Move to improve dementia care

It is a major concern of ageing Australians and their families – the looming threat of descending into the isolated and lonely world of dementia and slow cognitive decline.

“If my carer doesn’t know what I’m thinking, what I want, what I fear... then how can care and treatment be tailored to help me?” is a real-world worry. 

There is no cure for dementia, but the earlier the diagnosis and treatment the better the chances of managing the disease. 

More than 420,000 Australians are estimated to have dementia, with around two-thirds living at home with support services and the rest in residential aged care. 

Surprisingly, there is currently no requirement for mandatory reporting of outcomes relating to the care for people living with the disease. That, combined with the lack of dementia-specific training of carers, fails to offer hope to older people confronting the disease and wanting the best possible care. 

Researchers at the University of Queensland’s Centre for Health Services Research have sought to address this by developing recommendations for the nation’s first framework to track and improve the care of dementia patients in our aged care system. 

It was developed in consultation with people living with dementia, care providers, policy makers, and health care professionals, and is designed to aid government policy, and aged care providers modify current practices. 

The project aimed to identify key outcome measures collected during routine care and used to evaluate the effectiveness of interventions concerning dignity, hygiene, pain, and meaningful activities. 

“These will help ensure that the care provided meets the needs of people living with dementia, either at home with support services or in aged care,” the university’s Professor Tracy Comans said. 

“Using the recommended measures ensures that care quality is evaluated in a clear and consistent way and with information that can be compared across different aged care services.” 

Carer education lacking

Researcher and PhD candidate, Danelle Kenny, said the project highlighted how important it is for carers to receive quality dementia training. 

“While formal qualifications don’t necessarily translate to improved care, the lack of dementia-specific training can lead to breakdowns in communication and erodes the positive care relationships between those giving and receiving care,” Mrs Kenny said. 

“For too long, health care has reduced patients to a collection of symptoms, labels, and problems to be fixed and we need to move beyond this to see these issues in the context of the whole person.” 

The Core Outcome Measures for Improved Care (COM-IC) project’s recommendations are available on the Centre for Health Services Research website. 

Sleep and exercise

While not well understood, good sleep and regular exercise play a role in managing dementia. For instance, poor sleep in midlife is associated with a higher risk of developing the condition – althougn that doesn’t prove one causes the other.  

And a recent study suggested that people with “chronic” insomnia (i.e. who struggled to sleep for at least three nights a week over a period of at least three months) might be at a 20% higher risk. 

In the study, 2,750 participants with an average age of 70 were tracked for 5.6 years. All were dementia-free at the start.  

Throughout the study, researchers conducted memory and thinking tests as well as brain scans. They also looked at participants’ sleep habits.  

Researchers said the results suggest insomnia may affect the brain in different ways, involving not only amyloid plaques, but also small vessels supplying blood to the brain. 

The buildup of amyloid plaque proteins and poorer heart and vessel health have been independently linked to increased dementia risk. 

The study found that chronic insomnia appeared to be linked to a 40% higher risk of mild cognitive impairment, which can be a precursor to dementia.  

Meanwhile, peak body, Exercise and Sports Science Australia (ESSA), is encouraging the government, aged care providers, carers, and families to better recognise the role structured exercise, delivered by qualified professionals, plays in preventative therapy. 

Exercise can slow the rate of cognitive decline and preserve brain and body function. 

ESSA says structured exercise also improves activities of daily living. It allows people to get dressed, bathe, and move with better independence; helps manage behavioural and psychological symptoms such as agitation and depression; and gives people confidence and helps them remain socially connected. 

ESSA says, however, that structured exercise remains an underused resource in aged care and community dementia services.