Twilight terror of our time

Few may be able to see it, but a tsunami is threatening to swamp New Zealand. This "tsunami" happens to be a rapidly gathering wave of dementia patients, and it's already starting to wash over the country's health services.
More than 43,000 New Zealanders suffer from dementia, an incurable neurological disease that attacks cognitive function, communication, personality, independence and quality of life. By 2026, experts say this number will have climbed to 74,000 people, and to a further 146,000 by 2050. And in half of all cases, it is family members who are lumped with the responsibility of providing around-the-clock care for the sufferer.
The World Alzheimer Report 2010 states dementia as the "single most significant health and social crisis of the 21st century". Even more alarming was Alzheimer's Disease International chairwoman Dr Daisy Acosta's statement that the world's governments are "woefully unprepared" for the tsunami of dementia cases.
The worldwide costs of dementia - attributed to informal care provided by family and community, and to residential care - will exceed 1 per cent of global GDP this year; a staggering US$604 billion ($834 billion).
Alzheimers New Zealand has been urging the Government to tackle the issue as soon as possible and, in May, handed Health Minister Tony Ryall ideas in its National Dementia Strategy. The strategy urged the Government to join Australia and the UK in making dementia a national health priority and to increase funding to cope with the 200 per cent increase in New Zealanders with dementia every 20 years. It also called for appropriate residential and respite care, carer support, training for health professionals, more funding for research and an awareness campaign to promote early diagnosis.
Alzheimers New Zealand support workers across the country are making as many people aware as possible about the dementia tsunami, while also informing communities of the toll the disease takes and promoting their support, education and advocacy services. Among them will be staff from Alzheimers Tauranga which, like other branches, are supporting far more sufferers than they were two years ago.
"The growth is a combination of increased community awareness about dementia, the fact Alzheimers Tauranga's office moved to a more user-friendly location, and the growing incidence of people with dementia," says manager Jane Moore. "It's a chicken-and-egg situation. Because we have had more people, we have had to have more staff. We have a high client-staff ratio with about 50 clients per staff member.
"The rise in numbers seems to be happening because our premises are more visible and we are working closely with the Health and Ageing Group at the hospital, where people are often referred to us, she says. "We have probably raised people's awareness, which has been one of the biggest issues for us. We have also seen an increase in people with younger onset dementia."
Although the national average of people over 65 years is 12 per cent, this number sits at 17 per cent in the Bay of Plenty. "Support services for dementia are always going to be growing," Ms Moore says. "We have a high number of people with dementia who live alone or without family support, who have moved here for retirement, so there is a huge element of isolation." A Bay of Plenty District Health Board contract provides 34 per cent of funding for Alzheimers Tauranga, yet this was not enough to meet the surge in client numbers. In Tauranga, the situation was recently made worse when the Oceania Group elected to close the Carruth Day Care Centre, affecting about 30 Alzheimers Tauranga clients. "We are working efficiently to meet the needs of people with dementia but funding needs to be increased in the future," Ms Moore says. "The Government, our district health board, community support and philanthropic funding must meet this need. We will continue to provide support groups for people with dementia and their carers at our centre, which will become more critical with the losing of the day centre."
And although staff were under pressure, Ms Moore says there is an "incredible dedication" to the organisation. "Everyone in our team is passionate about the work they do. They are committed, they believe in what they are doing, they are professional and caring and always try to find efficient ways to work."
For information about dementia, or what help is available to sufferers, see www.alzheimers.org.nz.
FACTBOX

Alzheimers New Zealand reports there are three stages of dementia; early, moderate and severe.
The start of dementia is very gradual, and often this stage of dementia is apparent only when looking back.
At the time, it may be missed or put down to old age or work pressure.
The symptoms of EARLY DEMENTIA include:
* An unwillingness to try new things/unable to adapt to change.
* Taking longer to do routine jobs
* Losing interest in hobbies and activities.
* Being irritable and easily upset.
* Showing poor judgment and making poor decisions.
* Repeating oneself.
Symptoms of MODERATE DEMENTIA include:
* When independent living can be risky and some supervision is usually required
* Forgetting to eat and/or neglecting personal hygiene.
* Seeing or hearing things which are not there.
* Becoming easily lost if away from familiar environments.
* Forgetting about recent events or the names of family and friends.
* Becoming very easily upset and distressed through frustration.

Symptoms of SEVERE DEMENTIA, when the sufferer needs continual supervision, include:
* An inability to recognise family and friends or even everyday objects.
* An inability to locate their own room and bed.
* Forgetting about what happened in the past few minutes.
* Incontinence of urine, and later, faeces.
* Disturbance at night and restlessness at sundown.