Are older Australians slipping through gaps in primary healthcare?

The latest news from the Better Evaluation and Care of Health (BEACH) study, as recently covered at Croakey, raises some questions about the quality of dementia care, says Carol Bennett, chief executive officer of Alzheimer’s Australia.

Carol Bennett writes:

Carol BennettAre older Australians slipping through the health care gaps?

It was interesting to read the Bettering the Evaluation and Care of Health (BEACH) Report, Australian General Practice Activity 2014-15, released recently, which unequivocally said that older Australians are visiting their GPs more and more.

If this is the case, why then is the average time from first symptoms of dementia to diagnosis still three years?

We know that one in 10 people over 65 and three in 10 over 85 have dementia. If these older Australians are in fact visiting their GPs more and more – why is dementia still one of the most under-diagnosed and misunderstood of the chronic diseases?

We know that the role of primary health is absolutely critical for people with chronic conditions like dementia, as this is almost always their first point of contact.

Yet many GPs, as well as nurses and allied health professionals, have difficulty differentiating normal aging from the early stages of dementia. They often lack specific knowledge about dementia assessment, management and appropriate referral pathways.

At Alzheimer’s Australia, we believe this is due to a lack of good information and education about dementia, its warning signs, and its assessment, both for health care professionals and for the community in general.

The BEACH report indicated that with population ageing, older people have more chronic disease and higher health care needs and are going to require more diagnostics, more referrals, and more treatment and management.

We need to ensure these Australians are not falling through the gaps by providing targeted information and education on dementia in the primary health care area. This includes:

  • A systematic, competency-based approach to cognitive assessment, which includes input from family members and carers
  • Including cognitive assessment in the 75+ health assessment
  • Ensuring adequate management of medications that may cause or exacerbate cognitive impairment
  • Improving clear referral pathways to specialist dementia services
  • Providing education and support to enable primary health care nurses to play a greater role in assessment, diagnosing and managing dementia, as part of a primary health care team.

The 342,800 Australians living with dementia deserve to be better supported by their health care system so they can live successfully in the community for longer, where most people want to be, reducing early admission into residential aged care, reducing higher levels of avoidable hospital admissions and poorer end of life care.

To begin to achieve this, we need a comprehensive approach to education and information across general practice, primary health care, acute care and the aged care sector, to support our ageing population experiencing chronic illness.

• The report mentioned in the feature image, Dementia Friendly Societies, is available here.