ADI Virtual Side Event and Report Launch Maintaining dementia as a - - PowerPoint PPT Presentation

ADI Virtual Side Event and Report Launch Maintaining dementia as a priority in unprecedented times

@AlzDisInt

Paola Barbarino CEO, 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
• n 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 O 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 t to d date: : MOH involved in mind walk organized by ADOK § May 2 2018: : Collaboration of the STRiDE team (Strengthening responses to dementia in developing countries) with Ministry of Health § June 2 2018: : STRiDE Theory of Change Workshop where the Ministry of Health got to interact with stakeholders involved in dementia care § 20 2018-2020: 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 2018-2020: : Generation of local evidence by STRiDE Kenya team which will inform the National Dementia Action Plan § 5th

th March 2

2020: : The Ministry of Health formally requested for partner support on the development of a National Dementia Action Plan. § 12 12th

th March 2

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 2 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

st June 2

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 2 2020: : First draft of the Situational analysis on overall health system, long term care and dementia care by STRiDE Kenya shared to stakeholders § 18 18th

th June 2

2020: : Submitted a concept note and updated budget (in the context of COVID 19 government directives) shared with partners including WHO § June 2 2020: : Plans underway for Kenya to contribute to the Global Dementia Observatory

MINISTRY OF HEALTH

Plan to impact roadmap

§ June 2 2020: : Technical Working Group (with representation from service user

• rganizations and families/carers) to spearhead the development and implementation
• f the National Dementia Action Plan (includes the National Advisory Group on STRiDE

Kenya) § June 2 2020: : National Dementia Action Plan and related activities is part of the annual workplan for the Division of Mental Health, Ministry of Health § Timelines s set f for N National D Dementia A Action P Plan: § Ju June-July 2 y 2020: : Planned first stakeholders meeting. Output: Draft zero of the Action Plan. § Ju July-November 2 2020: : Draft reviews and validation meetings. Output: Final Draft

• f the Action Plan.

§ No November-December 2 2020: : Launch of National Dementia Action Plan § January 2 y 2021-December 2 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

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QNDP Progress against WHO Indicators and QNDP Action Areas

WHO Indicators (Policy) Highlights Status Dementia governance MoPH appointed Focal Lead National 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 dementia Driving 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

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Progress against WHO Indicators and QNDP Action Areas

WHO Indicators (Service Delivery) Highlights Status Adequately trained dementia health and social care workforce

Launched training for 600 PHCC Family

• Physicians. In addition ongoing

education delivered to physicians, nurses, allied health professionals, clinical social workers National Dementia Training Programme Launched ADI Certified CSW Training Initiated

Dementia diagnostic rate (Global target diagnostics) Dementia Registry Project MRCGrant Approved 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 requirements Expansion of RH Memory Clinics Dementia-specific nongovernmental

• rganization

Qatar Alzheimer’s Association application-Legal approved - undergoing approval checks

QNDP Action Areas: Dementia diagnosis, treatment, care and support

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Progress against WHO Indicators and QNDP Action Areas

WHO 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 Alz Society ADI -LED 11 National Dementia Trainers Selected

Dementia awareness & risk reduction campaigns (Global target for campaign)

Qatar Participated in Worlds Largest Survey

• n Attitudes towards Dementia –ADI London

Led 3rd Annual WAM Campaign (Sept) 5000 People -23 Events Risk reduction messages to be embedded into NCD campaigns MOPH 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.Plus CSW Training

QNDP Action Areas: Support for Dementia Carers, Dementia Risk Reduction, Dementia Awareness & Friendliness

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Progress against WHO Indicators and QNDP Action Areas

WHO 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

• f 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 care QNDP 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

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COVID 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”National Alzheimers 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

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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 DrivingSafety

Guidelines /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 PRIORITYS DIFFERENT

PRE COVID CHALLENGES CONTINUE

Dedicated Budget Limitations 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 PhD 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 (MHLW) -Japan

25 June 2020 ADI Vir tual Side Event & Repor t Launch: Maintaining dementia as a priority in unprecedented times

https://maps.gsi.go.jp/#5/36.104611/140.084556/&vs=c1j0h0k0l0u0t0z0r0s0f1

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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 81.25 Female 87.32 Life Expectancy (1950) Male 59.57 Female 62.97

Development of National Policies on Dementia

2012 - 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 their families for the purpose of delaying the onset of dementia and building a society in which everyone can live with hope, even if they develop dementia

*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

• f 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 measures

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 ① Raising awareness / Supporting persons with dementia to express their views ② Risk Reduction

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③ 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 Policies

5 pillars of measures Japan Public-Private Council on Dementia Raising Awareness Dementia Supporter (>12M)

The Number of Saloons and Rate of Participants

43,15455,52170,13476,49291,059

2.7 3.2 3.9 4.2 4.9 1 2 3 4 5 6

20,000 40,000 60,000 80,000 100,000

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 Toyoake Branch (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 Policies

5 pillars of measures Dementia Café (>7,000) Support for caregivers Intensive Support Team Team Orange project

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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_aN6dcs4 https://www.ncgg.go.jp/cgss/news/20200605.html

• Apps for e-Saloon

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

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○ “Comprehensive Strategy to Accelerate Dementia Measures (New Orange Plan)” was formulated in 2015, and measures have been promoted aiming for realizing 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 regarding dementia issues under close collaboration among related ministries and agencies, and “National Framework for Promotion of Dementia Policies” was adopted 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 can live 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

• f 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

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Thank You for Your Attention !

39

Jeewon Suh, MD Deputy Director, National Institute

• f Dementia, Department of

Neurology, National Medical Center, Republic of Korea

Advances in the Korean dementia plan During 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 1 Case management, Supply of goods, public guardian Routine practice Stage 2 Home visit, counseling, screening and diagnostic test 1:1 contact with hygiene management Stage 3 Shelter, dementia cafe for family, cognitive training program Remote 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

• f 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

Thank you

E-mail: gudlaug.einarsdottir@hrn.is

Fumie Griego Deputy Director General and Chief Operating Officer, International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)

@AlzDisInt

? ? ? ?

Question and answer

Paola Barbarino CEO, 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.