DESK REVIEWS | 04.04.01.03. Timely dementia diagnosis, post-diagnostic supports and care
DESK REVIEW | 04.04.01.03. Timely dementia diagnosis, post-diagnostic supports and care
The “National Policy for Primary Care” is responsible for the first contact with the population and for referring people to more specialised services in order to receive proper diagnosis (Brazilian Ministry of Health, 2012). We had previously estimated that dementia is underdiagnosed, and we believe that those diagnosed are in general at more advanced stages of the disease. In practice, patients suspected to have dementia by primary care professionals should be referred to a specialist (usually a geriatrician, psychiatrist, or a neurologist), who will follow through each case and will prescribe anti-cholinesterase drugs or other medication routinely. The post-diagnostic support is generally provided through primary care services in which people living with dementia would receive a similar type of support like other older people with chronic conditions. The care itself is not provided by public services and there are no dementia-specific mainstream post-diagnostic services for people living with dementia and their carers. A few initiatives can be found locally through University hospitals where support groups are provided, or through private services.
Brazilian Ministry of Health. (2012). Política Nacional de Atenção Básica. http://22.214.171.124/dab/docs/publicacoes/geral/pnab.pdf
The fourth action step focuses on early diagnosis and management. However, post-diagnostic support outlined second action step appears to be more focused on caregivers and provides little information about post-diagnostic support and care for people living with dementia (Ministry of Health Republic of Indonesia, 2015b).
Ministry of Health Republic of Indonesia. (2015b). National Strategy: Management of Alzheimer and Other Dementia Diseases: Towards Healthy and Productive Older Persons. Ministry of Health Republic of Indonesia.
It points out the need for timely diagnosis and treatment, as well as for strengthening care at the community and family level, with a comprehensive outpatient, non-hospital vision for the long-term care of patients with dementia, through specific rehabilitation programs.