DESK REVIEWS | 07.04.10. Question 07.04.02 investigated the number of residential long-term facilities. Do mental health hospitals/institutions play a role in the provision of residential dementia care?
DESK REVIEW | 07.04.10. Question 07.04.02 investigated the number of residential long-term facilities. Do mental health hospitals/institutions play a role in the provision of residential dementia care?
Yes, in a small proportion. The psychiatric reform in Brazil that happened in the last few decades reduced substantially the number of psychiatric hospitals, especially those that kept patients living there for many years. However, there are still some mental hospitals that continue to serve as residence for people with mental health that may include people living with dementia.
No, or probably a very limited role. For people with dementia who are aged under 60 but in need of hospital care or residential care, they may be referred to psychiatric inpatient service or Long Stay Care Home. Yet, there is no information about this group of people with dementia.
There are dementia patients in mental hospitals in Indonesia (PERDOSSI, 2015), although mental hospitals are not explicitly stated to be in the care pathway for dementia in the national clinical guideline (Wijayanto, 2019). For instance, in 2018 an older person was not allowed to embark on a pilgrimage trip to Mecca because of their dementia symptoms and was referred to a mental hospital (BPJS Kesehatan, n.d.).
BPJS Kesehatan. (n.d.). Panduan Praktis Pelayanan Alat Kesehatan. 2938.
PERDOSSI. (2015). Panduan Praktik Klinik: Diagnosis dan Penatalaksanaan Demensia. PERDOSSI.
Wijayanto. (2019). Mengidap Demensia Berat, JCH Asal Gagal Berangkat.
Mental health hospitals and institutions don’t tend to play a role in the provision of residential dementia care, with DHB run facilities accounting for only 0.3% (120 beds) of the total beds (NZACA, 2020).
NZACA. (2020). Aged Residential Care Industry Profile 2019/20. NZACA.
Based on this desk review, dementia seems to largely be acknowledged as falling under a psychiatric jurisdiction (mental health and not a non-communicable disease). As described previously, South Africa has 1 remaining psychogeriatric unit (3 wards, 77 beds) at Stikland Hospital in Bellville (Western Cape) (Health24, 2018b). Based on the information available from online sources it is unclear whether these beds are dementia specific. However, specialised treatment for dementia is usually provided by a psychiatrist (Health24, 2018b). There are an estimated 650 psychiatrists across the country (i.e., 0.4% per 100 000 in the public sector), with only 3 specialising in old-age psychiatry (Health24, 2018b).
Health24. (2018b). SA has only 3 psychiatrists specialising in old-age. https://www.health24.com/Mental-Health/News/sa-has-only-3-psychiatrists-specialising-in-old-age-20180813