This op-ed was originally published by iPoltics on April 8, 2022.
Canada should capture the moment before it fades, and clear pathways to dementia care, writes Chad Leaver.
It’s true for everyone. We witness a moment, and it captures us. Seizing a moment in time so we can revisit it — or share it with others — is the magic of memory and human nature. We survive and thrive because of our experiences. At our core, moments make us. When we experience Alzheimer’s disease or other dementias, fading and lost moments dismantle us.
In June of 2019, Canada released its first national dementia strategy, titled “Together We Aspire.” The pandemic response continues to take priority, and implementing Canada’s dementia strategy at the provincial level has been in a holding pattern. It’s time to recapture the moment.
Over half a million Canadians are living with Alzheimer’s or another form of dementia, with 25,000 new cases every year. The Alzheimer Society of Canada estimates that nearly one million Canadians will be living with dementia by 2031, and that the associated direct and indirect costs per year will approach $17 billion.
Alzheimer’s and other dementias aren’t a normal consequence of aging; there’s more at play. Yet the reality is that 75 per cent of cases worldwide go unrecognized and undiagnosed for many years after the onset of symptoms. Yet, it’s education, early diagnosis, and intervention that can make the biggest difference. The negative impacts on society, the health system, and the economy will be immense unless action is taken now to prepare for the surge in demand for access to care. Patients, caregivers, and families desperately need access to: treatments on the horizon, better community-support services, and long-term-care reforms.
Canada is ill-prepared to tackle this growing and unsustainable burden on its health-care systems. Inaction is simply not an option. We should ask ourselves: What will it take to mobilize a system of research and care for Alzheimer’s that’s comparable to cancer care?
Canada, take note: The lack of coordination and monitoring of wait times for both primary and specialized dementia care and diagnostic services nationwide is in stark contrast to many modern health systems. The U.K., for instance, has a policy to ensure that two-thirds of the estimated number of people with dementia are diagnosed with appropriate post-diagnostic support, and that no more than six weeks elapse between a patient’s referral to a memory-assessment service and the start of his or her evidence-based treatment. No such benchmarks exist in Canada.
The scientific journey of new treatments for Alzheimer’s disease has been long. Fortunately, a commitment to discovering safe and effective treatments is paying off. New disease-modifying treatments are on the horizon. As these new treatments are developed and approved — and when doctors and patients can access them early in the course of the disease — they can alter, slow, or arrest progression to more advanced stages of dementia.
Despite the promise of such therapies, recent evidence suggests that their introduction will create significant challenges for modern health systems — systems like Canada’s that are already frayed by the pandemic.
To help decision-makers take strategic action, The Conference Board of Canada released a paper examining current pathways to diagnosis of Alzheimer’s and other dementias, along with models of care, that are available to Canadians.
It lists several actionable recommendations for: federal and provincial governments, regulatory colleges for health professions, and agencies and associations in the sector. Our results challenge leaders to reconfigure health systems and workforce capacities, and optimize access to diagnostic testing nationwide.
The urgency in advancing Canada’s dementia strategy can’t be underestimated. Canadians have to understand that access to potentially life-saving treatment requires system-wide coordination, from the front lines to the highest levels of administration, and to local and national governments. If we followed the recommendations we received from patients, caregivers, and leaders in the field, we’d deliver solutions more quickly that lessen the burden on long-term care facilities — solutions for: a sustainable capacity of the health system, timely consultation for patients and caregivers, and the diagnostic and support services Canadians desperately need.
The pandemic continues to challenge the national perception that Canada’s health-care system will always be there for our needs, the needs of our loved ones, and the needs of our communities. Is the situation alarming enough for Canadians to demand action? Not acting to capture this critical but diminishing opportunity to prepare for the availability of advanced treatments of Alzheimer’s disease has never been more important. It’s time to embolden and task strategy tables, policy levers, value-based funding, and community-based practice models with reigniting Canada’s dementia strategy.