DESK REVIEWS | 05.08. About public awareness campaigns and dementia, have these (or earlier) campaigns been evaluated? Is there evidence of impact?
DESK REVIEW | 05.08. About public awareness campaigns and dementia, have these (or earlier) campaigns been evaluated? Is there evidence of impact?
Most of the public awareness campaigns were conducted out of funds mobilised by ARDSI and, thus, no impact study was conducted. Two campaigns conducted by the ARDSI national office in Kerala had local state funding as part of the Kerala State Initiative on Dementia (KSID project) (Social Justice Department and ARDSI, 2014). Feedback was collected at some of the sites where the project was implemented; however, these records are not publicly available.
Social Justice Department and ARDSI (2014). Kerala State Initiative on Dementia. Alzheimer’s Disease International.
There has not been formal evaluation for the campaigns. However, the awareness campaign that was held in local dialect (Kikuyu), had a greater number of views in YouTube (17,000) than the campaigns that were held in English language, which had about 1,000 views each. There was also more feedback on the awareness campaign held in kikuyu language (Alzheimer’s & Dementia Organization Kenya (ADOK), 2018). From preliminary discussions, STRiDE Kenya intervention revealed an increased interest among Community Health Workers in expanding coverage to target more community members.
Alzheimer’s & Dementia Organization Kenya (ADOK). (2018). World Alzheimer’s Day 2018.
No, currently no specific initiatives to improve the accessibility for people with dementia are in place. However, several laws and regulations around the rights of people with disabilities include granting accessibility to public spaces and buildings, making education and work opportunities available, as well as enhancing mobility (streets).
Some actions were taken to make public spaces and buildings more accessible; such as parks with parking lots reserved for older people, ramps for entering public buildings, wider sidewalks to reduce older people’s risk of falling. However, these improvements are not evenly adopted across the country. Many cities and neighbourhoods do not have any of these accessibility spaces, especially those located in the poorer regions of Brazil. Some cities in the country have developed a program called the “City Gym” (Academia da Cidade, in Portuguese). This program aims to revitalize public spaces by making them more accessible and transforming them into public gyms where people of all ages can participate in physical activities and enjoy a leisure environment (Recife City Hall, 2019). Based on this programme, originally developed by some municipalities, the Brazilian Ministry of Health created the “Health Gym” (Academia da Saúde, in Portuguese) Programme, which aims to promote physical activity, healthy diet, education in health, and healthy and sustainable lifestyle at national level (Brazilian Ministry of Health, 2011a).
Brazilian Ministry of Health. (2011a). Academia da Saúde.
Recife City Hall. (2019). Academia da Cidade | Prefeitura do Recife. http://www2.recife.pe.gov.br/servico/academia-da-cidade
Free public transport is available for people over 65 years of age using urban public transportation, as secured by the ‘older people’s statute’ (Presidency of Republic of Brazil, 2003). For more details on this, please refer to part 9. The public transport is mostly made up of buses and, although they have priority seats for older people, they are not well adapted in terms of accessibility for older people to use them. For example, the buses’ steps are very steep, making it difficult for many older people to enter. In addition, the bus floors may not be adequate or spacious enough for older people to walk on. A selection of the buses available are adapted for disabled people, in which wheelchairs can be allocated. People living with disability should also have access to free transportation under the ‘disabled people’s statute’. The Federal and District Attorney services are responsible for ensuring that these laws are realised in practice at municipal level.
Presidency of Republic of Brazil. (2003). Estatuto do Idoso. Presidency of Republic of Brazil; National Congress of Brazil’s Information System. http://www.planalto.gov.br/ccivil_03/leis/2003/l10.741.htm
There have been various initiatives in Indonesia aimed to increase the elderly’s access to public transportation services and to increase their general mobility. In 2017, the City Government of Bandung plans to eliminate fees for the use of public transportation for elderly citizens. The mayor ensured that the Bandung City Government was committed about empowering its elderly citizens, such as through the creation of the Elderly Regional Commission (Komda Elderly) of the City of Bandung (Pemerintah Provinsi Jawa Barat, 2017).
In 2020, DAMRI, a State-Owned Enterprise supported the Government of West Java to become an operator of Scania Low Deck buses. This type of bus is accommodated to the needs of elderly and disabled population (Humas DAMRI, 2020).
Humas DAMRI. (2020). DAMRI Operasikan Bus Scania Low Deck Ramah lansia, Difabel dan Lingkungan.
Pemerintah Provinsi Jawa Barat. (2017). Hormati Lansia, Pemkot Bandung Gratiskan Transportasi.
The Brazilian Ministry of Health produced guidance on home safety for older people, which is available on its Virtual Library Webpage (Brazilian Ministry of Health, 2018b). The state of São Paulo has adopted a “Universal Design” for guiding the construction of affordable homes and villas in the state. As part of it, there is a public document with guidance towards home adaptation aiming at including all citizens with special needs over the life-course (Government of the State of São Paulo, n.d.). Some manuals for carers also include guidance on home modification, for example, the Alzheimer’s Carer Manual (d’Alencar et al., 2010). Health professionals frequently provide guidance to patients regarding home safety. However, we could not find any document (widely-known by the population) with guidance towards home modification.
