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ADI Virtual Side Event and Report Launch
Maintaining dementia as a priority in unprecedented times
@AlzDisInt
Paola BarbarinoCEO,
Alzheimer’s Disease International (ADI)
Welcome and introductions
@AlzDisInt
• Kate Swaffer, Dementia Alliance International• Dévora Kestel, World Health Organization• Dr. Nasri Omar, Government of Kenya• Dr. Hanadi Khamis Mubarak Alhamad, Qatar Ministry of Public Health• Dr. Kanako Kitahara, Government of Japan• Dr. Jeewon Suh, National Institute of Dementia, Republic of Korea• Gudlaug Einarsdottir, Government of Iceland• Fumie Griego, International Federation of Pharmaceutical
Manufacturers & Associations (IFPMA)
Speakers
From plan to impact III: Maintaining dementia as a priority in unprecedented times
• Reporting on progress towards WHO’s Global action plan on the public health response to dementia 2017-2025− Some progress but national plan development behind
schedule
• The challenges and opportunities of COVID-19 for global dementia policy− Diagnosis, post diagnostic support, research, clinical trials− Residential care facilities
• Expert essays and case studies
• Calls on governments to heed to lessons from COVID-19
Kate Swaffer
Chair, CEO, co-founder, Dementia Alliance International (DAI)
Dévora Kestel
Director, Mental Health and Substance Abuse, World Health Organization (WHO)
Dr. Nasri Omar
Focal Point for Mental Health System and Services, Mental Health Division, Ministry of Health, Government of Kenya
PLAN TO IMPACT (TOWARDS A NATIONAL DEMENTIA ACTION PLAN
IN KENYA)DR NASRI OMAR
MINISTRY OF HEALTH
Presentation Outline
1. Conception of the plan towards a dementia action plan
2. Prioritizing Dementia in the context of COVID 19 response
3. Plan to impact roadmap
4. Summary
MINISTRY OF HEALTH
Conception of the plan towards a dementia action plan
§ 2017: 4th African conference on dementia hosted for the 1st time in Kenya§ Commemoration of World Alzheimer's day starts on 21st September 2017. Done
every year§ Commitment made by Director of Mental Health to develop a national dementia
action plan
§ 2018 to date: MOH involved in mind walk organized by ADOK
§ May 2018: Collaboration of the STRiDE team (Strengthening responses to dementia in developing countries) with Ministry of Health
§ June 2018: STRiDE Theory of Change Workshop where the Ministry of Health got to interact with stakeholders involved in dementia care
§ 2018-2020: Looking for funding from STRiDE partners and other contributors including World Health Organization Kenya Country Office
MINISTRY OF HEALTH
Conception of the plan towards a dementia action plan
§ 2018-2020: Generation of local evidence by STRiDE Kenya team which will inform the National Dementia Action Plan
§ 5th March 2020: The Ministry of Health formally requested for partner support on the development of a National Dementia Action Plan.
§ 12th March 2020: Kenya reported the first case of COVID 19. (shift of priority to COVID 19)
§ All non-COVID related projects put on hold
MINISTRY OF HEALTH
Prioritizing Dementia in the context of COVID 19 response
§ May 2020: The Director of Mental Health, Ministry of Health informs his team to begin working on projects put on hold due to COVID 19. The National Dementia Action Plan was one of those priority projects.
