National Framework for Action on Dementia 2015-2019

The National Framework for Action on Dementia 2015-2019 in Australia aims to provide improved life for the dementia patients and their caregivers. The policies and strategies include increasing awareness and reducing risks, timely diagnosis, accessing care and support post diagnosis, accessing continuing care and support, and care during the hospitalization period and post hospitalization period. The target audience is the older age population, and healthcare professionals have a crucial role in implementing these policies.

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1. POLICY STATEMENT
Australia is one of the high- income countries in the world and it also has a
very large and enhancing older age population. The quantity of the total older age
population is smaller than of total older age population of the japan and western
Europe. The among of total older age population ( Age 65 years or above) in
Australia in recent time is 15% of the total population and it is expected that the
number will increase to 22.5% by the ending of 2050(McPake & Mahal , 2017). The
increasing older age population I recent years is mainly due tip few reasons and they
are lowering rate of older age people mortality and another reason is the declining
fertility rate. In 1960, a 65 years old male can expect almost 12.5 years of additional
life. Whereas, with growing technology in medical science, this additional life
expectancy has increased and almost reaches about 19.5 additional years of living.
However, for the female the number is 15.7 years and 19.5 years respectively
(McPake & Mahal , 2017). In addition to this, total fertility rate is also decreased to
1.9 ( 2013) from 2.9 (1973) (McPake & Mahal , 2017). With growing numbers of
older age population, there are various health care service and policies to address
the problems of older age population. Mainly the older age population have the
problems like dementia, hearing problem, Alzheimer’s disease, fall related problem
due to their aging. In Australia it is assumed that by 2050, almost 1.13 million of
older age population will be affected by the dementia and this wil ultimately increase
the social burden and in 2013 the number was almost 322,000 (McPake &
Mahal , 2017). However, not only Australia, the global scenario of this disease is

very much serious. Australian government has taken various measures to address
the problem of the dementia. To implement those policies the health care
professionals ( HPs) and the health care systems play a crucial role. The main oal of
those policies are to prevent the risk factors of dementia in the older age population.
The National Framework for Action on Dementia 2015-2019 has been developed
under the guidance of Australian health ministry and this involves all the family
members, care givers in the care policies of dementia patients.
2. AIMS
The main aim of this National Framework for Action on Dementia 2015-2019
is to provide improved life for the dementia patients and also to their supportive
caregiver of the family. This framework is designed to inform the policies to the
dementia affected people and as well as to increase the proper awareness to the
older age patients with the dementia ((Australian Government, Department of
Social Services ,2015).
3. TARGET AUDIENCE
In this case, although dementia prevention policies are applied to all
population, the main target audience of these policies are the older age population
that is the age group of 65 and over. It is also evident that, the prevalence of
dementia in older age people is much higher than other age group people.
4. RESPONSIBILITIES
The implementation of those policies is completely dependent on the
general practitioners, multi- disciplinary teams of the health care centre
and also the various tools of assessing dementia that too help the HPs to

assess the problems of dementia patients. The general practitioners are
the first level of caregiver of the dementia patients as they can assess the
symptoms of the disease and start the initial procedures of the policy. They
are also responsible for the long term planning and policies for the disease
as well. To provide a proper support the general practitioners should have
proper knowledge about the disease , its prevalence, the evidence of the
disease. In addition to this, the awareness about the patient service, the
knowledge about the clinical tools about that disease will also help them to
implement the policies properly. General practitioners also need to know
the seriousness of the disease and according to the condition, they have to
refer the patients to the other specialists. The home-assessment that is
implemented by the nurses can be a crucial part of the dementia care
policy. As dementia needs a multidisciplinary team to implement the
pollicises of care , there are various members of the multidisciplinary team
such as experts in various sections like neurologists, cardiologist,
anaesthetist, psychiatrist, geriatricians, specialist nurses. Along with this,
the family and other care giver of the patients plays a crucial role in
detection of dementia as they are in the family can see the person most of
the time. This information from the family member is a crucial factors for
the HPs too. However, if the disease is detected in early stages, it is quite
easy to keep the patient under the strategy plan. Whereas the people who
are living alone and may not have the family support , the multidisciplinary
teams play crucial role in assessing the symptoms of those people with the
support of the community and give proper support to the lonely older age
people with dementia. The diagnostic tool that is required to assess the

