DESK REVIEWS | 04.03.07. (How) are health and long-term care workforce represented in the policy document?
DESK REVIEW | 04.03.07. (How) are health and long-term care workforce represented in the policy document?
Yes. The need for multidisciplinary healthcare teams with sufficient knowledge about older people is mentioned as a challenge to be overcome in the National Policy for Older People’s Health and in the Law Project 4364/2020 (Brazilian Federal Congress, 2020; Brazilian Ministry of Health, 2006). However, the long-term care workforce is not specifically mentioned.
Brazilian Federal Congress. (2020). Projeto de Lei do Senado 4364, de 2020. https://www25.senado.leg.br/web/atividade/materias/-/materia/144381
Brazilian Ministry of Health. (2006). Política Nacional de Saúde da Pessoa Idosa. http://bvsms.saude.gov.br/bvs/saudelegis/gm/2006/prt2528_19_10_2006.html
The Mental Health Review Report (MHRR) recommends the Government to increase the supply and structured trainings for health and social care providers (e.g., social workers, nurses, occupational therapists, physiotherapists, programme assistants, etc.) to empower them with equipped necessary skills and knowledge in dementia care (Food and Health Bureau, 2017a, pp. 186-187). It also mentions the need to pilot the programme in order to test the readiness of service providers on clinical effectiveness, cost economic analysis, and service statistics (Food and Health Bureau, 2017a, p. 186). In the part of capacity building and workforce training, this report recommends that structured training should be given to empower service providers in detecting dementia symptoms, understanding the disease trajectory, and developing dementia care approaches (Food and Health Bureau, 2017a, p. 172).
The Elderly Services Programme Plan (ESPP) indicates the demand for long-term care services and workforce to address the increasing population of older people. Apart from ongoing measures to strengthen the workforce, it is also important to explore other sources of informal care providers, such as neighbours and volunteers who can serve as “elder-sitters” to support older people in the community (Working Group on Elderly Services Programme Plan, 2017, pp. 32-34).
Food and Health Bureau. (2017a). Mental Health Review Report. Retrieved from https://www.fhb.gov.hk/download/press_and_publications/otherinfo/180500_mhr/e_mhr_full_report.pdf.
Working Group on Elderly Services Programme Plan, Elderly Commission of Government of Hong Kong SAR,. (2017). Elderly Services Programme Plan. Hong Kong: Elderly Commission of Government HKSAR Retrieved from https://www.elderlycommission.gov.hk/en/download/library/ESPP_Final_Report_Eng.pdf.
The health and long-term care workforces are represented especially in the fifth action step: establishing a system to strengthen professional and sustainable human resources. This is described in their indicators, particularly:
- ‘Indicator 1.1 All medical and nursing schools are expected to include older people’s cognitive health in their curriculum.
- Indicator 1.2 Doctors and other healthcare workers who are trained in dementia management are present in all Puskesmas, hospitals, and senior homes.
- Indicator 1.3 There are healthcare workers who have been trained to be trainers for dementia management’ (Ministry of Health Republic of Indonesia, 2015a, p.22).
The Long-term care workforce appears to be represented by the Ministry of Social Affairs in the same action step. The plan describes the need to develop a strategy to ensure health care workers understand the role of care partners in dementia care coordination. The indicators are:
- ‘Indicator 2.1 There are regular meetings of all healthcare workers and care partners involved in dementia management
- Indicator 2.2 There is a dementia care coordination’ (Ministry of Health Republic of Indonesia, 2015a, p.22)
Ministry of Health Republic of Indonesia. (2015a). Ministry of Health Regulation No. 67/2015 on Geriatric Services in Public Health Center (Permenkes No. 67/2015 Tentang Penyelenggaraan Pelayanan Kesehatan Lanjut Usia Di Pusat Kesehatan Masyarakat). Kementrian Kesehatan Indonesia, 1–140.
The health and long-term care workforce is represented in the National Plan through two strategies, the first one aims at training adequate and specific human resources through the following lines of action:
- To increase the number of specialists to provide care for dementia patients, in accordance with the needs of the country.
- To implement permanent training programs to update health professionals and non-professional personnel.
- To include topics on aging during undergraduate and graduate training for all health professionals, with emphasis on dementia.
- To promote human resource training strategies, taking advantage of new information technologies and inter-institutional collaboration.
- To create scholarships for the training of non-medical health professionals specialised in the care of the elderly with dementia.
- To promote family guidance for better care and management of family members affected by dementia.
The second strategy is aimed specifically at long-term care in the last stages of the disease, focussing on the need for programs or services for comprehensive palliative care at home.
NZ Dementia framework:
One of the three key principles of the framework is the requirement to provide accessible, proactive, and interactive services and highlights the need for services to partner and engage the person with dementia and their family/whānau. The framework also identifies workforce education and training as important overarching factors and describes requirements for educational and training opportunities that should
- be based on best practice,
- focus on the meaning of a people-centred and people-directed approach,
- include input from people with dementia and their families and whānau,
- include experiential learning,
- address different learning styles and abilities, including English as a second language,
- recognise the different needs of cultural diversity and cultural groups and finds ways to address those needs,
- respond to the needs of people with co-existing conditions and/or impairments,
- be supported by the health and social support service providers.
Throughout the framework, guides and resources are provided for health and social service providers throughout the dementia journey.
Dementia Action Plan:
The dementia plan acknowledges the need to strengthen capability across the sector and identifies the need to “make training support across the medical, disability and social support services more available across the sector in all DHB area”.