§ 1st June 2020: Included slides on Dementia in Psychological Frist Aid training module being offered as part of the national mental health and psychosocial support COVID 19 response:§ Target groups: Health care workers, police officers, prison officers, palliative care
specialists, community health volunteers among others
§ June 2020: First draft of the Situational analysis on overall health system, long term care and dementia care by STRiDE Kenya shared to stakeholders
§ 18th June 2020: Submitted a concept note and updated budget (in the context of COVID 19 government directives) shared with partners including WHO
§ June 2020: Plans underway for Kenya to contribute to the Global Dementia Observatory
MINISTRY OF HEALTH
Plan to impact roadmap
§ June 2020: Technical Working Group (with representation from service user organizations and families/carers) to spearhead the development and implementation of the National Dementia Action Plan (includes the National Advisory Group on STRiDE Kenya)
§ June 2020: National Dementia Action Plan and related activities is part of the annual workplan for the Division of Mental Health, Ministry of Health
§ Timelines set for National Dementia Action Plan:§ June-July 2020: Planned first stakeholders meeting. Output: Draft zero of the
Action Plan.§ July-November 2020: Draft reviews and validation meetings. Output: Final Draft
of the Action Plan.§ November-December 2020: Launch of National Dementia Action Plan§ January 2021-December 2021: Dissemination of the National Dementia Action
Plan across the 47 counties in Kenya*This is dependent on availability of funds
MINISTRY OF HEALTH
Ongoing work & priority activities (2020-2021)
■ National Dementia Action Plan (2020-2025)
■ Alzheimer awareness day /month
§ Public awareness campaign (Mind Walk and other strategy)
§ Data collection and reporting (GDO)
§ Caregiver support group and caregiving training
§ User friendly Clinics at KNH & MTRH, Counties target- Nyeri, Makueni, Mombasa, Nakuru and Kisumu
§ Social care services (Respite home, Palliative home, disability and older people support )
§ Counselling and psychosocial support linkage and network (Pre and Post diagnosis counselling, Caregiver counselling)
§ Dementia friendly society (partnership and collaboration with Transport (Matatu sector, Employers, Police)
§ Access health products, equipment and technologies (through KEMSA- essential medicines and tracking gadget)
§ QualityRights dementia initiative ( Quality of care and human rights in community and health/social services)
MINISTRY OF HEALTH
Acknowledgements
§ Ministry of Health
§ World Health Organization
§ STRiDE Kenya team
§ National Advisory Group on STRiDE Kenya
§ STRiDE collaborators including ADI and LSE
MINISTRY OF HEALTH
Dr. Hanadi Khamis Mubarak Alhamad
National Lead for Healthy Ageing for the Qatar Ministry of Public Health, Medical Director –Rumalilah – QRI
21
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Global Action Plan Targets
Description Status
Dementia Plan 75% of countries will have developed or updated national policies, strategies, plans or frameworks for dementia, either stand-alone or integrated into other policies/plans, by 2025
Dementia diagnostic rate
In at least 50% of countries, as a minimum, 50% of the estimated number of people with dementia are diagnosed by 2025
Dementia carer support services
75% of countries provide support and training programmes for carers and families of people with dementia by 2025
Dementia awareness & risk reduction campaigns
100% of countries will have at least one functioning public-awareness campaign on dementia to foster a dementia-inclusive society by 2025
Dementia-friendly initiatives
50% of countries will have at least one dementia friendly initiative to foster a dementia-inclusive society by 2025
Dementia education and training for non-health professionals
50% of countries will have at least one dementia-friendly initiative to foster a dementia-inclusive society by 2025
Published dementia research output
The output of global research on dementia doubles between 2017 and 2025
Qatar’s Progress against Global Action Plan Targets
23QNDP Progress against WHO Indicators and QNDP Action Areas
WHO Indicators(Policy)
Highlights Status
Dementia governance MoPH appointed Focal LeadNational Dementia Stakeholder Group (MoPH)
National Dementia Plan (Global Target for National Plan)
QNDP launched Dementia public health priority under NHS2 Healthy Ageing
Dementia legislation Draft Elderly law ready which includes protection of people with dementiaDriving and Dementia –Initial Meeting at MOPH took place recently
Dementia guidelines National Dementia Guidelines and practice recommendations Launched
Dementia Care Coordination Care coordinator system in planning phase under NHS Integrated Care
QNDP Action Area: Dementia as a Public Health Priority
24
Progress against WHO Indicators and QNDP Action AreasWHO Indicators(Service Delivery)
Highlights Status
Adequately trained dementia health and social care workforce
Launched training for 600 PHCC Family Physicians. In addition ongoingeducation delivered to physicians, nurses, allied health professionals, clinical social workersNational Dementia Training ProgrammeLaunched ADI Certified CSW Training Initiated
Dementia diagnostic rate (Global target diagnostics)
Dementia Registry Project MRCGrantApproved
Community based services for dementia
