In most parts of the world old people are excluded just because they are old. The days when old people were respected for their wisdom and experience have mostly disappeared.
Dementia, usually of the Alzheimers’ or vascular type, occurs almost entirely in older people. The great majority of people with dementia are doubly excluded both because they are old and because they have lost their memories and are regarded as useless and a nuisance. This is no way for people to end their lives. Those who care for people with dementia are also excluded from society because they do not have the time or the money to enjoy a social existence. This need not happen.
Dementia care is a global problem. 2 out of 3 people with dementia live in developing countries. There are currently 18 million people with dementia world-wide. This number will rise to 34 million in 25 years time. This is entirely due to the rapid aging of populations. Most people in this room have a close relative or family friend with dementia. Think of that person and multiply the problem by 34 million. Most carers have to cope with dementia in a relative with many fewer resources than you do.
Raising awareness of the disease amongst members of the general public, professionals and policy makers is the most important priority for action throughout the world. Raising awareness is the primary objective of memory care are two further priorities for action. Families want to know what is wrong with their relatives when they have loss of memory. They need to know how to manage and to plan for the future. The disease is slowly progressive, can last up to 20 years, and is ultimately fatal. Primary care workers in every country need to understand the importance of making a diagnosis when a person has a memory problem. People with the disease and their families then need to be fully informed about the disease and need support and advice on a long-term basis. Support can be very effectively done by Alzheimer associations in collaboration with primary care workers. If families are well supported, the people they are caring for often become much easier to manage.
The challenge for policy makers is to provide cost-effective but humane resources for the care of people with dementia and their families. For this to happen every country needs to have prevalence figures for dementia. It is crucial that epidemiological research is encouraged, particularly in developing countries where awareness about dementia is only just beginning to surface. Social research on the impact of the disease on the individual and the family also needs to be carried out in every country. Ways of reducing the distress and the burden of caring will be different in different cultures. Knowing the figures and having an understanding of the caring arrangements is essential to policy makers for the planning of services.
There is as yet no cure nor any way of preventing the disease. But we already know from existing research that much can be done and the quality of life of the person with dementia and their carers can be much improved.