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Global Epidemic - Local Action The Singapore Perspective

Global Epidemic - Local Action The Singapore Perspective. Prevalence Expected increasing numbers with a rapidly ageing population Costs High life time costs: financial, social, services utilisation to patients and families/ caregivers. Current Concern. Current Estimates. Source:

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Global Epidemic - Local Action The Singapore Perspective

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  1. Global Epidemic - Local ActionThe Singapore Perspective

  2. Prevalence Expected increasing numbers with a rapidly ageing population Costs High life time costs: financial, social, services utilisation to patients and families/ caregivers Current Concern Current Estimates Source: 1. Chiam et al. Prevalence of Dementia in Singapore – Results of the National Mental Health Survey of the Elderly 2003. Ann Acad Med Singapore 2004; 33(5): S14-15. NATIONAL MENTAL HEALTH SURVEY OF THE ELDERLY 2003 2. Dementia in the Asia Pacific Region: The Epidemic is here. Report by Access Economics Pty Limited for Asian Pacfiic Members of Alzheimer’s Disease International. 3. Sahadevan et a. Ethnic differences in Singapores’ Dementia Prevalence: The Stroke, Parkinson’s Disease, Epilepsy and Dementia in Singapore study. J Am Geriatr Soc 2008; 56: 2061-8.

  3. SINGAPORE BURDEN OF DISEASE (SBOD) STUDY – KEY RESULTS Top 10 Causes of DALYs for ages 65+, Singapore 2004 27 Feb 2008

  4. Stages of Dementia & Care needs Institutional care 15-20% Community care 80-85% Most can remain in the community  Better for them

  5. Emphasis on health promotion and prevention Individual responsibility, family responsibility Many helping hands approach PRINCIPLES OF HEALTH CARE FOR ELDERLY 3 “M” Financing Framework Medisave Compulsory medical savings scheme Insurance against catastrophic illness and large medical bills MediShield Medifund Safety net for the needy

  6. Dementia recognised as a priority Need to build more infrastructure & invest more resources More Capacity: Build more Community Hospitals, Nursing homes More Capability: Extended HMDP programme to ILTC sector More Money: Move beyond 3Ms to finance long-term care New 3 “E” Framework ElderSave Similar to Medisave (in-progress) ElderShield Severe disability Insurance scheme ElderFund Safety net for needy elderly Dementia – A Priority

  7. 1984: White paper on ageing 1985-2008 Multiple committees on ageing 2005: National Mental Health Blueprint Committee Recognised long-term investment needed & prioritised recommendations for action Additional investment in mental health of $88 million over 5 years (2007-20011) Areas of focus Mental Health Promotion Developing Community-based Services Integrating Hospital-based Services Developing Manpower Research and Evaluation A Brief History

  8. 2007: Formed a Working Group on Mental Health Inter-ministerial efforts for mental health; a whole-of-government approach Acting early to build mental resilience can prevent the onslaught of mental illness and improve chances of recovery NMHWG’s over-arching strategies Education and prevention Early detection and treatment Tailored measures to the needs of 3 population groups - Children, Adults, Elderly National Mental Health Working Group - Approach

  9. Health promotion across health spectrum Healthy At Risk Unhealthy • National Healthy Lifestyle Campaign (’92 – Current) • Encouragephysical activity, proper nutrition & decrease smoking • Encourage cognitive stimulation eg language classes, bridge, sudoku • Prevent & control diabetes, hypertension & hyperlipidaemia • Talks and skills-building workshops on: • Healthy ageing • Stress management & Positive mental health • Workshops and public forums on: • Anxiety management • Dementia & Depression

  10. Mental Health Education Nurture Your Mind@ • Current Initiatives • Nurture Your Mind (NYM) • Nurture Your Mind • for Older Persons (NYMOP) • Community Partnerships • Dementia & Depression Awareness and Education Programmes • Caregiver Education Programmes

  11. Framework for (Early) Detection and Identification of Dementia and Depression

  12. Community Psychogeriatric Programme Train GPs and social ILTC facilities in screening & early detection; working through community partners Provide home care for frail elderly with mental disorders and unable to access services Early Detection • 3 Pilot projects: • 2007 – CGH to run 1 team in East • 2008 – 2nd team by IMH for Central • 2009 – 3rd team by IMH (TBC) for West

  13. GPs (dementia skills course) & memory clinics in hospitals provide assessment services After initial assessment and diagnosis, GPS and Polyclinics provide follow up care in the community; Community-based dementia specific care teams provide support and co-ordination of various caregiver, home support and dementia daycare services required Towards a Shared Care Model

  14. Lions Home for the Elderly APCATS Ageing with Grace & Dignity

  15. Thank You

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