Australia needs urgent healthcare reform to cope with future dementia numbers

The Future of Alzheimer’s Disease in Australia White Paper presents recommendations across Australia that would address challenges with education, workforce capacity, diagnostic pathways, and system integration.

If Australia doesn’t implement healthcare reform, the experts in the White Paper believe complicated clinical pathways, non-standardised diagnostic mechanisms, inadequate workforce resourcing, and under-utilised educational opportunities will negatively impact those living with Alzheimer’s disease and their carers.

The White Paper was informed by an expert Think Tank and an extensive consultation process undertaken over the last nine months.

Associate Professor Michael Woodward from Austin Health Memory Clinic in Victoria, one of the experts who participated in the Think Tank that informed the White Paper, explains that a lot of work needs to be done to prepare Australia for the increase in dementia cases.

He says, “As clinicians, researchers, and care providers, we are at the precipice of an exciting, yet daunting journey to optimise care for Australians living with Alzheimer’s disease. 

“The potential future arrival of disease-modifying therapies brings us to a critical juncture in this journey, compelling us to come together to effect purposeful, sustainable and beneficial change.”

There are 472,000 Australians who live with a form of dementia, and 70 percent of this cohort have Alzheimer’s disease.

With the expectation that by 2058 there will be over a million older people with dementia in the country, experts believe that systemic change in healthcare will be necessary to cope with future patient demand for diagnosis and management of dementia.

The Paper states that “there is a window of opportunity to prepare the sector and ensure models of care, infrastructure and the workforce can meet the needs of this increasing patient population.”

The Think Tank brought together nearly 40 individuals from Government, primary and specialty care, nursing, patient and carer advocacy, and professional and allied health associations to work through system challenges that people with dementia and Alzheimer’s disease face.

The Future of Alzheimer’s Disease Think Tank includes experts like Maree McCabe, Chair of Dementia Australia; Professor James Vickers, Director of the University of Tasmania’s Wicking Dementia Research and Education Centre; Dr Tom Morris, Senior Service Manager of Research & Analytics within The Dementia Centre at HammondCare; and many more.

From the Think Tank’s expertise and insights, recommendations were made for solutions to different issues in healthcare, including:

• Improvements in case findings to support early diagnosis

Including normalising brain health checks and discussing cognitive health in the primary care setting and supporting the role of practice nurses in the discussion and assessment of mild cognitive impairment (MCI).

• Clarity and structure on diagnostic pathways

Such as establishing standardised referral, diagnostic and support pathways; supporting multicultural health professionals to champion discussions of MCI and Alzheimer’s disease (AD) in their communities, and supporting the development of dementia-friendly communities.

• Establishing infrastructure and skills to deliver treatment options

Including exploring the potential for case managers or care coordinators to support people recently diagnosed to access treatment and support services, and upskilling practice nurses and pathology centres to administer disease-modifying therapies (DMTs).

• Growing awareness and understanding of the importance of brain health

Recommendations include developing an education and awareness-raising campaign for the general public on MCI, AD and the importance of early identification; conducting an audit of existing medical education programs on cognition to identify availability and gaps; and incentivising primary health professionals to undertake further cognition education.

• Determining the role of primary care

Such as exploring the potential for specific aged-care primary practices; and determining the financial supports required to better support primary care practitioners to play a role in cognitive assessments and dementia care.

• Establishing system-wide collaboration and integration

Including supporting the development of a national framework for the management of MCI/AD in Australia; and establishing multidisciplinary teams (MDTs) to help coordinate and optimise care.

Chair of the Australasian Association for Academic General Practice and Dementia Specialist, Professor Dimity Pond, was another expert that was involved in the Think Tank.

She says, “The Think Tank highlighted work that is already underway across the system to address some of these areas, but we must do more.

“Coming together earlier this year proved that we can be more impactful and efficient when we work together. Combining our experience, expertise and resources we have the chance to ensure our system is fit-for-purpose and well-prepared for what lies ahead of us.”

There will be a committee established, the Brain Health Collective, which will continue to advocate for the recommendations in the Paper, continue discussions on dementia, and drive future healthcare reform and solutions.

To view the full White Paper, you can download it from here.