing more harm than good.
“As an advocate for the 425,000 Australians and their families impacted by dementia, Dementia Australia is encouraged by the release of guidelines to recognise that the experience of people living with dementia is individual and unique,” Dementia Australia CEO, Ms Maree McCabe, said.
All medications have a number of side effects and when individuals are taking multiple doses of different drugs, it could have the opposite impact than intended.
“While there are certainly instances where the prescription of ongoing and multiple medications is beneficial for people living with dementia, this is not always the case. Over time, certain medications can lose their effectiveness and they can hinder quality of life rather than improve it,” McCabe said.
An estimated 425,000 people have dementia in Australia and this number is projected to reach more than 1.1 million by 2056.
On the 8th February, a national public consultation program began to ensure the quality and safety of senior Australians is at its peak.
Minister for Aged Care, Ken Wyatt AM, publicised an expert team in November to develop Australia’s first aged care workforce strategy.
“This online survey is important because it allows all voices to be heard,” Minister Wyatt said. “Aged care residents, families, carers, aged care workers, service providers, employee organisations and everyone with an interest in quality care should have their say on this vital issue.”
These guidelines seem to be a step in the right direction for improving the quality of care for the aged. Centre for Medicine Use and Safety Professor Simon Bell suggested that gradually stopping medication will ensure the risks no longer outweigh the potential benefits.
“The guideline provides clinicians, consumers and carers with new recommendations regarding the withdrawal of cholinesterase inhibitors or memantine. In particular, the guideline highlights the important role of people with dementia and their carers in deciding whether or not to trial discontinuation,” Bell said.
Former carer, Ms Tara Quirke, who is also an advisor on the guidelines and advocate for the consumer voice in treatment decision making, said from a care partner perspective, these guidelines are timely and provide strong evidence of the need to reduce medications that are no longer effective, or may cause more harm, to the person living with dementia.
“These guidelines put individuals’ values, preferences and experiences ahead of their illness. I am encouraged by the very clear message it sends to everyone who is treating, caring for or living with dementia,” Ms McCabe said.
Individuals with dementia have a vast number of support systems available, however there are many individuals who may not be able to access help for certain circumstances such as homelessness.
HammondCare is an independent Christian charity with the aim to improve the quality of life for people in need. They have a number of dementia centres, and in 2016 they announced plans for a purpose-built residential care home for the aged homeless in Sydney’s Darlinghurst to hopefully be operational from 2019.
HammondCare Residential General Manager, Angela Raguz said, “We currently operate 18 care homes in 10 locations in NSW and Victoria.”
In 2017, HammondCare cared for 1,693 people through their residential care homes, and an additional 3,473 people in 72 areas through home care visits. They regularly care for more than 1200 people living with dementia, including about 700 residents in our dementia-specific aged care homes.
“Work is currently underway on HammondCare Darlinghurst, a service that will be the first of its kind in Sydney to offer permanent accommodation with specialised healthcare for the homeless and those at risk of homelessness. Fundraising for the $20 million project is ongoing, and received a significant $2.5 million boost from the Ian Potter Foundation in December,” Raguz said.
“HammondCare Darlinghurst will offer high levels of care to older people with complex mental and physical healthcare needs, including dementia, chronic disease, and significant frailty.”
Similarly, St Basil’s Lifestyle Options for Ageing Australia opened less than a year ago in Randwick and they offer many services for aged people suffering from dementia.
Business Development Manager of St Basil’s, George Koromvokis said, “Around 70% of our residents in our facilities including the home care clients are suffering from dementia. We offer low care and high care for those who suffer from dementia as well as home care services and a day centre for those who want to keep active and socialise with other people in our community.”
With the significant number of individuals who have dementia, these updated guidelines should have a positive impact on their health, ensuring they are only taking the medicine necessary and allowing them to receive the help and assistance they require.
