Dementia burden on the Australian economy raises concerns

By Dr. Ananya Mandal, MDApr 11 2012

According to a new report increasing number of people with dementia will have huge economic and social costs for health systems around the world.

The report by the World Health Organization and Alzheimer's Disease International added that policy priorities should include raising awareness of the disease ensuring timely diagnosis. It estimates the global cost of dementia is more than $600 billion per year.

In a related new report it was found that Australia's aged-care system is overwhelmingly failing the needs of dementia sufferers and their carers.

Alzheimer's Australia surveyed 1000 people affected by the condition across the country and concluded an extra $500 million was needed to fight the dementia epidemic, often made worse by inadequate residential aged-care facilities. The report found it was not uncommon for the health of sufferers to decline rapidly once they were admitted to an aged care home.

“For many older Australians dementia specific care is matched by the reality of locked wards,” Minister for Mental Health and Aging Mark Butler said. There are problems like lack of adequately qualified staff, the use of physical and chemical restraints, including antipsychotics at some facilities. These have often distressed families and carers.

The report found that, specifically, community care packages were inadequate and inflexible and that the system was beset by long waiting times, lack of transparency in administration costs and clogged by bureaucratic roadblocks. “As Australians, we enjoy one of the longest life expectancies in the world but we need to make sure that those extra years are years of quality,” Mr Butler said.

There are 280,000 Australians with dementia, with the number set to reach 400,000 within 10 years with 1600 new cases diagnosed every week. Diagnosis of the condition is another major problem - in some instances families waited for more than three years after the onset of symptoms to get a proper diagnosis.

Alzheimer's Australia chief executive Glenn Rees said that even after more than a decade in the job, he was shocked by some of the stories that emerged during the consultation process. “There is a dramatic contrast between the experiences of the people with dementia and family carers who benefited from timely diagnosis and referral to services, and the overwhelming majority of those who were traumatized by poor diagnosis, lack of information and care services that had next to no understanding of dementia,” Mr Rees said. “People with dementia and their carers don't know where to turn to receive services and support.”

Pointing to improvements that had already been made, Mr Butler said aged-care funding had increased by two thirds in the past five years, while the number of home-care places had increased by 40 per cent. But much more work was needed to reform a system that was devised in the mid-1980s, he admitted. “It's much more than a question of additional money. It's a question of very complex system reform,” he said.

Australian Nursing Federation federal secretary Lee Thomas said that workforce considerations were a critical sticking point for improving aged care services. “Respondents to the Alzheimer's Australia consultation call for better paid, better trained and higher levels of aged care staff.  This is a critical element of reform if we are to create a system which gives older people the opportunity to age well – with dignity, choice and quality services,” she said.

Aged and Community Services Australia president Rob Hankins said the report outlined the need for more community-based care, higher-quality residential care, better access to respite and an improvement in services for people from different backgrounds. “There are systemic problems with aged care in this country and we can't afford to just keep patching up the system and hope it will resolve itself,” Mr Hankins said. “Comprehensive reform is the only way forward and the Government must show the leadership to commit to it once and for all in the Budget this May.”

Questioning the timing of the report, Opposition health spokesperson Senator Concetta Fierravanti-Wells said it was typical of the Labor government to release bad news over the Easter long weekend. “Older Australians deserve a response as to what changes, if any, the government is going to make to the aged-care system,” she said in a statement.

The report was commissioned by the Department of Health and Ageing in response to the Productivity Commission's review, Caring for Older Australians, released in August. At the time of the report the commission recommended reforms be carried out over five years. Alzheimer's Australia predicts it is more likely to take 10 years.

The  National Aged Care Alliance - an overarching body of 28 organizations representing consumers, providers and aged care workers - said a complete overhaul of the aged care system was urgently needed, adding their claim was backed by the Productivity Commission.