Expansion to 3 Memory Clinics in PHCC Settings to improve early diagnosis
Dementia health and social care facilities
Review of inpatient requirementsExpansion of RH Memory Clinics
Dementia-specific nongovernmental organization
Qatar Alzheimer’s Association application-Legal approved -undergoing approval checks
QNDP Action Areas: Dementia diagnosis, treatment, care and support
25Progress against WHO Indicators and QNDP Action AreasWHO Indicators(Service Delivery)
Highlights Status
Dementia carer support services (Global target for education)
RAHA –National Alzheimers and Memory Services –Helpline Launched ADI Membership Voted in Favour of Qatar AlzSociety ADI -LED 11 National Dementia Trainers Selected
Dementia awareness & risk reduction campaigns(Global target for campaign)
Qatar Participated in Worlds Largest Survey on Attitudes towards Dementia –ADI London Led 3rd Annual WAM Campaign (Sept)5000 People -23 Events Risk reduction messages to be embedded into NCD campaignsMOPH Led WHO supported International Risk Reduction Workshop held Qatar Feb 2020
Dementia friendly environments
Qatar Dementia Friends application accepted. Competition launched amongst nurses
Dementia education and training of non health professionals (Global target for education)
Geriatrics for non Geriatrics course to be added to National Elderly Training Unit (HITC). ADI training to be sustained.PlusCSW Training
QNDP Action Areas: Support for Dementia Carers, Dementia Risk Reduction, Dementia Awareness & Friendliness
26Progress against WHO Indicators and QNDP Action AreasWHO Indicators(Service Delivery)
Highlights Status
Dementia monitoring (Global target for diagnostics)
Minimal data set to be embedded into Cerner. Education of physicians to improve recording of diagnosis. Dementia registry submission undergoing approval checks.Coding Process under Review
Dementia research agenda Draft proposal for Dementia Centre of Excellence to strengthen national research agenda for dementia and align with education and patient careQNDP Contacts made with Dementia UK Research Team MOPH Led WHO supported Workshop on Dementia Research Feb 2020
Dementia research investment
No dedicated funds for dementia research
Dementia research participation
No opportunities as yet for people with dementia and their carers to contribute to research
QNDP Action Areas: Information & research, Dementia research & innovation
27COVID Pandemic Achievements in Elderly and Dementia Care
ACHIEMENTS CHALLENGES TO OVERCOME
Established Virtual Consultations Memory Clinics
Finding the Appropriate Cognitive assessment Tool ( MINICOG/MOCA Blind )
Established “RAHA”NationalAlzheimers Helpline
Need for Formal Guidance Tool ( WHO/ADI)
Established Elderly Urgent Care Unit
Difficult to Get some of Our Patients with Dementia
Established Acute Geriatric Assessment Unit
Still lack Dementia Friendly Environment
Establish Telephone Outreach Service
On occasions may not be getting through Right Carer still
Establish Geriatric Telepharmacy System to address Polypharmacy Need to Build Links withSpecialities
28
CLINICAL FOCUS LAST 4 MONTHS COVID WORKS
COVID TIMES –CHALLENGES -QNDP
DELAY IN APPROVALS ON PLANS PROJECTS FROM MINISTERY SECTIONS - AWAITING FINAL
REGISTRATION QATAR ALZ SOCIETY
- -Awaiting DrivingSafetyGuidelines /Assessment Centres
QNDP –RELATED INTERNATIONAL COLLOBORATION –DELAY IN WORKS
-ADDENBROOKES TEAM COLLOBORATION -NHS OT EXPERTS LED TRAINING
STAFF WORK LOAD
WORKFORCE REDPLOYMENT
Full capacity staff not in
FUNDING PRIORITYSDIFFERENT
PRE COVID CHALLENGES CONTINUE
Dedicated BudgetLimitations Measure of Risk Reduction Works –Dementia Index Score ( Stop Smoking COVID Helped RR Works )
Dr. Kanako Kitahara
Director, Office of Long-Term Care Insurance Data Analysis, Division of the Health for the Elderly, Health and Welfare Bureau for the Elderly, Ministry of Health, Labour and Welfare, Government of Japan
Dementia Policies in Japan
Kanako KITAHARA MD PhDDirector
Office of Long-Term Care Insurance Data Analysis,Division of the Health for the Elderly,
Health and Welfare Bureau for the ElderlyMinistry of Health, Labour and Welfare (MHLW) -Japan
25 June 2020ADI Virtual Side Event & Report Launch:
Maintaining dementia as a priority in unprecedented times
https://maps.gsi.go.jp/#5/36.104611/140.084556/&vs=c1j0h0k0l0u0t0z0r0s0f1
32
377,972 km2 with 6,852 islands
State of California: 423,970 km2
Population
125,988,000 people(2020)
Population aged 65 and over
28.4 %(2019)
Life Expectancy (2019)
Male 81.25Female 87.32
Life Expectancy (1950)
Male 59.57Female 62.97
Development of National Policies on Dementia2012 - Orange Plan: 5-year plan for promotion of dementia policies launched by MHLW
2015 - New Orange Plan: a revised Orange plan launched by 12 related ministries and agencies
2019 - National Framework for Promotion of Dementia Policies:adopted at the Ministerial Council (Cabinet Decision).
<Basic Concept>To promote policies that focus on “inclusion”*1 and “risk reduction”*２
while underlining the perspectives of people with dementia and theirfamilies for the purpose of delaying the onset of dementia and building asociety in which everyone can live with hope, even if they developdementia
*1 “Inclusion” means that persons with dementia can live with dementia with dignity and hope, and that people can live together in one society regardless of whether they have dementia.