Brazilian Ministry of Health. (2018b). Casa segura para o idoso. http://bvsms.saude.gov.br/dicas-em-saude/2920-casa-segura-para-o-idoso
d’Alencar, R. S., Pedreira dos Santos, E. M., and Tebaldi Pinto, J. B. (2010). http://www.uesc.br/editora/livrosdigitais2015/alzheimer_manual_cuidador.pdf
Government of the State of São Paulo. (n.d.). Desenho Universal: Habitação de interesse social. Retrieved November 18, 2019, from http://www.mpsp.mp.br/portal/page/portal/Cartilhas/manual-desenho-universal.pdf
The Ministry of Social Affairs has led various ad-hoc initiatives to renovate residences of elderly living in villages. However, as of 2014 the renovation funding allocated per house was only IDR 10 million. The Minister of Social Affairs then argued that this budget is limited to evoke a sense of community spirit in the villages and entice neighbours to help the rebuilding process, thus saving labour costs (Marbun, n.d.).
Marbun, J. (n.d.). Kementerian Sosial Terus Perbaiki Rumah Lansia. 2014.
The SUS provides assistive technology such as wheelchairs, walking sticks, orthoses, protheses etc. (Brazilian Ministry of Health, 2016a). More details on this matter can be seen in Part 7.
Brazilian Ministry of Health. (2016a). Conheça a assistência oferecida pelo SUS às pessoas com deficiências.
There has been no widely available assistive technology to compensate for loss of capacity. However, the DKI Jakarta province developed an electronic reporting system through an application called Qlue, where people can report problems encountered in the city, including if they are finding an older person who is lost (Jakarta Resmikan Pasukan Ungu Bantu Penderita Demensia, 2016).
Jakarta Resmikan Pasukan Ungu Bantu Penderita Demensia. (2016). BeritaSatu. https://www.beritasatu.com/kesehatan/387342/jakarta-resmikan-pasukan-ungu-bantu-penderita-demensia
There are initiatives to improve community places in Brazil. Some municipalities have created age-friendly neighbourhoods and the International Longevity Centre – Brazil (ILC-Brazil), which is a think tank advocating longevity and active ageing, and has supported and supervised “age-friendly city” projects in Brazil (ILC Brazil, 2019). However, these initiatives are isolated and not generalised throughout Brazil. For example, in the city of São José dos Campos, in the state of São Paulo, there are age-friendly houses where older persons go to meet each other, exercise, dance and socialize together. This is a municipality initiative that is run by the department of social development, and not within the health department. In the state of São Paulo, there are social centres (social meeting spaces) for people aged 60 years and over to meet, socialize, and participate in activities (Secretaria Estadual de Assistência e Desenvolvimento Social, n.d.).
ILC Brazil. (2019). ILC BRAZIL. http://ilcbrazil.org/
Secretaria Estadual de Assistência e Desenvolvimento Social. (n.d.). SP Amigo do Idoso. Retrieved November 10, 2019, from http://www.desenvolvimentosocial.sp.gov.br/portal.php/programas_spamigodoidoso
There exist senior clubs where older people can meet and do social activities together. For instance, Griya Adiyuswa in Bintaro offers various activities, including cognitive stimulation therapy for prevention of dementia (Komunitas Lansia Griya Adiyuswa, n.d.).
Komunitas Lansia Griya Adiyuswa. (n.d.). Komunitas Lansia Adiyuswa Senior Club. 2019.
In Brazil, the FEBRAz associations organise social events for people living with dementia during the month of September. Throughout the rest of the year, the supporting events are targeted at carers of people living with dementia (FEBRAZ, 2019). Moreover, municipalities develop initiatives and places where older people can participate in social activities.
FEBRAZ. (2019). Instituto Não Me Esqueças. Http://Www.Naomeesquecas.Com.Br/. http://www.naomeesquecas.com.br/conteudo/
In 2015, the governor of Jakarta, Basuki Tjahja Purnama, invested in developing capacity for dementia including accessibility initiatives. He was awarded by Alzheimer’s Disease International for his efforts on investing into the programmes. Some of Purnama’s initiatives included the construction of taman lansia (a garden for the older people) and a villa for older people in Ciangir, Tangerang (Bogiarto & Martiyanti, 2015). He declared Jakarta to become a dementia-friendly city (Florentin, 2015). However, he has since lost his political power and was imprisoned (Mazrieva, 2019). It remains to be seen whether the successors will prioritise dementia.
Bogiarto, W., & Martiyanti, E. (2015). DKI Terima Penghargaan Ramah Demensia dan Lansia.
Florentin, V. (2015). Ahok Declares Jakarta as Age and Dementia Friendly City.
Mazrieva, E. (2019). ‘Ahok’ Case Highlights Indonesia’s Blasphemy Law.
The Self-Help Associations Bill 2015 provides a framework for the registration, operation and regulation of self-help associations at the county level of government. This allows people regardless of age to participate in economic activities within the counties and in turn, to improve their economic welfare. However, there are no planned activities specific to old age (Republic of Kenya, 2015).
Republic of Kenya. (2015). The Self-Help Associations Bill 2015. Kenya Gazette Supplement No.21 (Senate Bills No.2), 27 February, Nairobi, Kenya. 5–35. http://kenyalaw.org/kl/fileadmin/pdfdownloads/bills/2015/SelfHelpAssociationsBill_2015.pdf