dementia, has a critical responsibility in implementing those policies of
dementia as depending on those assessment, the patient can be enrolled
under the care policies. The aim of the aim the assessment of this disease
is to document the information about the changing behaviour of the
dementia patient. Along with this, the psychosocial issues, functional
behaviour, changed behaviour of the patients are also assessed. There
are various tools available to help the assessment of the disease. However
there are also few problems to achieve actual diagnosis about the disease
in some specific population group like people who have CLAD
background, Aboriginals and Torres strait Islander people. However, to
solve this problem, there are different tool for those people to address the
dementia among those people (Stokes, 2017).
5. DEFINITIONS
Under dementia, there are 100 different diseases that affect the
nervous system and brain tissues and ultimately causes progressive
development of declining function of cognitive function, memory, emotional
control, learning behaviour, decision making process as well. Dementia is
natural process of neuronal degeneration. It is associated with several
disease that is there are a number of various disease that can cause
dementia. Among them, the Alzheimer’s is one of the most common one and
causes almost 70-75% of dementia scenarios. In the second position of
dementia cases there is vascular dementia and causes almost 20-30 % of
total cases (Australian Government, Department of Social Services ,2015).
Although dementia is closely associated with the aging process ,but aging is

not the only reason of the dementia. It can be said that dementia one of the
major causative factors for the disease and it can also affect the younger
people. However, the prevalence is mostly seen in the older age population.
6.DOCUMENTATION
The National Framework for Action on Dementia 2015-2019 is based on the
few key principles. The dementia affected older age population should be
given proper value and respect and they also should be helped to maintain
the proper quality of life that includes their choice, safety that is emotional ,
physical and psychological safety, dignity. Their family members and other
care giver also should be respected. To motivate them for their life they
should be encouragd to participate in the various social activities. The people
with dementia should be given a proper care to implement various policies
and all the facilities should be given in a family person cantered way. The
policies under the National Framework for Action on Dementia 2015-2019 has
several policies. They are as follows (Australian Government, Department of
Social Services ,2015)-
A) Increasing awareness and reducing risks
As dementia is the third at position of causing death in Australia and it
was quite unusual that only one person out of five has knowledge about this that
disease In a study it is seen that, only one Australian among the every three feels
comfortable to spend time with the dementia patient(Smith, Ali & Quach, 2014). The
lack of proper awareness about the disease is responsible for this . Along with this,
negative perception and misbelief about the disease is also responsible for the
negligence about the disease. To resolve the problem there are few measures under
this policy and they are- a dementia community can be developed in a very friendly

manner where there will be proper environment for the dementia affected older age
people. Community based programmes can be arranged to promote social
engagement of the dementia patient . In addition to this proper awareness
programme should be launched to respect and understand the rights of the
dementia patient. A evidence based awareness will be mostly effective in this
condition and also an actual picture of consequences of the dementia should be
included in the awareness programme. The HPs and other care giver also should be
given proper knowledge about the disease.
B)Timely diagnosis
Timely diagnosis of the disease is one of the key factor of combatting against this
disease as the earliest recognition will help the HPs to bring the patient under the
dementia policy(Laver et al., 2016). There is a social stigma about the dementia that
it is a part of the normal ageing process and memory loss is a part of the disease
too. These are major barriers for the treatment of the disease(Swaffer,2014). This
problem can also be resolved by proper awareness programme among the society.
The HPs ,other nursing professionals and the multidisciplinary team are the major
part of this policy plan. To increase awareness among the HPs, proper education
and ongoing training can be conducted and that will ultimately increase the trained
person in the health care centres(Hunter & Doyle, 2014). The modern technology
should be used in assessing the disease. In this case, telehealth can be used and
along with this use of the specific diagnostic tools for the Aboriginal and Torres
islander people should be encouraged. The older age people who have dementia
and their family member, other care giver should be supported with proper
information to remove the misconception about the disease (Fleming & Sum, 2014).