*2 “Risk Reduction” doesnʼt mean “never to develop dementia”, but means “to delay onset of dementia” or “slow the progression of dementia”.
5 pillars of measures④ Promotion of “Dementia Barrier-Free” / Support for
people with early onset dementia / Support for social participation
⑤ Research and development / Industrial promotion / Global expansion
① Raising awareness / Supporting persons with dementia to express their views
② Risk Reduction33③ Medical and long-term care / Support for caregivers
① Raising awareness / Supporting persons with dementia to express their views ② Risk Reduction
National Framework for Promotion of Dementia Policies5 pillars of measures
Japan Public-Private Council on Dementia
Raising Awareness
Dementia Supporter (>12M)
The Number of Saloons and Rate of Participants
43,154 55,521 70,134 76,492 91,0592.7
3.23.9 4.2
4.9
0123456
020,00040,00060,00080,000
100,000
平成25年度 平成26年度 平成27年度 平成28年度 平成29年度FY2013 FY2014 FY2015 FY2016 FY2017
Exercise at the showroom of TOYOTA ToyoakeBranch (Nagoya Toyopet Co., Ltd.) at Toyoake city
Dandy Exercise Club at Setagaya-ku 34
④ Promotion of “Dementia Barrier-Free” / Support for people with early onset dementia / Support for social participation
⑤ Research and development / Industrial promotion / Global expansion
③ Medical and long-term care / Support for caregivers
National Framework for Promotion of Dementia Policies5 pillars of measures
Dementia Café (>7,000)
Support for caregivers
Intensive Support Team
Team Orange project
35
36
COVID-19 and Long Term Care
- Distribution of PPEs - Website for Dementia Supporter - Information about café etc.- e-Learning- Communication- Manual/Training for Caregivers
- Mental Support for Staffs at LTC Facilities- Support for Staff Dispatching
https://www.youtube.com/watch?v=RZN_aN6dcs4https://www.ncgg.go.jp/cgss/news/20200605.html
- Apps for e-Saloon
0
100
200
300
400
500
600
700
800
1/23 1/30 2/6 2/13 2/20 2/27 3/5 3/12 3/19 3/26 4/2 4/9 4/16 4/23 4/30 5/7 5/14 5/21 5/28 6/4 6/11 6/18
Number of Reported Cases
- Reward Program
37
○ “Comprehensive Strategy to Accelerate Dementia Measures (New Orange Plan)” was formulated in 2015, and measures have been promoted aiming forrealizing a society where persons with dementia can live with dignity in a pleasant and familiar environment as how they hope to be as long as possible.
○ In December 2018, Ministerial Council on the Promotion of Dementia Policies was set up in order to comprehensively promote measures regardingdementia issues under close collaboration among related ministries and agencies, and “National Framework for Promotion of Dementia Policies” wasadopted on June 18, 2019.
④ Promotion of “Dementia Barrier-Free” / Support for people with early onset dementia / Support for social participation
⑤ Research and development / Industrial promotion / Global expansion
③ Medical and long-term care / Support for caregivers
【Basic Concept】To promote policies that focus on “inclusion” ※１ and “risk reduction”※２ while underlining the perspectives of people with
dementia and their families for the purpose of delaying the onset of dementia and building a society in which everyone canlive with hope, even if they develop dementia
① Raising awareness / Supporting persons with dementia to express their views
② Risk Reduction
※1 “Inclusion” means that persons with dementia can live with dementia with dignity and hope, and that people can live together in one society regardless of whether they have dementia.
※2 “Risk Reduction” doesnʼt mean “never to develop dementia”, but means “to delay onset of dementia” or “slow the progression of dementia”.
・Promoting Dementia Supporter in private sector・Publicizing “Declaration to live well with dementia” etc.
・Expanding “Kayoinoba”, the places for older citizens to get together in the community・Gathering and publicizing evidence etc.
・Enhancing quality of system for early detection/intervention and strengthening collaboration・Promoting training for family caregivers and peer activities among family caregivers etc.
・ Establishment of living environment accessible for persons with dementia・ Consideration of certification and awards for private sector・ Promotion of social participation activities etc.
・Establishment of clinical trial ready cohort etc.
5 pillars of measures○ Anyone can develop dementia or see persons close to him/her develop
dementia. Now dementia has become increasingly more common to everyone.
