Dementia in an international environment
Dementia knows no boundaries; it does not respect race, religion, ethnicity, economic power, social position, gender or sexual orientation etc. Age is the biggest risk factor, but I have been advised that the youngest person ever diagnosed with it was aged 8! 1 in 14 people over the age of 65 will have it and 1 in 6 over the age of 80, with 1 in 688 under the age of 65.
Dementia will affect every nation and how badly it affects it relates to the age demographics of the country. Diagnosis rates vary from 50% to as low a 4% or no doubt even zero, which means that in some places it is a hidden problem, but just because it is hidden, does not mean it is not a problem.
Many of the things that make care relevant to a person are entirely transferrable, such as the pharmacological responses (medications). There are also social care responses, such as dance therapy, singing and pet therapy etc. These can have cultural biases and may not be so internationally effective.
The response to dementia also depends on the legal framework in a country and their human rights record. There are plenty of stories about people being tied to things such as a tree, as those caring for them don’t know how else to deal with them.
Any hidden problem can have stigma and shame associated with it. This can have an impact, not only on the person living with dementia but their carers as well. Since carers are often family members, this will have an enormous impact on the wider family. When one member of a family has a significant caring role (which usually become the responsibility of the women of the family), it affects their economic position and when women are economically affected, this usually affects the children, as women often spend their money on their children.
In the UK we have many advantages, we have human rights protection, so no-one living in the UK should be physically restrained as a means of care management. We have cutting edge research into the causes and symptoms of dementia. We also have care and support via the Local Authority if it is needed, to allow someone to live at home and as well as possible for as long as possible. With austerity, Local Authority funding is limited, so they are looking for the most cost efficient forms of care, which can have mixed results. The ability to pay privately for care allows someone much more choice, including having a live in carer. If it is appropriate.
We also very importantly have the framework to create Lasting Powers of Attorney, so that the person with dementia can appoint someone to look after their affairs if they need to. They can make financial and care decisions (assuming they have created both kinds of LPA).
We are fortunate in the UK to have support for both the person with dementia and their carers. There are lots of things here that are making life better, including the Dementia Friends campaign, which emphasises the living well with dementia. But wherever someone lives, it is still tough to live with this deteriorating condition for both the person and their carers.
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