Australia is not prepared for the huge anticipated increase in the number of people living with dementia, and “radical solutions” and “specialised education and training” will be essential for the nation to cope, experts say.
When Maree McCabe opened her hearing at the Aged Care Royal Commission, she revealed some sobering statistics about the growing prevalence of dementia in Australia.
“At the moment, there are 436,000 Australians living with dementia. By 2056, there will be 1.1 million Australians living with dementia,” she said.
“There won’t be anybody that is not impacted in some way”
“There won’t be anybody that is not impacted in some way, and the more that we educate people about dementia, the more we raise the profile about dementia, the better equipped the community will be to support people.
“This is the chronic condition of the 21st century… One in three of 20 us in this room will develop dementia at some point, and we need to know how to best support people living with it.”
Ms McCabe, who is the CEO of Dementia Australia, said growing numbers are also being diagnosed with young onset dementia.
“One in 13 Australians living with dementia are in their 50s, their 40s and their 30s,” she said.
At least 50% of nursing home residents are living with dementia
Ms McCabe said 50 per cent of people in residential aged care have been diagnosed with dementia, and many more will develop it during the course of their residence in an aged care facility.
She said doctors often don’t diagnose dementia for those who are already living in aged care because the condition is incurable.
“GPs often will tell us that they don’t give patients a diagnosis of dementia because there’s no effective treatment,” Ms McCabe said.
This often leaves residents struggling.
“The person themselves often knows that there’s something wrong and many people say it’s actually a relief to get a diagnosis because they’ve been struggling with some of the challenges, they’ve noticed changes, and they don’t know why,” Ms McCabe said.
Ms McCabe said a person’s quality of life can be greatly improved if they can be definitively diagnosed with dementia.
“The earlier the diagnosis the better the outcomes,” she said.
“There is a lot that we can do to support people. There are lifestyle changes that we can support people with. There’s a lot of research that exercise is great for reducing our risk of getting dementia but also delaying the exacerbation of symptoms. Making sure that people look after their vascular health if they have dementia is really important. Their blood pressure, their cholesterol, encouraging them to stop smoking if they smoke. There is a lot that we can do.
“We can connect them with social networks and resources, provide education for them about the challenges that they experience to ensure that they then can take control of the illness and what’s happening to them and are better equipped to deal with those challenges and we provide strategies for that.”
Too few staff receive dementia training
Ms McCabe lamented the fact that so few staff have specific training in how to care for people living with dementia, and said there is a need for “building capacity around education and training”.
She said of the 240,000 aged care workers in Australia, 70 percent work as personal care workers, and their Certificate III does not provide any education around dementia, as either mandatory or even optional training.
Ms McCabe said the key was to train staff to build their “empathy”, and be able to put themselves in the shoes of somebody living with dementia.
“Our theory was that if we could actually simulate that, it would change people’s attitude, it would change their behaviour and it would then change the practice and care that was implemented for people living with dementia”.
Lack of training “root cause” of Royal Commission revelations
Professor James Vickers, Director, Wicking Dementia Research and Education Centre, told HelloCare he believes that many of the problems being experienced in Australia’s aged care system stem from a lack of knowledge about how to properly care for someone living with dementia.
“Dementia is the rising issue in aged care, and really adds significantly to the complexity of aged care,” he said.
“We simply don’t teach our health care professional or vocational students enough about this area. We believe that this is the root cause of systemic issues now being discussed at the Royal Commission.”
Professor Vickers said the Wicking Centre has long known about the lack of dementia training in aged care. The Centre developed a free, 20-hour course ‘Understanding Dementia Massive Open Online Course (MOOC)’.
The program has already been accessed by more than 250,000 people all around the world; about two-thirds of the students are in Australia.
“We identified this [lack of training] as an issue some years ago – for aged care workers, doctors, nurses, and allied health professionals – as well as family carers,” he said.
The Wicking Centre has also developed an undergraduate course, the Diploma, Associate Degree and Bachelor of Dementia Care.
This course is “for those who really felt that they didn’t know enough about dementia to undertake their role in aged care properly,” Prof Vickers said.
“We have had approx 700 graduates to date, and there are approximately 2,000 people undertaking the course – most part-time, most women, and the majority working in aged care in some capacity,” he said.
Australia is unprepared
Professor Vickers said Australia is not prepared for the scale of the dementia crisis that will emerge in the years ahead.
“We need to sit back and have a hard look at how we provide and configure support and care for people with dementia.
“The 20th century model of aged care that continues today is not only not appropriate from a personal and human rights perspective, but is also not scalable for the increasing numbers of people with dementia with associated impacts socially and economically as well as in terms of care.
“Radical solutions, specialised education and training, and a reconceptualization of aged and dementia care will be necessary,” he said.