New dementia report highlights care and cost crisis

Australia is facing a shortage of nearly 60,000 paid workers to care for people with dementia, and the problem will be compounded by a shortfall of 94,000 unpaid (family) carers, according to the National peak body Alzheimer’s Australia.

These disturbing figures were released in an Access Economics report commissioned by Alzheimer’s Australia.

The report, ‘Making Choices – Future Dementia Care: Projections, Problems and Preferences’, shows that the current workforce of paid and unpaid carers of people with dementia will need to increase by 76% within two decades to meet the anticipated rapid rise in demand for dementia care services.

For the first time, the report also draws together surveys of carer preferences and suggests new strategies and recommendations to address the looming challenges identified in the supply of dementia care services in this country.

Glenn Rees, chief executive officer of Alzheimer’s Australia, says, “Workforce issues, both in respect to paid and unpaid carers should be centre stage in addressing how to care for the 465,000 Australians who will have dementia in 2030. The wages, conditions and training of paid workers are key issues.

“But there is a need too for radically new thinking in terms of how unpaid carers are supported and the choices that they and people with dementia are able to make between the mix of community and residential care services,” he said.

On the basis of current policy settings, the analysis done by Access Economics suggests that the major workforce supply constraints are in relation to unpaid carers (94,000 full time equivalent unpaid carers) and paid staff in high-care residential aged care facilities (59,000 full time equivalent staff).

Overall, Access Economics projects a workforce shortage of both paid and unpaid carers of 153,000 in 2029, relative to 2008 – 76% of the 2008 workforce and 36% of demand in 2029.

“The findings are critically important to the future planning and delivery of dementia care services in this country. Survey work done by Access Economics suggests that unpaid carers may be the only source of care for some people with dementia and that around 37% of people with dementia received no formal care in 2008.

“Unpaid carers provide long hours of care, often with negative effects on their physical and mental health, lifestyle and opportunities to work,” said Mr Rees.

“While we talk about ‘choice’ in care options, in reality the choice may be more about being stuck between a rock and a hard place. We need to ensure that future dementia care includes a range of options that can be tailored to meet the individual needs of the person with dementia and their unpaid carer as the person’s need for care changes.

“The choices made by unpaid carers between different care options are often complex, but on the basis of the carer survey work done by Access Economics, it was shown that a service option which included home support services (such as shopping, transport and cleaning) would have a 55% higher demand than one that did not include home care.

“Respite services also rated highly and a care option with this attribute would rate 48% more highly than one that did not,” he said.

Dr Anna Howe, a leading consultant gerontologist with many years of experience in service planning and evaluation, says that, “the survey work done by Access Economics provides interesting new insights into consumer preferences, particularly as regards home care and respite care.

“It is possible that relatively small amounts of support of this kind could be very effective in keeping people with dementia at home longer, provided consumers were assured the services were there when needed.

“It is not surprising that the demanding nature of dementia care means that carers of people with dementia have expressed a stronger preference for residential care than might be the case for carers of older people generally,” said Dr Howe.

Lynne Pezzullo, a director of Access Economics, says, “Providing quality dementia care for those with dementia is the immediate priority in the next two decades, but in the longer term, investment in research is the key to prevention and effective treatment of dementia.

“Adequate financial provisioning for quality care services requires a rethinking of high care capital financing mechanisms today, hand-in-hand with the gradual introduction of savings vehicles over the longer term”.