Background:

By the year 2025, the number of people with dementia in the Asia-Pacific region will more than double. This increase will be much more rapid than that occurring in the West. In 1999 and 2000, two Asia-Pacific Consensus Conferences on Dementia were held in Singapore and were attended by representatives from twelve national Alzheimer's Associations. The goals of these conferences were to elucidate the current regional situation regarding dementia and to reach consensus on plans to address dementia-related medical and service challenges in the region.  This document is a consensus statement forged by the twelve regional associations, nine of which are members of Alzheimer's Disease International

 

 

Area of Focus:

The working group members focused discussion on three critical areas: public awareness, caregiver support, and training of professionals. Consensus in each of these areas is described below.

 

A fundamental role of Alzheimer's Associations is to work continuously to establish public awareness and to improve public understanding of dementia. The specific aims of public awareness and public education activities are to change the misperception that dementia is part of "normal aging", to alleviate the social stigma associated with dementia and to dispel the myth that there is neither practical social support nor effective medical treatment for dementia. If these aims are successfully achieved, the general public will understand that dementia is a medical condition and that early detection and accurate diagnosis is necessary to improve quality of life for people with dementia and their families.

 

Aware of dementia must be developed at many levels and by various means. Dissemination of appropriate information to the general public can occur via distribution of locally prepared, free, printed materials such as pamphlets, bookmarks and the like.  Positively engaging local and regional newspaper, radio and television media can also advance awareness. Public testimonies from affected families, either live or in the form of videotapes and audiotapes, are additional effective tools for generating awareness. The success of public awareness and public education efforts can be enhanced by coordinating these activities with other organizations involved in the care of the elderly, and by working collaboratively with other interested healthcare and social service professionals.

 

Non-governmental organizations such as national Alzheimer's Associations need to convey to local and national governments relevant factual information about dementia, which can then be incorporated into disease awareness campaigns. Fundraising activities for dementia-related services can also serve as opportunities for building public awareness. Each national association must carefully identify the most appropriate level (e.g., general public, professional organizations, local government) at which to target their public awareness efforts.

 

 

Caregiver Support

Support for caregivers is the foundation for effective dementia care. The components of caregiver support must include medical, social, emotional, financial, legal and respite services.  These services must be culturally appropriate, as well as locally available, accessible, affordable, timely and practical.

Common needs identified by caregivers of persons with dementia include creating a safe living environment, managing functional problems such as incontinence, coping with behavioral problems like agitation, and maintaining family values, family relationships and personal dignity throughout the course of the disease. In addition, caregivers need to successfully manage their own stress in order to effectively care for their afflicted loved one. Practical services which need to be further developed in many countries of the Asia-Pacific region include caregiver support groups, day care centres, in-home or visiting nurse services, residential care, respite care and "how-to" caregiver information which is sensitive to local customs, cultures and languages.

 

 

Training of Professionals:

Formal education and training opportunities need to be available for anyone providing care for people with dementia or their families. Such training may range from credit awarding, continuing medical education programs for physicians, to workshops or "diploma course" in dementia care for caregivers. Those providers most likely to be involved in the early detection of dementia must be identified and trained.  Formal instruction on dementia should be a required part of the curriculum for students in all health and social science disciplines.

 

The training of dementia care providers must include instruction in several relevant dimensions. A philosophy of care should be taught which emphasizes principles such as autonomy, inclusiveness and respect for culture diversity. Established diagnostic criteria and accurate diagnostic methodologies have to be taught. Early detection of dementia and appropriate therapeutic intervention must be emphasized. Practical information such as telephone numbers of local support services, contact information for dementia care specialists and web page addresses for information on relevant dementing diseases should be provided.

 

National Alzheimer's Associations need to encourage their respective governments to acknowledge the need to train more specialists in all areas of dementia care. Each association should support the development of dementia care training and research centres, and must promote the establishment of dementia care guidelines and standards in their home country.

 

 

Summary:

The twelve national Alzheimer's Associations who contributed to this Consensus Statement will continue to network with one another regionally and will continue to share relevant expertise and practical resources. It is expected that regional consensus on dementia will evolve in individual member countries and in the Asia-Pacific region as a whole. It is the hope of the participating members of these two consensus conferences that this document will provide the inspiration, direction and practical ideas to further advance the goals of national Alzheimer's Associations and to further advance dementia-related medical and service activities within the Asia-Pacific region.

 

 

Acknowledgement: 

This work was supported by the Alzheimer's Disease Association, Singapore.