Alzheimers NZ National Dementia Strategy 2010-2015

Thank you for inviting me to the launch of Alzheimers New Zealand's National Strategy for Dementia in New Zealand.

I would like to acknowledge my colleague Dr Paul Hutchison and my other parliamentary colleagues here tonight.

Dementia is a severe and devastating disorder for both sufferers and their families - and it is increasingly making itself felt amongst us.

We're living longer, with more of us living over the age of 85, and that all adds up to many more people living with dementia.

That rising number of people with dementia will be a major factor in aged care in the future.

Ensuring the system supports people with dementia will be very important.

The National Dementia strategy

Your National Dementia Strategy is the culmination of many hours of hard work.  It aims to ensure the needs of people with dementia are recognised and supported.

I understand your strategy calls for collaboration between health professionals, service providers, funders, member organisations and people caring for those with dementia - to meet the needs of people with dementia while ensuring services are effective, efficient and cost-effective.

This is a worthwhile aim.

Your strategy sets out a significant work programme.

This vulnerable group of New Zealanders deserve the very best services possible.

Living with Dementia

The number of people with dementia (of any age) is expected to increase considerably. Estimates show that the numbers of New Zealanders who are living with dementia is approximately 41,000; this is expected to increase to 77,000 by 2026.

The rates of growth may be affected by various risk factors associated with dementia.

• A study of more than 10,000 people showed that obesity was associated with a 74 per cent increased risk of dementia 25-30 years later, while overweight people had a 35 per cent greater risk.


• Previous work has linked high blood pressure and high cholesterol with increased risk of Alzheimer's disease.

Protective factors may include physical activity:

• A study at Johns Hopkins in the US found that people who engaged in four or more physical activities, from gardening to biking, had about half the risk of dementia compared with those who engaged in one or none.


• Time spent in full-time education also appears to be negatively associated with dementia.


• Some research has suggested a possible link between a reduced risk of Alzheimer's disease and people with mentally demanding jobs

But as you know, there is no cure and the best science can do is slow down progression. An Australian study suggests that if the onset of dementia can be delayed 5 years, then by 2050 there would be 50% fewer people with dementia than otherwise projected.

PHARMAC's decision this week to fund a brand of the drug donepezil - Donepezil-Rex -  once it is registered by Medsafe, will, I understand, enable thousands of people diagnosed with Alzheimers or related types of dementia to have a better quality of life for longer.

We also need to concentrate on making sure people suffering from dementia receive quality services and live as good a life possible- whether they live at home or in residential care.

Earlier diagnosis and earlier provision of support will mean people will be able to stay longer in their homes in comfort and safety.

One important way to achieve that is to better support those who care for their older people with dementia at home.

One of the most moving experiences of my time in Health was meeting with a group of Tauranga women whose husbands had developed dementia in their early fifties.  Most of us can't  imagine what anguish these women have gone through.

It was very difficult to remain composed when one woman confided she had not had a weekend break from caring for her husband for almost three years because she could not find suitable respite care in town.

Caring for someone with dementia is hard work.  And that is why the new Government has boosted dedicated respite care for those caring for the elderly and those with dementia. 

We have invested an additional $5 million a year specifically targeted at increasing the number of respite beds available.

New Zealanders also want us improving the quality of the services provided to our older residents of rest homes and hospitals throughout the country.

This is particularly important for people with dementia - and it does seem that internationally and here in New Zealand, GPs and residential care are taking up the challenge.

The over-use of anti- psychotics is an issue a number of doctors and caring organisations are considering. Research in New Zealand found anti- psychotic prescribing varies for 90% of those with dementia in one resthome to around 20% in some others.  In all this debate the safety of residents must come first.

I visited a Wellington rest home earlier this year that was making good progress in creating a calmer more comfortable environment for their dementia patients - so much so that conflict and tension were lowered and the rest home had managed to reduce their use of anti-psychotic drugs by a half.

I was told they actively encouraged people to carry on with the little things that add up to everyday life - activities like sweeping floors, washing dishes, folding towels, posting letters, waiting at a bus stop - familiar routine things that soothe the spirit while the confused moment passes.

That often reduces aggressive behaviour which in turn reduces the need for medication.

This is an example of the maxim that small things do indeed count.   

Government priorities

It is crucial to maintain public confidence in the standard of care being provided in the country's rest homes for all our elderly.

There has been mounting public concern around issues of poor care in rest homes and residential facilities and this is particularly pertinent to older people with dementia who are more vulnerable.

The government has introduced spot auditing of rest homes and we are auditing the auditors, including those auditing dementia services, to ensure they meet quality standards.

Then we are publishing the results on the Ministry of Health's website.

For the first time ever, family members and older people can now see and compare audit summaries of rest homes online. This will help them know more about their options.

The Ministry will work on additional improvements.

We have recently agreed additional funding for the accredited visiting service, provided by Age Concern branches and other community organisations.  This funding will help lonely people to maintain social contact. It is an effective home- based intervention which helps people to remain at home.

Mental Health and Addiction of Older people and Dementia Project.

The Ministry of Health is also working with District Health Boards (DHBs) and interested stakeholders, including providers, to develop a guidance document to advise DHBs on the best ways to meet the specialist clinical mental health and addiction needs of older people, and those people of any age who suffer from dementia. 

Your strategy will inform this work.

The purpose of this project is to develop an integrated approach that crosses traditional boundaries, to make it easier for people with dementia, and their carers, to access specialist services for older people including those in residential care.

Long term trends in aged care

We need to be mindful of funding limitations on the Government at this time of economic challenge.

We recognise, however, that to address the upcoming demographic changes, Health of Older People will become an area of investment for governments into the future.

The Government acknowledges dementia as a key issue that for our country into the future we are committed to working to ensure people suffering from dementia receive quality services and live as good a life as possible - whether they live at home or in residential care.

Close

I wish you well as you begin working together to achieve the goals set out in your Strategy.

Thank you for the opportunity to be involved in the launch of the Dementia Strategy this evening and I wish you every success with your goals for the future.