Home' Australian Pharmacist : Australian Pharmacist June 2013 Contents Australian Pharmacist June 2013 I ©Pharmaceutical Society of Australia Ltd. 17
BE OUR GUEST
Stigma is alive and
By Ita Buttrose AO, OBE, President of Alzheimer's Australia and Austral-
ian of the Year 2013
I recently gave an address to the National Press Club titled The Australia I Want
to Live In* and in the course of this I discussed the fact that stigma is alive and
well with regards to dementia, with some 10% of Australians saying they would
actively avoid spending time with a person who had dementia.
In addition, many people admit they avoid
seeking help for symptoms of dementia
because they're worried about the
discrimination they will face if they get a
diagnosis. This is just not acceptable.
There are examples of stigma wherever you
care to look. For instance, former British
Prime Minister Margaret Thatcher, who died
recently, had vascular dementia yet there
was barely a mention of that fact on the
numerous TV, radio and newspaper reports
of her passing.
No one should feel ashamed to have
dementia. It is not a normal part of ageing,
it is a chronic disease.
When we talk about mental health,
disabilities and aged care, we know that one
size can never fit all. Yet we've continued
to provide care on exactly that basis with
a mindset locked into institutional and
residential care models of the previous
century. This is why I attach so much
importance to the passage of the legislation
in the life of this Parliament to implement
Living Longer. Living Better. We need to
empower consumers and give them greater
choice in the services that will respond to
their individual needs.
In our everyday lives we make choices and
we expect those choices to be respected.
It is a mark of our respect for one another.
Why should a person with mental health
issues, a disability, or who is getting older
be treated any differently?
The change in culture that's required to
bring the element of choice into the lives
of those people who require assistance is
huge -- but it is the challenge we have to
face in the Australia I want to live in.
We need to empower older people, those
with disabilities or mental health issues to
exercise choice in the services and support
they need to the extent they wish and
We need governments to adopt less
regulatory approaches and to promote a
partnership approach between consumers
and providers. And we urgently need to
address long-standing disquiet about
quality in residential care, particularly for
those with the severe behavioural and
psychological symptoms of dementia.
It is inevitable that some people will need
access to residential care. It is imperative
that we have a high quality residential care
system that respects the rights of residents.
I don't believe that is the case now.
Some facilities provide excellent care but
it seems to me that the majority struggle
to appropriately care for people with high
The failure to meet the standards that we,
as a community, have a right to expect was
all too well demonstrated in a recent story
on ABC's Lateline program about how some
aged care facilities manage dementia.
The only conclusion I could draw from the
program was that the rights of both the
carer and the person with dementia had
been violated: the carer faced with the threat
of the person they love being evicted for
making her views known; the person with
dementia involved in the alleged assault left
without the care and support that might
address the cause of his symptoms.
Last year, during consultations Alzheimer's
Australia held on the aged care reforms,
we heard that within weeks of entering
residential care many carers find that family
members and friends they've spent years
caring for have become unrecognisable
in terms of their physical, mental and
Nearly one quarter of residents are chemically
restrained with anti-psychotic medications,
often without their consent or the consent
that's legally required from their family.
It is unacceptable that such practices are
taking place today in Australia.
These medications provide a clinical benefit
to only one in five, and are associated with an
increased risk of serious side-effects such as
increased cognitive impairment, increased
risk of falls, strokes and death (see page 33).
Perhaps there could be no better area than
this for a class action.
In addition to an inclusive society where
people have choice over their own lives and
care, my vision also includes a health system
that is accessible and works for all Australians
regardless of age, disability or disease, and
that focuses on prevention and wellness as
well as treatment.
We could prevent around one third of
chronic disease in Australia by reducing
tobacco smoking, blood cholesterol and
obesity, and by controlling blood pressure
and increasing physical activity.
Interestingly, only 50% of Australians know
that there are ways to reduce their risk of
developing dementia and very few are aware
of the link between diabetes and dementia.
We need to not only promote physical
health but also mental health. A recent study
commissioned by Beyond Blue suggests
between 10 and 15% of older people living
in the community experience depression.
Rates of depression in residential aged care
facilities are thought to be much higher, with
another Australian study showing 35% of
aged care residents experience depression.
There needs to be a focus on wellness and
capitalising on strengths once a person does
develop a disability or chronic disease.
Strategies can be put in place to help people
with dementia make the best use of their
remaining cognitive abilities. In the Australia
I want to live in this has to be a priority.
The needs of people with dementia cannot
continue to be overlooked.
* The full text of the speech and the Alzheimer's
Australia Fight Dementia Campaign Election 2013
document are at www.fightdementia.org.au
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