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Dementia strategy focusing on care
On 24 May, the Government adopted a national strategy for dementia care. Sweden’s population is living longer. Life expectancy has risen almost continuously for the past 250 years, and is currently more than 84 years for women and close to 81 years for men. The risk of developing dementia rises with increasing age. This national strategy will enable the Government in the coming years to adopt a more comprehensive approach to dementia care. The Government wants to secure improved quality of care and increased safety and security for people with dementia and their families.
The strategy identifies seven key strategic areas in which the Government wants to secure improvements:
• Collaboration between health and social care
• Knowledge and skills
• Monitoring and evaluation
• Family and friends
• Digital and assistive technologies
"More and more people are living longer and being diagnosed with dementia, and we must tackle this trend with knowledge and skills, and a more systematic approach. Now we finally have a dementia strategy," says Minister for Children, the Elderly and Gender Equality Lena Hallengren.
Collaboration between health and social care
Effective collaboration is essential. Otherwise, there is a risk that major problems can arise for individuals with dementia and their families. Ineffective collaboration between a municipality and a county council, for example, entails a risk that a woman or man who has just been diagnosed with dementia is not offered the support they need.
To facilitate better collaboration, the Government has tasked the National Board of Health and Welfare with promoting and spreading a standardised care pathway model for people diagnosed with dementia. The aim is to make it easier for municipalities and county councils to organise the health and social care of people with dementia. The model will help ensure that people with dementia are offered the right support and the right interventions at the right time throughout the course of their illness.
For women and men with dementia, it is important that there is sufficient staff with knowledge about their particular needs. In 2015–2018, the Government invested SEK 7 billion to increase staffing levels in care for older people with the aim of improving care quality, safety and security for individuals. The National Board of Health and Welfare's follow-up indicates that in the first year alone, 2015, this staffing investment funded approximately 5 000 full-year equivalent employees across different professional groups for municipal and private providers of care for older people.
Knowledge and skills
For municipalities and county councils to be able to offer health and social care of high quality, ensuring staff have the right skills is essential. In its supporting documents for the national dementia care strategy, the National Board of Health and Welfare points out that knowledge about dementia is lacking in all professional groups working in social services and health care. In 2016, the Government invested SEK 178 million in skills development for support staff caring for older people and people with disabilities, an investment primarily in assistant nurses and care assistants. Municipalities have carried out 1 200 training initiatives on values, ethics and dementia.
Monitoring and evaluation
It is important to be able to monitor, both locally and nationally, the progression of the disease for people with dementia. Two quality databases are available for this – the Swedish Dementia Registry (SveDem) and the BPSD registry (register of behavioural and psychological symptoms of dementia). The Government has provided financial support for these databases for several years, which will continue in 2018.
Family and friends
The Government believes that in health and social care, the views of the families of the people with dementia are important. Families must be confident that their voice is heard and that their loved ones receive the health and social care they need. Dementia affects not only the person who has it, but also their family and friends. The work of the Swedish Family Care Competence Centre includes gathering and disseminating knowledge about how to develop the social services provided to families. It is essential that staff understand the importance of communication, information and training for families. Municipalities are required to provide support to families under the Social Services Act.
Achieving a dementia-friendly society requires collaboration and cooperation between the central government, county councils, municipalities, non-governmental organisations and the rest of civil society. It is essential that people with dementia are met with understanding and empathy – people must feel safe and secure living in Sweden, even if they have dementia.
Digital and assistive technologies
The Government believes that assistive technology solutions may greatly benefit people with dementia. They may enable women and men who have a disability, or who run the risk of developing a disability, to maintain or increase their confidence, independence and level of activity and participation. Assistive technologies may also improve the working environment for women and men working in social services. To better harness the opportunities offered by the increased use of assistive technologies, the pace of investment in these technologies needs to increase.
In the spring amending budget for 2018, the Government therefore proposed a targeted government grant of SEK 350 million to municipalities, which should go to investments in assistive technologies in social care.
Monitoring the national strategy for dementia care
In its appropriation directions for 2018, the National Board of Health and Welfare has been instructed to monitor and manage strategic issues within the framework of this strategy. The Board must present a plan for this work on 1 October 2018 and deliver its final report on 1 June 2022.
Investments in dementia care during this electoral period:
• In the 2015–2018 electoral period, the Government invested SEK 7 billion to increase staffing in care for older people, an investment that funded around 5 000 full-year equivalent employees and improved care quality, safety and security for individual older people.
• In 2016, the Swedish Dementia Centre was allocated SEK 1.8 million to increase the use of training material on countering the use of coercive measures in care.
• In 2017, the Government granted the Swedish Dementia Centre SEK 1.8 million to continue disseminating training material and SEK 910 000 to revise the Dementia ABC and Dementia ABC Plus training programmes.
• In 2018, the Swedish Dementia Centre received SEK 350 000 to follow up the Vision Zero training initiative and SEK 450 000 to support the training programmes Dementia ABC, Dementia ABC Plus, Working safely with drugs and Vision Zero.
• In 2016, the Government tasked the National Board of Health and Welfare with conducting an inquiry and producing comprehensive supporting documents for both a broad national dementia care strategy and a plan for prioritised measures in the area until 2022.
• In 2016–2018, the Swedish Dementia Registry was allocated SEK 1.5 million per year to develop the registry.
• In 2016–2018, the BPSD register (register of behavioural and psychological symptoms of dementia) was allocated SEK 1.5 million per year.
Facts about dementia
In Sweden, 130 000–150 000 people currently live with dementia, and each year 20 000–25 000 develop the disease. More women are affected than men, partly because women live longer and partly because dementia, especially Alzheimer’s disease, is more common among women.
There is no cure for dementia at present. However, through a variety health and care measures, it is possible to alleviate symptoms, make life easier and improve the quality of life for people with dementia and their families.