DESK REVIEWS | 07.02.01.01 Does the country provide health and long-term care services to support people with dementia in community-based settings?
DESK REVIEW | 07.02.01.01 Does the country provide health and long-term care services to support people with dementia in community-based settings?
Health and long-term care in community-based settings are provided through SUS and SUAS for all people who need them in the country. People living with dementia may access these services the same way people without dementia do. Health (SUS) is a right by the Brazilian constitution, whereas social care (SUAS) is means/needs tested.
Dementia organisations like NMT and private attender agencies like Portea, Life Circle Elder Care and more, run few home-based care programs primarily in urban areas where paid attenders are available to support home-based care.
Few studies have also examined the effectiveness of community-based interventions for people with dementia and their families. Dias and colleagues (2008) conducted randomised controlled trials to examine the impact of a community-based intervention consisting of home care advisors on caregivers of people with dementia in Goa, India. The authors found that this intervention led to improvement in caregiver mental health (Dias et al., 2008).
Dias, A., Dewey, M. E., D’Souza, J., Dhume, R., Motghare, D. D., Shaji, K. S., …& Patel, V. (2008). The Effectiveness of a Home Care Program for Supporting Caregivers of Persons with Dementia in Developing Countries: A Randomised Controlled Trial from Goa, India. PLoS ONE, 3(6), e2333. https://doi.org/10.1371/journal.pone.0002333
Persons with dementia are mostly taken care of by family members at home. The only services in community-based settings are at referral county hospitals at the mental health clinics and delivered by mental health nurses or psychologists. This involves counseling services mainly to the caregiver on the best ways of taking care of their loved ones. Little emphasis is made on the care of the carers and to people with dementia unless they are able to engage in a conversation. The mental health workers receive the person at advanced stage making it difficult to speak directly with persons with dementia (Musyimi et al., 2019; Musyimi et al., 2021).
Musyimi, C. W., Ndetei, D. M., Evans-Lacko, S., Oliveira, D., Mutunga, E., & Farina, N. (2021). Perceptions and experiences of dementia and its care in rural Kenya. Dementia. https://doi.org/10.1177/14713012211014800
Musyimi, C., Mutunga, E., & Ndetei, D. (2019). Stigma and dementia care in Kenya: Strengthening Responses to Dementia in Developing Countries (STRiDE) Project. In World Alzheimer Report 2019: Attitudes to dementia (pp. 121–122). London, UK: Alzheimer’s Disease International. https://www.alzint.org/u/WorldAlzheimerReport2019.pdf