“I can think of no other disease that places such a heavy burden on families, communities, and societies. I can think of no other disease where innovation, including breakthrough discoveries to develop a cure, is so badly needed.”
— Margaret Chan, Director General, World Health Organization (Opening remarks at the First WHO Ministerial Conference on Global Action against Dementia, 17 March 2015)
As January is Alzheimer’s Awareness month, I thought it fitting to highlight recommendations made as part of the report completed in November 2016 by the Standing Senate Committee on Social Affairs, Science and Technology.
We have heard that several different things can increase the risk of dementia (most recently living near a busy highway) however we do know for certain that the primary risk factor for dementia is getting older. The Canadian Institute of Health Research provides that approximately 1 in every 3 persons over age 85 is likely to develop dementia. A National Strategy is needed and needed quickly.
Recommendations put forward by the committee include:
RECOMMENDATION 1: the federal government immediately establish the Canadian Partnership to Address Dementia with a mandate to create and implement a National Dementia Strategy.
RECOMMENDATION 2: The committee further recommends that the federal government, when establishing the Canadian Partnership to Address Dementia, take into consideration the structure and function of the Canadian Partnership Against Cancer, however the new organization must:-include representation from, but not be limited to, federal, provincial and territorial governments, dementia and other health-related organizations, individuals affected by dementia and their caregivers, healthcare professionals, housing organizations, researchers and the Indigenous community;-be required to evaluate, report on and update the strategy annually; and,-receive adequate federal funding of at least $30 million annually.
RECOMMENDATION 3: the federal government adjust the annual funding provided to the proposed Canadian Partnership to Address Dementia in response to annual evaluations and strategy updates.
RECOMMENDATION 4: the proposed Canadian Partnership to Address Dementia, in its development and creation of Canada’s National Dementia Strategy, be guided by
-the Alzheimer Society of Canada’s The Canadian Alzheimer’s Disease and Dementia Partnership: Strategic Objectives, and -Alzheimer’s Disease International’s report Improving Dementia Care Worldwide: Ideas and Advice on Developing and Implementing a National Dementia Plan.
RECOMMENDATION 5: the federal government allocate to the Canadian Institutes of Health Research’s Dementia Research Strategy, as a component of the proposed National Dementia Strategy, 1% of current direct dementia care costs, or approximately $100 million annually.
RECOMMENDATION 6: the Public Health Agency of Canada create and implement, within the National Dementia Strategy, a comprehensive public awareness campaign that includes promotion of the Dementia Friends Canada website as well as high-visibility/high-impact approaches regarding prevention, early diagnosis, symptom recognition, quality of life, and services and supports.
RECOMMENDATION 7: with respect to prevention strategies, the federal government implement recommendations 20 and 21 of the Standing Senate Committee on Social Affairs, Science and Technology’s 2016 report entitled Obesity in Canada: A Whole-of-Society Approach for a Healthier: report report entitled Obesity in Canada: A Whole-of-Society Approach for a Healthier Canada, by:-designing and implementing a public awareness campaign on healthy eating based on tested, simple messaging, and -implementing a comprehensive public awareness campaign on healthy active lifestyles in collaboration with other relevant departments, agencies, experts and trusted organizations.
RECOMMENDATION 8: the federal government ensure that Public Health Agency of Canada receive adequate resources for the Canadian Chronic Disease Surveillance Program so that it can provide robust, timely and accessible dementia surveillance data beginning in 2017.
RECOMMENDATION 9: the proposed Canadian Partnership to Address Dementia ensure that Canada’s National Dementia Strategy encourages the implementation of the Alzheimer Society of Canada’s First Link® early intervention program across Canada, adapted as necessary to be appropriate and culturally sensitive to each community.
RECOMMENDATION 10: the federal government explore fiscal options to reduce the financial stress on informal caregivers including:-expanding the Employment Insurance compassionate care benefit beyond palliative care; and,-amending the Caregiver Tax Credit and the Family Caregiver Tax Credit to make them refundable in order to benefit lower income Canadians.
RECOMMENDATION 11: the federal government promote the workplace best practices identified in the 2015 report commissioned by Employment and Social Development Canada entitled When Work and Caregiving Collide: How Employers Can Support Their Employees Who Are Caregivers.
