Almost 50 per cent increase in Ontario dementia patients since 2010: OMA

There has been a 48 per cent increase in patients with dementia in Ontario since 2010 according to an analysis of OHIP billing data released Thursday by the Ontario Medical Association (OMA).

OMA President Dr. Andrew Park says large gaps in care available for patients with dementia are contributing to that number.

“We had a statistic that there were 82,000 home care visits. But in order to support the needs of the patients with dementia, we’re estimating that over two million are needed. So that’s a big gap between the supply and the demand,” said Dr. Park.

“From a system level standpoint, we have 2.3 million Ontarians without a family doctor – that’s 2.3 million Ontarians who have the potential to fall through the cracks when it comes to early diagnoses for conditions like dementia … without a family doctor, you lack access into the system. If you lack access into the system, you lack access to diagnoses in a timely fashion.”

Dr. Park stressed that early detection is critical, so being vigilant is key.

“[Dementia] doesn’t start on the day of diagnosis. It started years to decades prior to that. And so our ability to get to it early has a couple of implications. Number one, for the patient itself in terms of disease severity, it has a big impact. But number two, our ability to do anything about it is really the greatest at the earliest stages of the diagnosis.”

One of the most common initial signs of dementia is loss of memory, progressing into a variety of neurodegenerative symptoms.

“Language, behavior, mood can all masquerade in some way as dementia. Your executive functioning – so the ability to do things like driving would be one that requires quite a bit of complex, executive machinery [and it could be affected],” said Park.

He advises that if you notice unusual changes in the behaviour of a loved one, however minor, it is best to seek medical attention – whether it be your family physician or a walk-in clinic.

“Trust your instinct and reach out to a provider, a physician that can then do a more extensive history, understand their living circumstance, what they used to do, potentially some blood work and other tests, and try to figure out if this is an early diagnosis of dementia,” he said.

For Dave Spedding’s mother, it began with increased forgetfulness.

“And not forgetting a name or an address like we all do, but mixing up my name and my half-brother’s name all the time. Leaving the water running in the sink all the time after she was done in the kitchen, leaving burners on. And again, anybody can do that, but this became very patterned and very frequent, and we got concerned about her safety and reached out to her doctor.”

Spedding and his sister became their mother’s primary caregivers when she was diagnosed at 79. Now in her late 90s, she’s living in a long-term care facility.

“She raised me, she taught me my values. I learned my life lessons and everything from her. Watching her on this long, slow journey [is very difficult] … watching that decline … seeing her not recognize my children about four or five years ago – I’ve stopped taking them because it’s hard to explain to them,” he said.

He added that being a caregiver is hugely taxing, both physically and emotionally, so he reached out to the Alzheimer’s Society of Toronto for support. Now serving as the organization’s CEO, he said it was a critical resource in the early years of his mother’s diagnosis and continues to be so.

“I attended some of the support groups, I attended the education sessions, they’re all free. And I think when you’re trying to navigate this journey for a person living with dementia your local Alzheimer’s society is a great resource,” he said.

“I knew about Meals on Wheels, but I didn’t know my mom would qualify. So it can link you up with those community partnerships – whether you’re in the north or the east or the west or a large city like Toronto.”

Spedding said funding such organizations that support caregivers should be built into the larger healthcare strategy for patients with dementia as families shoulder a large portion of the burden of care and with an aging population, he feels it’s going to get worse. Dr. Park agrees.

“We do anticipate going forward that we’re going to see a continued rise in the percentage of patients that are being diagnosed with dementia,” said Dr. Park.

He feels the province is not well prepared for the impending wave of dementia diagnoses in the near future. To that end, the OMA has released a “prescription” for Ontario and is urging the government to take action on three key priorities.

“Number one, to ensure that everyone has a family doctor and number two, to ensure and bolster and improve access to community and palliative care resources at home where patients want to be – not once they’ve failed and been in hospital – that’s too late. We need to get these patient supports early on,” he said.

“And then the last one is to ensure that doctors are able to do their job. Doctors are spending 19 hours a week on administrative tasks. And it’s important to ensure that we have the ability to practice medicine and be in front of our patients and not in front of a computer.”

He reiterates the importance of taking proactive steps now so that the healthcare system is primed and ready for the future.

“So the real push is to ensure that we’re starting to have these conversations today because one, two, five, 10 years from now is not the appropriate time to realize that we are in a crisis state. We are highlighting that we are in a crisis state today.”