World Alzheimer Report calls for changes to care system

As the world population ages, the traditional system of informal care by family, friends and community will require greater support, according to the World Alzheimer Report 2013, “Journey of Caring: An analysis of long-term care for dementia.” Decreasing family size, increased urbanization, workforce mobility and the changing role of women are changing the way Alzheimer’s disease is addressed in long-term care, the report’s authors say.

The report was researched and written by Martin Prince, MD, Matthew Prina, PhD, and Maëlenn Guerchet, PhD, on behalf of the Global Observatory for Ageing and Dementia Care, which is hosted at the Health Service and Population Research Department, King’s College London. The authors note:

• About half of all older people who need personal care have dementia.
• Those with cognitive impairment are more than twice as likely as others to receive paid care at home to help with activities of daily living.
• As many as 70 percent of people with Alzheimer's disease in the United States live at home.
• More than 68 percent of all nursing home residents have some degree of cognitive impairment, according to Alzheimer's Association 2013 Alzheimer's Disease Facts & Figures.
• 80% of older people in nursing homes specifically have dementia.
• The worldwide cost of dementia care exceeds $600 billion, or around 1% of global gross domestic product.

Based on their findings, the report authors make the following recommendations:

• Governments should make dementia a priority by implementing national plans and by initiating national debates on the future of long-term care.
• The quality of dementia care needs to be monitored in senior living and community settings.
• The wishes of those with dementia and the people who care for them should be prioritized to maximize autonomy and choice.
• Health and social care systems should be better integrated and coordinated to meet people’s needs.
• Front-line caregivers should be adequately trained, and systems should be created to ensure that paid and unpaid caregivers receive appropriate remuneration so that the informal care system can be sustained and the recruitment and retention of paid caregivers can be improved.
• Because few prefer to receive care in a facility rather than at home, the unpaid work of family caregivers should be properly valued.
• Facilities remain an important component of long-term care, so their quality should be monitored and judged by the quality of life and satisfaction of their residents in addition to routine inspections.

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Lois Bowers

Lois A. Bowers was senior editor of I Advance Senior Care / Long-Term Living from 2013-2015.