Issue link: https://maltatoday.uberflip.com/i/1467182
maltatoday | SUNDAY • 8 MAY 2022 6 ELDERLY CARE WITH one in nine persons in the world already aged 60 years and over and projected to increase to as much as one in five by the year 2050, population ageing is a phenomenon that can no longer be ignored. Malta is no exception to ageing trends and evidence is showing that the nation is transforming into an ageing society. Malta's gerontological transition was largely the result of a declining fertility rate, together with an in- creasing life expectancy in both men and women. Demographic projections indicate that Malta will be one of the fastest ageing countries in the European Union as life expectancy at birth was projected to increase to 85.1 and 89.1 years for men and women respectively by the year 2060 (Eu- ropean Commission 2015). Increasing longevity is definite- ly an indicator of social and eco- nomic progress. It represents the triumph of science and public policy over many of the causes of premature death, which truncat- ed lives in earlier times. However, it is also true that population age- ing has significant and extensive repercussions for all aspects of public policy. Active Ageing and Commu- nity Care (AACC) aims to help persons to stay in charge of their own lives for as long as possible as they age. AACC also offers opportunities for older adults to remain physically, mentally and socially active, within their local communities. Several projects and initiatives are being carried out by AACC to help older per- sons to improve their quality of life as they continue to age in place. AACC has embarked on a pro- ject to open multidisciplinary clinics in each Government Care Home. The first to be opened was that at Mtarfa home last June, fol- lowed by that at Mellieha home last March through the invest- ment of €30,000. The aim of the multidisciplinary clinics is to pro- vide comprehensive care to resi- dents in the relative Government Care Homes in a safe and private space. The clinics are also being used by older persons living in the surrounding locality. Vari- ous health care professionals are providing a service within these clinics, namely physiotherapists, occupational therapists, speech language pathologists, podolo- gists, psychotherapists, tissue via- bility nurses, medical doctors and geriatricians. Continence clinics are run by specialised continence nurses and all individuals who are re- ferred to the clinic are provided with a holistic initial continence assessment, which can include a bladder scan and urinalysis, so that the cause and type of in- continence are identified. Elders who are being provided Diabetes Care Services in the community, which includes administration of insulin together with blood glu- cose monitoring, can be provided holistic support so that their con- dition of Type 2 Diabetes is better managed. This clinic will be managed by the diabetic link nurse togeth- er with the support of a medical practitioner. The team will as- sure continuity of care including education, independence and self-management of the elders' condition. Additionally, the team will help elders suffering from this condition to better control their diabetes and reduce long term complications by providing the necessary knowledge and su- pervision if the need arises. Also, elders will be followed up and re- ferred to other professional ser- vices as required. The need of these clinics has been felt especially during the months of the pandemic. Prior to the introduction of these clinics, service was provided in the resi- dent's own room within the care home, which is often shared with other residents. Sessions were therefore more likely to be inter- rupted by other residents in the room or by other staff members assisting the other residents in the same room. The clinics will provide a space where a resident can undergo treatment and speak privately with the health care profession- als. They will provide an adequate space to provide a service with all the equipment readily available. They are also easily reached by residents in the surrounding lo- cality, increasing the accessibility for these services. They also facil- itate joint collaboration between health care professionals for combined sessions to be carried out with residents, and a private area for a multidisciplinary team meeting. Plans are in the pipeline for an outreach multidisciplinary clin- ic and an ancillary clinic which will open in the last quarter of this year at Dar Padova Dementia Centre in Għajnsielem, Gozo for persons who are 60+ using both the centre and those in the com- munity. The biggest unmodifiable risk factor associated with dementia is old age. This means that as one grows older, he or she is more likely to develop a form of demen- tia which will directly affect their biopsychosocial abilities. Demen- tia is a term describing a number of conditions characterised by progressive deterioration in men- tal functions including memory, judgement, communication skills and behavioural changes which are serious enough to interfere with the person's daily life. Lo- cally, the number of individuals living with dementia in 2022 is estimated to be around 7,400 according to a study carried out by Scerri & Scerri (2012). The figure is projected to reach 3.62 per cent of the population by the year 2060, bringing the figure to 14,037 individuals living with the condition. It is well recognised that demen- tia presents a psychological and financial challenge both to those with the condition as well as their caregivers and family members. Active Ageing & Community Care (AACC) has implemented a number of projects in various areas of dementia management and care with the overarching aim of enhancing the quality of life for individuals with dementia (IWD), their caregivers and fam- ily members. In 2021, AACC, opened two new Dementia Activity Centres in Mtarfa and Safi. These day and night centres aim to support fam- ilies living with the condition, by managing the consequences of the condition and improve their quality of life. When attending these centres IWD will have the opportunity to engage in mean- ingful activities which support their abilities and help the use of residual skills. Trained caring staff facilitate a range of activi- ties which promote strength, re- duce the rate of cognitive decline, enhance communication, draw interest and engagement and en- hance self-esteem. Increasing awareness on de- mentia is another milestone that AACC is working towards. In fact Malta's National Dementia Strategy (2015-2023) recom- mends increasing awareness and understanding of dementia among the general public to re- duce stigma and misconceptions about the condition. AACC is working with Local Councils to help create Dementia-friendly communities by educating their local communities on the con- dition and the services available. AACC is engaging in Memoran- dums of Understanding agree- ments with several local councils so that together we work towards increasing the understanding of the public and local services on the condition. AACC is currently focusing on making agreements with Gozitan local councils so as to increase awareness among the Gozitan community. International research has shown that online support pro- grammes and online training has several benefits over more traditional face-to-face training. Online training programmes are always available, conven- ient, privacy-preserving, scalable and also cost effective. Recently grounded in the evidence-based guidelines and recommendations of the World Health Organiza- tion's (WHO) Mental Health Gap Action Programme (mh- GAP), WHO convened a panel of international experts to devel- op "iSupport", a self-help online training and support programme designed to provide education, skills training and social support to informal caregivers of IWD. A Memorandum of Under- standing was signed with WHO in relation to the iSupport pro- gramme. Thereafter, a team of experts from Active Ageing and Community Care has been working closely with the WHO to adapt their online skills edu- cation programme to the Maltese context and situation. iSupport's original content has been adapt- ed to the Maltese context and needs. iSupport is a self-help tool for carers of people with demen- tia, including family members, relatives and friends. This online educational pro- gramme is aimed for caregivers of IWD and is currently available online for free via the website – www.activeageing.gov.mt/isup- port. The course has 5 modules and takes approximately seven hours to complete fully. Once enrolled in the course, carers can choose to work through all mod- ules and lessons consecutively, or select the lessons that are the most relevant to their everyday lives. All lessons consist of brief readings, descriptive examples and several exercises. Carers receive feedback as they work through each exercise. Par- ticipants have to complete all modules, exercises, and the feed- back survey to be issued a certif- icate of completion. iSupport for dementia, aims to prevent and/ or decrease mental and physical health problems associated with caregiving and to improve the quality of life of those caring for people with dementia. Community outreach services for older persons Mtarfa Dementia Centre