Dementia: New Zealand within a Global Perspective. Get Smart, Think Differently, Do Better Professor Graham Stokes

Bupa Centre Medical

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Bupa is an international provider of specialist dementia care

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UK

Spain

Australia

New Zealand

•In any given year Bupa cares for around 83,000 people across the world. Around three quarters of residents are living with dementia, most with complex behaviours and/or multiple morbidities.

•We are the only global provider of dementia care

•We put the Person First, and dementia second in everything that we do

Poland

Chile

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The scale of the challenge and the opportunity 2015

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Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa)

Bupa Priv ate and Confidential

2030

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Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa)

Bupa Priv ate and Confidential

2050

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Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa)

Bupa Priv ate and Confidential

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A global ageing population

Age is the greatest risk factor for dementia.

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People with Dementia 2015 2050

World 46.8million 131.5 million

New Zealand 40,746 146,699

Dementia – a growing global health concern

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The prospects for a pharmacological breakthrough are ..

• Dementia is one of the biggest global health challenges facing our

generation.

• At this time when the need is greatest to come up with a medical

breakthrough a recent report by the World Innovation Summit for

Health’s Dementia Forum revealed that pharmaceutical companies are

retreating from the search for disease-modifying treatments after

repeated and costly failures to develop a breakthrough drug.

• In the 2012 UK central government and charity research expenditure

allocated to dementia meant that for every £10 of health and social

care costs £1.08 in research funding was spent on cancer, £0.65 on

coronary heart disease, £0.19 on stroke, and just £0.08 on dementia

• New Zealand has the lowest level of funding for dementia research of

all OECD countries

.... not encouraging

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We are in a moment of great opportunity to change the narrative

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2016 - a recent change of tone, focus

and ambition

Personal responsibility

to be risk aware

Civic responsibility so we all own

dementia

Government responsibility

for health and care

Enabling people to live well with dementia at all points on their journey

Potentially reducing the number of people living with dementia

Bupa Priv ate and Confidential

Personal responsibility to be risk aware

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2015 - a recent change of tone, focus

and ambition

Personal responsibility

to be risk aware

Civic responsibility so we all own

dementia

Government responsibility

for health and care

Enabling people to live well with dementia at all points on the dementia journey

Potentially reducing the number of people living with dementia

Bupa Priv ate and Confidential

Personal responsibility. Risk awareness and risk reduction

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• Smoking and diabetes at any age increases our

dementia risk

• High blood pressure in middle age

• High cholesterol, physical inactivity and obesity are

also risk factors.

• “What is good for your heart is good for your brain”.

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• One other significant risk factor unrelated to health.

• A poor education in early life is consistently associated with a greater risk of

dementia, with a good education (measured by years spent in school and college)

offering a protective effect against developing dementia later in life.

• This is possibly to do with education increasing the size of the brain or improving

how the brain functions.

•Unsurprisingly there is is also the possibility that a lifestyle characterised by

intellectually stimulating activity also reduces risk.

Risk-awareness and reduction

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We are in a moment of great opportunity to change the narrative

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2015

- a recent change of tone, focus

and ambition

Civic responsibility so we all own

dementia

Government responsibility for health and

care

Diagnosis

Managed care

Care of the most

vulnerable

Personal responsibility

to be risk aware

Potentially reducing the number

of people living with dementia,

or living with co-morbidities

Enabling people to live well with dementia at all points on the dementia journey

Bupa Priv ate and Confidential

Post-diagnostic support and managed care of people with dementia

A diagnosis is only a passport to living well with dementia if something

happens after the diagnosis.

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Bupa Priv ate and Confidential

Civic responsibility so that we all own dementia

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2015 - a recent change of tone, focus

and ambition

Personal responsibility

to be risk aware

Civic responsibility so we all own

dementia

Government responsibility

for health and care

Enabling people to live well with dementia at all points on the dementia journey

Potentially reducing the number

of people living with dementia,

or living with co-morbidities

Bupa Priv ate and Confidential

Civic responsibility: We all own dementia

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Bupa Priv ate and Confidential

Civic responsibility to deliver and support dementia-friendly and dementia-inclusive communities

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In the United Kingdom there are 1million

Dementia Friends

An idea from Japan where there are 4 million Dementia Friends

Bupa Dementia Buddies

make a Person First pledge

Bupa Priv ate and Confidential

A Dementia Friendly Society

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Prime Minister’s challenge on dementia 2020

By 2020 UK Government wishes to see:

• Alzheimer’s Society delivering an additional 3 million Dementia Friends in

England, with England leading the way in turning Dementia Friends in to a global

movement including sharing its learning across the world and learning from

others.

• Over half of people living in areas that have been recognised as Dementia

Friendly Communities, according to the guidance developed by Alzheimer’s

Society working with the British Standards Institute.

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The bitter end

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2015

- a recent change of tone, focus

and ambition

Civic responsibility so we all own

dementia

Government responsibility for health and

care

Diagnosis

Managed care

Care of the most

vulnerable

Personal responsibility

to be risk aware

Potentially reducing the number

of people living with dementia,

or living with co-morbidities

Enabling people to live well with dementia at all points on the dementia journey

Bupa Priv ate and Confidential

A reality to be acknowledged and addressed

Living Well with dementia means ...

Living long with

dementia

Advanced dementia is a

time of total dependency

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...Except it is not...

It’s caring for people who do not know they need to be cared for.

But what do we mean when we talk about dementia care?

It is caring for people whose brains are so damaged by disease their

dementia renders them incapable of taking responsibility for their

hygiene, personal care and daily lives. It is caring for people whose

judgement is so diminished they cannot take responsibility for their

actions and who as a result engage in unacceptable risks

When people with dementia know they need us, they need us least;

when they need us most, they know they do not need us at all.

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There is only one reason why a person lives in a care home

To get a better life

There is a distinction between quality of care and quality of life

It is not one and the same thing

Good care contributes to a person’s quality of life and to think otherwise

sets the bar far too low

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A care home as a solution

Healthcare Personal care

Safety

Quality of life

Family relations

The 11 hours

- no longer closed places, but working beyond the walls, engaging with the community, supporting primary and secondary healthcare

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In conclusion ….

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.... the possibility to think differently and deliver innovation

is only restricted by the limits we place on our imagination

and ambition.