Nursing Review Issue 2 March-April 2022 - Page 22

clinical practice
clinical practice
Professor Michael Woodward . Photo : Eugene Hyland
“ Advocacy by the aged care industry and advocates is going to help .

System ‘ shake up ’

Dementia experts urge for health system reform .
By Eleanor Campbell

Australia ’ s healthcare system will buckle under an increase in cases of Alzheimer ’ s disease unless systemic reform is introduced , experts have warned .

The nation ’ s top brain doctors and advocates outlined a number of strategies to better treat the condition in the Future for Alzheimer ’ s disease in Australia White Paper .
Associate Professor Michael Woodward , who helped to develop the paper ’ s key recommendations , said there are not enough resources to give future generations the care they will need .
“ We ’ ve estimated that all of the memory clinics in Australia can only assess only about a quarter of all people with new cognitive disorders ,” Woodward told Nursing Review .
“ Private specialists can do some of the work , but they have difficulty accessing neuropsychology and other investigations , which can be very expensive .”
The number of Australians with Alzheimer ’ s disease is expected to rise to one million by 2058 .
According to the treasury , estimated costs for treatment rose to more than
$ 15 billion in 2018 , a figure expected to nearly triple as the population ages .
Woodward , who heads the Austin Memory Clinic in Victoria , said that general practitioners and nurses should be armed with better training to help meet growing demand .
“ We don ’ t have any such specialist training of general practitioners here in Australia ,” he said .
“ We know GP ’ s talk about preventing heart disease and preventing cancer , but preventing cognitive decline is important because Alzheimer ’ s will be the main cause of death in our society .”
In response to rising rates of dementia , the UK introduced admiral nurses in 2012 to give specialist support to patients and their families .
Studies have shown the program reduced pressure on the public hospital system and helped to initiate more personalised forms of care .
Establishing a similar program in Australia could help to minimise delays in diagnosis and treatment , said Woodward .
“ We need primary health care teams to better recognise cognitive disorders and to have a clearer root or pathway into diagnosis ,” he said .
“ A recent patient of mine I saw just a few days ago has been struggling to work out where to go , the GP finally referred him to me , but he just said to me that the precipitant was the people in his golf club who contacted his wife .
“ His mates knew that there was something going on but the health professionals hadn ’ t really done much about it and didn ’ t know what to do about it .”
Experts are also calling for increased awareness around the development of treatment options for Alzheimer ’ s disease .
Last year the US Food and Drug Administration approved the first new drug in nearly twenty years designed to slow the progress of the condition .
Aducanumab , sold under the brand name Aduhelm , has divided the scientific community due to its side effects and efficacy on symptoms .
“ This is a major breakthrough , no question about it , but it ’ s one of several ,” said Woodward .
“ We need our colleagues to better understand that even though these drugs aren ’ t absolute miracles , they are the beginning of a process whereby we are only going to have better and better drugs as time goes on .”
In preparation for the shifting treatment landscape , the public should continue to demand better quality drugs , Woodward said .
“ We saw the same with other conditions such as AIDS where it was argued that the healthcare professionals were a bit slow , but the public didn ’ t lie down and accept that .
“ Unfortunately , older people with Alzheimer ’ s are not quite as good at advocating as 40-year-olds with HIV , but nevertheless I think that advocacy by the aged care industry and advocates is going to help .”
Following the recommendations outlined in the report , an expert brain health committee has been formed to continue to advocate for reform .
“ There ’ s no doubt that if we start treating hundreds of thousands of people with very expensive drugs it will put a huge cost on the health care sector ,” said Woodward .
“ We need to significantly shake up the system for the tsunami of Alzheimer ’ s and dementia which is upon us .” ■
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