RECOMMENDATION 12: the proposed Canadian Partnership to Address Dementia ensure that additional caregiver supports be promoted through the National Dementia Strategy including:-education and training;-respite services; and,-a web resource portal that provides access to information about these programs and initiatives.
RECOMMENDATION 13: the federal government provide, in the upcoming Health Accord, targeted funding of $3 billion over four years for a comprehensive package of home care services.
RECOMMENDATION 14: the federal government require that the targeted funding for home care services under the new Health Accord be subject to regular evaluation and reporting that demonstrates effective use of funds, which will provide the basis for annual, success-based adjustments to funding.
RECOMMENDATION 15: the federal government assess the need for home care funding beyond the initial four-year period as provincial budgets for health services and social services develop and implement integrated models of care.
RECOMMENDATION 16: the proposed Canadian Partnership to Address Dementia engage stakeholders in promoting innovative technologies and the Home-Care-Plus model that integrates specialists in dementia care into the home care model.
RECOMMENDATION 17: he federal government in collaboration with provincial and territorial counterparts:-assess the fiscal barriers currently preventing the integration of health and social services; and,-implement the necessary changes in order to facilitate the re-structuring necessary for integrating health and social services.
RECOMMENDATION 18: the federal government implement recommendation 1 of the Standing Senate Committee on Social Affairs, Science and Technology’s 2014 report Prescription Pharmaceuticals in Canada — Unintended Consequences, regarding:-establishing targets for the implementation of electronic health and prescription drug systems;-promoting the use of and accelerating the uptake of electronic databases by health professionals through an aggressive targeted awareness campaign; and,-public reporting on the progress of implementing electronic health and prescription drug systems.
RECOMMENDATION 19: the proposed Canadian Partnership to Address Dementia, within the National Dementia Strategy, promote:-models of dementia care that integrate healthcare delivery, such as the Dementia-plus Care Model;-integration of social services into dementia care; and,-a continuum of care that includes advance care planning for integrating of palliative and end-of-life care.
RECOMMENDATION 20: the federal government invest $540 million in continuing care infrastructure to increase the capacity for long-term care in provinces and territories.
RECOMMENDATION 21: the proposed Canadian Partnership to Address Dementia ensure that the National Dementia Strategy includes efforts to:-examine and update as necessary the staffing, care and accommodation standards applied to seniors’ residences, including legislation and regulations; and,-explore and assess a range of opportunities to improve access to seniors’ housing.
RECOMMENDATION 22: the proposed Canadian Partnership to Address Dementia include within the National Dementia Strategy the assessment and promotion of specific models of dementia care for rural and remote communities including that of Rural and Remote Memory Clinics.
RECOMMENDATION 23: the federal government expedite the funding of the new program to enhance high-speed broadband coverage throughout Canada.
RECOMMENDATION 24: he Home and Community Care Program, delivered by Health Canada’s First Nations and Inuit Health Branch:-be funded to reflect current Indigenous population levels; and, -permit and encourage innovative approaches to program delivery.
RECOMMENDATION 25: the proposed Canadian Partnership to Address Dementia work with Accreditation Canada, within the context of the National Dementia Strategy, to develop standards of dementia care for acute-care hospitals.
RECOMMENDATION 26: the proposed Canadian Partnership to Address Dementia, within the context of the National Dementia Strategy, in collaboration with provincial governments, medical faculties, nursing programs, and their regulatory and licensing bodies, address health human resource capacity, training and professional development with respect to aging and dementia care.
RECOMMENDATION 27: the proposed Canadian Partnership to Address Dementia ensure the development, implementation and promotion of a secure Best Practices Portal available to health and social service providers of dementia care.
RECOMMENDATION 28: the Canadian Partnership to Address Dementia consider the programs and practices listed in Appendix 1 for inclusion in the proposed Best Practices Portal.
RECOMMENDATION 29: the proposed Canadian Partnership to Address Dementia ensure that persons with dementia are included in all aspects of its work.
Great recommendations however we are not there yet. Future blogs will continue to update the progress of our elusive dementia strategy.