C)Accessing care and support post diagnosis
After detection of the dementia, there should be proper effective planning and
decision making related to the patient. There should be interdisciplinary care that
includes a proper referral pathway. Dementia people may require continuous
monitoring and support from the HPs. In referral pathways, the HPs will refer the
patients to the appropriate specialists like geriatricians, counsellor according to the
condition of the patient. The HPs need proper transparent guidelines and as well as
information about the referral pathways that can assist them to refer the patient to
the proper specialist (Samsi & Manthorpe, 2014). Person cantered care should also
be followed to give them mental strength to fight against the disease. In this care, the
patient and his or her family is directly involved in the treatment process. This care
policy for the dementia policy will allow the patient to enhance their independent
nature and the decisions are mainly made according to the needs of the patient
(Brooker, & Latham, 2015).To implement the referral strategy, there should be ideal
referral pathway and that must be followed during the referrals. The HPs must also
follow the idea of family centred care policy to include the family in the treatment.
D)Accessing continuing care and support
Due to the progressive nature of the disease, it requires a continuous changing
treatment that means the carers of the dementia people need various facilities like
respite, community, residential care. It is seen that, people with dementia shows
better response when they are given care by their family and that also reduce the
health care cost for the person. In order to engage the dementia patient in several
activities, they should be engaged more in various social activity. Another important

strategy is to maintain the respite care that giving same priority to the care giver of
the patient (Neville et al., 2015). Residential care is another important in the policy
for caring dementia. In this care, the best plan is to meet with the people in the
residence and the activities of daily life like bathing , eating should also be
encouraged and that will promote the self-esteem, independence behaviour, and
dignity (Fleming et al., 2016). Dementia patient should be given a safe environment
and this will ultimately reduce the agitation, confusion and will increase the social
interaction in the dementia patient. A ultimate collaboration between the HPs, health
care centre, patients’ caregiver will prevent the hospitalization and help the patient to
stay in the home environment (Chenoweth et al., 2014). In case of CLAD
communities, the culturally appropriate care should be given.
E)Care during the hospitalization period and post hospitalization
period
Dementia patients need the acute care setting in caring of the patient and in this
practice the family member and the HPs have a major role. Dementia awareness
training should be included in all the courses of undergraduate and post graduate
courses of nursing so that they can have awareness. Age specific design principle
for dementia should be followed to create an environment that ultimately supports
the dementia. Along with this, in hospital setting there should be an exact discharge
and admission planning for the dementia patients and in hospital there should be a
proper a secure and safe environment that can fulfil the needs of the patient (Martin
et al.,2016).
F)Palliative care
Palliative care is very much essential for the dementia patient and for their carer too.
The planning of future medical care and is very much important for the people wit

dementia . This future care planning mainly means that , the patient’s of dementia
include himself or herself in the care plan and can get assurance about the condition
that they may have in future. A proper palliative care plan can improve the condition f
dementia. To increase the practice of palliative care there should be a awarness
programme in the people. Carers should also be given proper training about the
palliative care of the dementia patients (Robinson et al., 2014).
G)Supporting research
To promote the awareness and for maintaining the dementia
policies ,Australian government had published its aged care reform package
that allows almost $3.7 billion of funding for five years for the betterment of the
aged dementia patient and among them government will give $268.4 million I
five years. Among them, $41.3 million is for the supporting the HPs in timely
diagnosis of dementia. $41 million is for the betterment of the older age
population with dementia in residential care. $123 million for the home care
facilities, $ 39.2 million for improvement of acute care services( Brian , 2014).
In addition to this, $200 million is extra provided for the research of the
dementia that is coordinated through NHRMC. This funding is for the project
of Living Longer Living Better (Jeon & Kendig, 2017).
.

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8. REVISION & APPROVAL HISTORY
Date Revision No. Author and Approval
2015