Hospital del Salvador and U. de Chile launch a guide to improve care for people with dementia nationwide

Alzheimer’s and frontotemporal, vascular or Lewy body dementias are part of the cognitive disorders that more than 200,000 people suffer from in Chile. Faced with this reality, specialists from both institutions prepared this document that “delivers tools for the care of people with dementia, in an orderly and systematized manner, which will serve as a model for the more than 30 devices in the country that are in the process of of implementation”, explains Andrea Slachevsky, an academic at the Faculty of Medicine of the U. de Chile.

Communications University of Chile.- “Operation Guide: Memory Unit. Center for Memory and Neuropsychiatry” is the name of the document launched virtually by specialists from the Neurology Service of the Hospital del Salvador together with the academic from the Faculty of Medicine of the University of Chile and member of the Center for Geroscience, Mental Health and Metabolism (GERO), andrea slachevsky, coordinator of the Memory Unit of the Neurology Service of the Hospital del Salvador. He This text seeks to be a contribution to the continuity of care required by people with cognitive disorders, addressing everything from prevention and early diagnosis to palliative management..

Between 1990 and 2014, the number of older adults has doubled. As a result of that, currently a 8% of people older than 60 years they would have dementia, with a high prevalence in the rural population. Faced with this scenario, during 2017 the Ministry of Health promoted the National Dementia Plan with the aim of improving the quality of life of people who suffer from this alteration of brain capacity, through access to comprehensive and continuous socio-health care.

Within the measures of the plan, the creation of the Memory Unit of the Neurology Service of the Hospital del Salvador, space supported by the Center for Geroscience, Mental Health and Metabolism (GERO) and the Faculty of Medicine of the University of Chile. After six years of its operation, the entity prepared this guide, with the aim of share their experiences and reflections on its implementation and operationhoping to contribute to other spaces and thus strengthen the care of patients with cognitive disorders.

For the academic from the Faculty of Medicine of the University of Chile and member of GERO, Andrea Slachevsky, it is important to give an account of how the process of the Memory Unit of the Hospital del Salvador has been, because although there is currently the National Plan for Dementia and Explicit Health Guarantees (GES), there are still shortcomings in procedures with patients. “The guide provides operating tools for the care of people with dementia, in an orderly and systematized manner, which will serve as a model for the more than 30 devices in the country that are in the process of implementation”indicated.

Notably currently there are only three Memory Units nationwide. However, on October 1, 2019, the Ministry of Health implemented the GES 85 tool, aimed at guaranteeing the right of access to care and protection against dementia, making it possible to create new spaces for this matter.

national challenges

According to the National Dementia Plan of the Ministry of Health, these disorders bring with them psychological and behavioral symptoms and cognitive failures that demand a constant and wide range of specialists and support networks. However the fiscal budget allocated to mental health has not exceeded 2% of the total health budget during 2022.

This is why both the specialists from the Hospital del Salvador and the academic from Casa de Bello emphasized that today there are a number of challenges related to the National Dementia Plan that can directly impact the lives of patients. Among them is the lack of knowledge about the program and its application, the shortage of professionals in the area, the lack of resources for implementation, and the null follow-up.

According to the psychologist at the Memory and Neuropsychiatry Clinic of the Hospital del Salvador, Alejandra Pintoone of the problems has to do with the “failures related to technical-political decisions”, since “There was a technical and political declaration to extend the Dementia Plan to other communes, but it was discontinued”.

In this line, the nurse from the Memory and Neuropsychiatry Clinic of the Hospital del Salvador, Loreto Castroindicated that “the non-expansion of the National Dementia Plan has limited the strengthening of interventions in the specialty. In some communes the National Dementia Plan has not worked, since there is no specific program or professionals who can receive people with dementia and their caregivers for continuity of care in primary health care”.

The neurologist of the Memory Unit, Teresita RamosMeanwhile, he warned that “more than four years ago dementias were incorporated into the Explicit Health Guarantees (GES), but we are still waiting for technical guidelines for the implementation of adequate carewhich generates some uncertainty between the different devices of the public health service that care for people with dementia”.

A document for public opinion

Six years after the implementation of the National Dementia Plan, the launch of this “Operating Guide: Memory Unit. Memory and Neuropsychiatry Center”, seeks to be a contribution to the national discussion on this topic. Documenta is based on the capabilities of a team of more than ten specialists from various disciplines in the health area such as neurologists, psychologists, nurses, occupational therapists, social workers and psychiatrists, among others.

The text makes known the experience of the Memory Unit of the Hospital del Salvador to transfer their knowledge and make good practices visible. It also enables self-assessment of specialty care and provides a critical look at procedures with patients with dementia.

It has five sections, in which a general description of the Center for Memory and Neuropsychiatry and the Memory Unit is made, and the clinical actions, criteria for referral and admission of patients, and evaluation and diagnostic announcement. In addition, it gives an account of the operation of the treatments, the accompaniments for both the patient and the caregivers, the cognitive stimulation therapy and details the Biopsychosocial Program, as well as the skills of the professionals who are part of the unit.

For the psychiatrist of the Memory and Neuropsychiatry Clinic of the Hospital del Salvador, Tomas Leon Rodriguezthis document serves as an example of success regarding the operation of the unit, which can be a contribution so that, at a national level, these spaces specialized in dementias are created. “The State must have a systematic way of taking charge of dementias and that does not depend on the will of each one of the health centers”he concluded.

Finally, the experts call to improve the National Dementia Plan due to the increase in the elderly population in Chile, since there is a life expectancy similar to that of developed countries, 77 years for men and 82 for women. On the other hand, 8% of the population over 60 years of age suffers from this type of cognitive disorder.