Dementia: New Zealand within a Global Perspective. Get Smart, Think Differently, Do Better Professor Graham Stokes
Bupa Centre Medical
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Bupa is an international provider of specialist dementia care
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UK
Spain
Australia
New Zealand
•In any given year Bupa cares for around 83,000 people across the world. Around three quarters of residents are living with dementia, most with complex behaviours and/or multiple morbidities.
•We are the only global provider of dementia care
•We put the Person First, and dementia second in everything that we do
Poland
Chile
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The scale of the challenge and the opportunity 2015
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Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa)
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2030
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Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa)
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2050
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Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa)
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A global ageing population
Age is the greatest risk factor for dementia.
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People with Dementia 2015 2050
World 46.8million 131.5 million
New Zealand 40,746 146,699
Dementia – a growing global health concern
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The prospects for a pharmacological breakthrough are ..
• Dementia is one of the biggest global health challenges facing our
generation.
• At this time when the need is greatest to come up with a medical
breakthrough a recent report by the World Innovation Summit for
Health’s Dementia Forum revealed that pharmaceutical companies are
retreating from the search for disease-modifying treatments after
repeated and costly failures to develop a breakthrough drug.
• In the 2012 UK central government and charity research expenditure
allocated to dementia meant that for every £10 of health and social
care costs £1.08 in research funding was spent on cancer, £0.65 on
coronary heart disease, £0.19 on stroke, and just £0.08 on dementia
• New Zealand has the lowest level of funding for dementia research of
all OECD countries
.... not encouraging
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We are in a moment of great opportunity to change the narrative
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2016 - a recent change of tone, focus
and ambition
Personal responsibility
to be risk aware
Civic responsibility so we all own
dementia
Government responsibility
for health and care
Enabling people to live well with dementia at all points on their journey
Potentially reducing the number of people living with dementia
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Personal responsibility to be risk aware
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2015 - a recent change of tone, focus
and ambition
Personal responsibility
to be risk aware
Civic responsibility so we all own
dementia
Government responsibility
for health and care
Enabling people to live well with dementia at all points on the dementia journey
Potentially reducing the number of people living with dementia
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Personal responsibility. Risk awareness and risk reduction
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• Smoking and diabetes at any age increases our
dementia risk
• High blood pressure in middle age
• High cholesterol, physical inactivity and obesity are
also risk factors.
• “What is good for your heart is good for your brain”.
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• One other significant risk factor unrelated to health.
• A poor education in early life is consistently associated with a greater risk of
dementia, with a good education (measured by years spent in school and college)
offering a protective effect against developing dementia later in life.
• This is possibly to do with education increasing the size of the brain or improving
how the brain functions.
•Unsurprisingly there is is also the possibility that a lifestyle characterised by
intellectually stimulating activity also reduces risk.
Risk-awareness and reduction
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We are in a moment of great opportunity to change the narrative
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2015
- a recent change of tone, focus
and ambition
Civic responsibility so we all own
dementia
Government responsibility for health and
care
Diagnosis
Managed care
Care of the most
vulnerable
Personal responsibility
to be risk aware
Potentially reducing the number
of people living with dementia,
or living with co-morbidities
Enabling people to live well with dementia at all points on the dementia journey
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Post-diagnostic support and managed care of people with dementia
A diagnosis is only a passport to living well with dementia if something
happens after the diagnosis.
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Civic responsibility so that we all own dementia
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2015 - a recent change of tone, focus
and ambition
Personal responsibility
to be risk aware
Civic responsibility so we all own
dementia
Government responsibility
for health and care
Enabling people to live well with dementia at all points on the dementia journey
Potentially reducing the number
of people living with dementia,
or living with co-morbidities
Bupa Priv ate and Confidential
Civic responsibility: We all own dementia
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Civic responsibility to deliver and support dementia-friendly and dementia-inclusive communities
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In the United Kingdom there are 1million
Dementia Friends
An idea from Japan where there are 4 million Dementia Friends
Bupa Dementia Buddies
make a Person First pledge
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A Dementia Friendly Society
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Prime Minister’s challenge on dementia 2020
By 2020 UK Government wishes to see:
• Alzheimer’s Society delivering an additional 3 million Dementia Friends in
England, with England leading the way in turning Dementia Friends in to a global
movement including sharing its learning across the world and learning from
others.
• Over half of people living in areas that have been recognised as Dementia
Friendly Communities, according to the guidance developed by Alzheimer’s
Society working with the British Standards Institute.
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The bitter end
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2015
- a recent change of tone, focus
and ambition
Civic responsibility so we all own
dementia
Government responsibility for health and
care
Diagnosis
Managed care
Care of the most
vulnerable
Personal responsibility
to be risk aware
Potentially reducing the number
of people living with dementia,
or living with co-morbidities
Enabling people to live well with dementia at all points on the dementia journey
Bupa Priv ate and Confidential
A reality to be acknowledged and addressed
Living Well with dementia means ...
Living long with
dementia
Advanced dementia is a
time of total dependency
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...Except it is not...
It’s caring for people who do not know they need to be cared for.
But what do we mean when we talk about dementia care?
It is caring for people whose brains are so damaged by disease their
dementia renders them incapable of taking responsibility for their
hygiene, personal care and daily lives. It is caring for people whose
judgement is so diminished they cannot take responsibility for their
actions and who as a result engage in unacceptable risks
When people with dementia know they need us, they need us least;
when they need us most, they know they do not need us at all.
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There is only one reason why a person lives in a care home
To get a better life
There is a distinction between quality of care and quality of life
It is not one and the same thing
Good care contributes to a person’s quality of life and to think otherwise
sets the bar far too low
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A care home as a solution
Healthcare Personal care
Safety
Quality of life
Family relations
The 11 hours
- no longer closed places, but working beyond the walls, engaging with the community, supporting primary and secondary healthcare
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In conclusion ….
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.... the possibility to think differently and deliver innovation
is only restricted by the limits we place on our imagination
and ambition.