the oecd thematic review of early childhood education and care
Care Needed - OECD
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CARE NEEDED: Improving the lives of people with dementia Francesca Colombo Head of the OECD Health Division London, 12 June 2018
Transcript of Care Needed - OECD
CARE NEEDED: Improving the lives of people with dementia Francesca Colombo
Head of the OECD Health Division
London, 12 June 2018
Dementia affects million of people in OECD,
and the numbers will continue to rise
0
5
10
15
20
25
30
35
40
45People with dementia per
1 000 population 2017 2037
Source: OECD Health Statistics 2017
Dementia prevalence is high and rising with ageing populations
• First ever G8 Summit on dementia mobilised international
commitment
• 22/35 OECD countries now have national dementia plans or
strategies
Policy attention and action have grown
Dpa Picture Alliance – Andy Rain
…But evidence shows that we are still failing
people with dementia…
…and there is a risk that political attention
moves away.
COUNTRIES ARE POORLY EQUIPPED TO DIAGNOSE
DEMENTIA
Improvements needed to identify
dementia
Access to diagnosis
• Less than half of people with the condition are diagnosed
• Primary care serves as the first point of contact for memory
problems in 26 OECD countries
Diagnostic quality
• Many people with dementia do not have more than a general
diagnosis of dementia recorded
• 16 countries have developed clinical guidelines for dementia
Screening for dementia
• 4 countries currently offer cognitive screening
• Uptake can be low, even when offered
Data remains poor
<40% of OECD countries can estimate diagnosis rates
Fewer than 1 in 5 OECD countries regularly link primary care data
6 OECD countries have developed dementia registries to help fill data gaps
FRAGMENTED INITIATIVES IN THE COMMUNITY
Weak post-diagnostic support: Post-diagnostic care pathways have been developed
for people living with dementia in 9 countries, but
adherence varies
Insufficient action for dementia-friendly
communities 90% of OECD countries have dementia-friendly
communities, but they rely on local associations and
NGOs, and remain ad-hoc
Support for informal carers is sorely lacking interventions that support the caregiver’s own
personal wellbeing are critical, but underprovided
Fragmented community care
POOR STANDARDS OF CARE FOR PEOPLE WITH
ADVANCED DEMENTIA
Training for care workers is insufficient The required level of dementia training for home and
residential care workers is very low
Access to dementia-suitable care facilities is weak Small scale living communities not widely available; four
countries (Denmark, Ireland, UK, Norway) have developed
guidelines to promote dementia-friendly design
Hospitals are ill-adapted for the needs of people
with dementia Poor coding, poor management of condition
Help needed for people with advance
dementia
High rates of antipsychotic use indicate
poor care persists 2
9.7
30
.5
30
.9
31
.3
33
.7
34
.6
45
.8
47
.6
47
.8
51
.7
55
.7
56
.5
58.2
65
.0
70
.4
75
.0
0
10
20
30
40
50
60
70
80
90
100
Pe
r 1
00
0 p
ers
on
s a
ge
d 6
5+
2015 2011
Lack of comparable data across the full
pathway of care
22 OECD countries
have recently
developed
dementia policies
and strategies
We have evidence
to support best
practice in some
areas
But most countries
have very few
indicators of
dementia care; lack
of robust,
systematic data
Very difficult to
make international
comparisons of
dementia care
Identifying dementia – Scale-up training and support for physicians, particularly in primary care
– Improve dementia coding and data linking, from primary care to hospital
Caring in the community – Develop and disseminate best practice dementia-friendly communities
guidelines
– Strengthen post-diagnostic pathways, care coordination and case management for people with dementia, especially for complex dementia
– Scale-up training and support for informal carers
Improving quality of care for people with advanced dementia – Strengthen dementia management skills and training for care staff
– Develop and disseminate best practice dementia-friendly building guidelines
– Consider financial and professional incentives for care staff with dementia training
– Develop and regularly monitor key quality of care measures, including antipsychotics prescribing
Key recommendations
Thank you for listening
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