Abstract
ObjectiveTo determine the state of the health and supportive services available to elderly people with dementia – and their families – in rural Lanxi county, in the province of Zhejiang, China.MethodsIn November 2014 and January 2015, we interviewed 14 key informants on dementia care face-to-face, using a semi-structured questionnaire. The informants included three rural physicians, an urban geriatrician, seven directors of institutions for the care of the elderly and three officials of the civil affairs bureau. We also completed in-depth interviews with five family caregivers of elderly people with dementia.FindingsThe interviewees indicated that there was a lack of specialized services designed specifically to address the needs of individuals with dementia and their family members. Non-psychiatric medical services and the available facilities for long-term care appeared to be ill-equipped to manage these needs. They lacked both clinical staff and standardized, evidence-based practices for the diagnosis, care, treatment and rehabilitation of patients with dementia. As care facilities often refused to admit elderly people with dementia, families were generally forced to care for elderly relatives with dementia at home.ConclusionIn Lanxi county – and probably in much of rural China – more public resources are needed to support family caregivers and to improve the capacity of care facilities for the elderly to care for individuals with dementia.
Highlights
In China, the longevity of the inhabitants and the prevalence of conditions associated with ageing are increasing
The estimated number of people with dementia increased from 3.68 million in 1990 to 9.19 million in 2010.6 The condition reduces the earnings of the people with dementia and/or their families – by an estimated mean of 1159 yuan (¥) or about 183 United States dollars (US$) per month per person with dementia – and adds an estimated ¥51.3–59.8 billion to the national health-care costs annually.[7]
The geriatrician, who worked in this hospital, said that: “Early diagnosis may help to slow progression [of dementia] but we have no standards or motivation to deal with dementia since it is the responsibility of psychiatric hospitals.”
Summary
In China, the longevity of the inhabitants and the prevalence of conditions associated with ageing are increasing. Between 2010 and 2040, the proportion of the population that is 65 years or older is expected to more than double from 9.0% to 22.6%.1. Since the 1980s, family-planning policies and a decline in births have led to reductions in the number of working-age people.[2] The old-age dependency ratio – i.e. the number of people that are 65 years or older per 100 people aged 20 to 64 years – is expected to increase from 13 in 2010 to 45 in 2050.3. The estimated number of people with dementia increased from 3.68 million in 1990 to 9.19 million in 2010.6 The condition reduces the earnings of the people with dementia and/or their families – by an estimated mean of 1159 yuan (¥) or about 183 United States dollars (US$) per month per person with dementia – and adds an estimated ¥51.3–59.8 billion to the national health-care costs annually.[7]
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