Monday, November 30, 2015

Clinical and Advocacy: Dementia increasing in Canada, national policy urgently needed to address demand for care

Canada needs a plan to deal with increase in dementia: Editorial

The Trudeau government should use some of its early goodwill to kick-start the process of developing a national plan to address the slow-motion crisis of dementia.


Health experts have been warning for years that Canada must face up to the growing crisis brought on by a rising tide of people afflicted with dementia. As the population ages, we will all be touched – as patients, as caregivers, and as taxpayers.

This is a global problem, as explained over the past 10 days in a series of articles by Star writers Jennifer Yang, Kate Allen and Amy Dempsey. No country will be spared, but some will be better prepared than others. And it’s high time Canadian governments came together and developed a national strategy to deal with a crisis that will severely challenge both health care budgets and society as a whole.

We can learn much from looking at the experience of a country that has aged faster than us and is already grappling with the issue we will face over the next couple of decades. In Japan, the world’s first “super-aged” nation, those over 65 already form a quarter of the population. And, as Yang reported, that country is pioneering ways to deal with a rising tide of people living with dementia – 4.6 million of them.

The Japanese are training thousands of doctors on dealing with dementia – from making the right diagnosis to supporting caregivers. One city, on the outskirts of Kyoto, has dedicated itself to become a “dementia-friendly” community where people with the disease can live normally.

Most importantly, as far back as 2000 the Japanese government introduced mandatory long-term care insurance. Everyone starting at age 40 must pay into a national insurance fund. When they turn 65 or are afflicted by an aging-related disease such as dementia, they can draw on a variety of support services – from daycare to meal preparation.

Since funding is guaranteed through the insurance plan, that has created a robust market for such services.
It’s far from clear that such a plan could work in Canada. Social norms are very different in Japan, and our health care system is run by individual provinces. But it’s the type of big thinking that is badly needed – but so far sadly lacking – in this country.

The provinces, including Ontario, haven’t yet put together an overall strategy for dealing with our aging population. They still struggle even to provide a bare minimum of home care. And yet just the cost of treating the 747,000 Canadians with dementia has already hit $33 billion a year and is rising fast.


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