Social Policy in Ontario

Canada needs a national dementia strategy

Posted on September 14, 2014 in Health Policy Context

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TheStar.com – Opinion/Commentary – By 2031, an estimated 1.4 million Canadians will be suffering from dementia. To provide these patients quality care, and to keep wait times under control, we need a national strategy.
Sep 13 2014.   By: Dr. Chris Simpson

Just a few months ago as a panelist at a conference on dementia, I made front-page news by stating the obvious.

I said the reason there is a nine-month waiting time in this country for a hip replacement is because there are so many patients with dementia taking up acute-care hospital beds.

Why are they there?

Because there is nowhere else for them to go.

This problem may be old news to physicians and policy-makers but it is a real issue for hundreds of thousands of Canadian families who struggle to care for loved ones battling dementia. Just as is the case for health care generally in our country, the care and support you get from the system depends largely on where you live.

Canada and France were co-hosts last week to something called a Global Dementia Legacy Event growing out of last year’s G8 meeting in London. It was one of four global dementia “Legacy Events” being held to gather international dementia experts and come up with solutions.

Make no mistake, this international focus is good news. But Canada’s doctors and the patients we serve are interested in how this meeting will translate into strategic action to address a disturbing dilemma in our health care system here at home.

The health care system euphemistically calls people stranded in acute care hospital beds “alternate level of care patients.” Through no fault of their own, so-called ALC patients occupy 3 million bed days a year in our hospitals. They don’t have acute disease; they have chronic diseases. Fully one third suffer from dementia.

If this situation sounds urgent it is because it is. In fact, dementia numbers are staggering — and set to rise even higher — in most of the developed world. This is why 13 countries around the world have some form of national dementia strategy.

Strangely, Canada is not among them.

Sure, Ottawa has (since 2006) invested more than $860 million through the Canadian Institutes of Health Research to support neuroscience research with $182 million earmarked for prevention, diagnosis and care of dementia. And the 2014 federal budget allocated new funding to CIHR for a consortium on neurodegeneration in aging. This investment in research is appropriate and welcomed. But it is only part of what we need to be doing to address this impending crisis.

No doubt organizers of the Canada-France conference will have plenty to report back to their (now G7) partners next year. But the time for discussing dementia in opaque, abstract language at high-level conferences is over.

The federal government needs to be doing some things — now — like sitting down with the provinces to develop a dementia strategy that aims to give Canadians with dementia the care they deserve, at home and in their communities, while freeing up expensive acute care hospital beds to serve the patients for whom they are intended.

Ottawa, the provinces and territories should be talking about more support for families and other caregivers, home-care support where possible and addressing a serious deficit in long-term care facilities.

Or, Ottawa could be taking the lead in helping to develop a comprehensive health human resources plan that assembles the right mix of health care providers to properly care for the 747,000 Canadians with dementia. We need more geriatricians (there are only 260 in Canada) and we need to fully harness the great potential of multi-professional primary care teams. Canada’s family physicians speak eloquently and passionately about the “Medical Home” — the concept that all patients deserve a home base with professionals to care for their complex needs in their homes and communities. Canadians with dementia need this support and dedication.

The Alzheimer Society of Canada projects there will be 1.4 million Canadians suffering from dementia by 2031. This group, as well as CARP and others are united in calling for more political leadership to battle this terrible disease and to support families in their battle against it.

Canada today has almost as many diagnosed dementia patients as the United Kingdom does at 847,000, despite a difference in population of 30 million.

The United Kingdom has a dementia strategy. Why don’t we?

Dr. Chris Simpson is the new president of the Canadian Medical Association and chair of the Wait Time Alliance, a coalition of 18 specialist associations dedicated to eliminating unnecessary waits for medical tests, treatments and procedures.

< http://www.thestar.com/opinion/commentary/2014/09/13/canada_needs_a_national_dementia_strategy.html >

Tags: disabilities, Health, mental Health, pharmaceutical, standard of living

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