The future cannot be more of the same

The future cannot be more of the same A digital mind-set for a digital age Professor Graham Stokes Global Director of Dementia Care, Bupa Visiting Professor of Person-Centred Dementia Care, University of Bradford

2015 Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa) 2

2030 Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa) 3

2050 Source: World Alzheimer Report 2015: The Global Impact of Dementia (Alzheimer’s Disease International, supported by Bupa) 4

Dementia – a growing global health concern People with Dementia World 2015 2050 46. 8 million 131. 5 million New Zealand 60, 000 154, 000 What might be the 21 st century response to this dramatic increase in prevalence that will have profound human and health economic consequences? 5

The worldwide costs of dementia A health economic crisis Standard & Poor’s has described global population ageing as the biggest threat to the sustainability of sovereign debt. Among the chronic diseases, dementia makes by far the largest single contribution to disability and need for care among older people. The current (2015) global societal economic cost of dementia is US$818 billion Costs will escalate proportionately with numbers affected, and with increased demand formal care services, particularly in low and middle income countries A UK study has estimated that the health and social care costs for dementia almost match the combined costs of cancer, heart disease and stroke. World Health Organization and Alzheimer’s Disease International, Dementia: a public health priority, Geneva April 2012, http: //www. alz. co. uk/WHO-dementia-report 6

The prospects for a pharmacological breakthrough are. . . not encouraging • Dementia is one of the biggest global health challenges facing our generation. • At this time when the need is greatest to come up with a medical breakthrough a recent report by the World Innovation Summit for Health’s Dementia Forum revealed that pharmaceutical companies are retreating from the search for disease-modifying treatments after repeated and costly failures to develop a breakthrough drug. 7

A lifespan approach to dementia 5 years – early education 15 years – educational opportunities 25 years – life touched by dementia 35 years – risk awareness and lifestyle changes 45 years – responsibility for ageing parents 55 years – dementia becomes greatest health concern 65 years – a time of transition 75 years – dementia vulnerability becomes real 85 years – the time of greatest risk. Where can people with dementia be supported safely, avoid isolation and their families have peace of mind? 8

Care homes, hospitals and dementia care in the UK • 426, 000 people in care homes in the UK • In England, Alzheimer’s Society (2013) estimates 80% of people in care homes have dementia or significant memory problems • More than 300, 000 people with dementia live in care homes • 40% of all people with dementia in the UK • Dementia is a significant challenge for the NHS with an estimated 25% of acute beds occupied by people with dementia Source: Low expectations, Alzheimer Society 2013, http: //www. alzheimers. org. uk/site/scripts/download_info. php? download. ID=1024 9

Care at home • Home is so favoured over any other alternative that staying put has become an aim in itself, regarded as the highest good, and families turn themselves inside out to make it possible… When the Time Comes (2009) by Paula Span • 1: 4 family care-givers suffer from depression • Family care-givers have a higher mortality risk compared to the general population • In the USA 13% of family carers had to go from working full-time to part-time, 11% had to take a less demanding job, and 11% had to give up work entirely • Not only are numbers of people with dementia increasing, so are the numbers of those living by themselves. In the UK roughly one in three people older than 65 live alone • One-third of people with dementia live alone, most are aged women • The number of working-age people per older person is expected to drop globally by more than 50 per cent over the next 50 years 10

Digital health: A digital mind-set for the digital age 11

Innovate or die - Blockbuster “Neither Redbox or Netflix are even on the radar screen in terms of competition” Jim Keyes, CEO, Blockbuster, 2008 12

We don’t know what we don’t know Netflix revenue 2015 - $6. 8 billion 13

Avatars, apps and robotics - ‘to me where I want to be’ Technological innovation to • provide bespoke information • access services To be welcomed or a dehumanising approach to care and support? • support independence • monitor health • promote safety • improve life quality and well-being 14

A way to go! US$752 b Annual cost of aged healthcare in the USA US$8 b Digital health investment over past 2. 5 years US$208 m Dedicated to aged care solutions 15