○ The society where the persons with dementia can keep their dignity and continue to live their own life in the familiar community should be realized even if they have difficulties in their daily life, by preventing serious conditions and promoting understanding and cooperation from community members aiming that persons with dementia can be positive with hope and make use of their own abilities to reduce difficulties as much as possible.
○ While promoting measures with the potential to delay the progression of dementia symptoms such as increasing physical exercise, preventing lifestyle diseases like diabetes or high blood pressure, and relieving feelings of isolation through social inclusion, the “preparatory measures” including risk reduction of dementia should be promoted based on proper understanding of dementia while gathering and publicizing evidence. The goal is that average age of onset among people in their 70s is delayed by 1 year in next 10 years as a result of those measures.Research and development should also be promoted to elucidate mechanisms of onset or progression of dementia and develop methods for prevention, diagnosis and cure.
Concept
National Framework for Promotion of Dementia Policies (Outline)(Adopted at Ministerial Council on the Promotion of Dementia Policies on June 18, 2019)
Comprehensive Promotion of Dementia Policies
①〜⑤ should be promoted prioritizing perspectives of persons with dementia and their families
Target Period: until 2025 38
Thank You forYour
Attention !
39
Jeewon Suh, MD
Deputy Director, National Institute of Dementia, Department of Neurology, National Medical Center, Republic of Korea
Advances in the Korean dementia planDuring the pandemic
Jeewon Suh, MD
Deputy director, National Institute of Dementia, Republic of Korea
Local Dementia Center in Korea
256 Local Dementia Centers in Korea
Dementia café
Cognitive training program for MCI
Dementia shelter
COVID-19 epidemic trend in Korea
Announcement of “A new routine distancing in daily life” Ø Official announcement of instructions
for Dementia centers in a new routine
Reference: Korean Centers for Disease control & Prevention
Prohibition of group activities and gathering events Ø Dementia Centers
closed Increasing “Remote Services” in Dementia center
Instructions for Dementia centers in a period of “routine distancing in daily life”
Stage Contents Instruction
Stage 1Case management, Supply of goods,
public guardianRoutine practice
Stage 2Home visit, counseling, screening and diagnostic
test
1:1 contact with hygiene
management
Stage 3Shelter, dementia cafe for family,
cognitive training programRemote service
Guðlaug Einarsdóttir
Senior Advisor, Ministry of Health, Government of Iceland
The First National Dementia Plan in Iceland
Guðlaug Einarsdóttir, Senior Advisor
ADI Virtual Side Event & Report Launch 25 June 2020
Maintaining dementia as a priority in unprecedented times
Iceland
• 340.000 inhabitants
• Icelandic – everything must be translated
• Ministry of Health – 50 people
• Dementia and Elderly
• Nordic Cooperation
• Strong Infrastructure of Health and Social Services
• Estimated that 4-5000 people in Iceland
live with dementia - 250 people under the
age of 65.
Biggest challenge
Limited support at the beginning
of the disease - random content.
Shared responsibility between state and municipalities.
The task
Connecting the infrastructure
and building bridges from current
situation to future vision.
The Process of the Icelandic Strategy
• A parliamentary resolution adopted to draw up a strategy on service to persons with dementia (spring
2017).
• The minister of health assigned one of Iceland´s most respected geriatricians, Jon Snaedal, to write a
report with policy draft (2019).
• Contributions to the report received from the main stakeholders via official governal web consultation portal which is open to all (autumn 2019).
• Implementation schedule based on the proposals in the report and the comments received (winter 2019-
2020).
• The strategy released in April 2020.
Content of The Action Plan
1. Self-determination, patient involvement and legal framework.
2. Prevention.
3. Timely diagnosis of dementia in the right place and follow-up after diagnosis.
4. Activity, self-help and support.
5. Proper service based on the level of dementia.
6. Scope, research, knowledge and skills.
Awareness of Dementia in Iceland
• Alzheimer Iceland.
• The new action plan.
• Friendly communities.
• The President of Iceland invests former deputy mayor of Reykjavík, Elly Katrin
Gudmundsdottir, with the Order of the Falcon, for her contribution to open discussion about
Alzheimer´s disease - Miss Gudmundsdottir was diagnosed with Alzheimer by the age of 51
and has been a pioneer to other young people with Alzheimer.
www.covid.is
Fumie Griego
Deputy Director General and Chief Operating Officer, International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)
@AlzDisInt
???
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Question and answer
Paola BarbarinoCEO,
Alzheimer’s Disease International (ADI)
Closing remarks
Follow ADI on Twitter and Instagram @AlzDisInt │ Like us on Facebook /alzheimersdiseaseinternational Visit our website: www.alz.co.uk
THANK YOU.