Response to Written Question PT9

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YANG BERHORMAT DAYANG HAJAH SAFIAH BINTI SHEIKH HAJI ABD SALAM

QUESTION:

Yang Berhormat Dayang Hajah Safiah binti Sheikh Haji Abd Salam asks the MINISTER OF HEALTH to state the strategy for raising early awareness among all levels of society about dementia as the seventh leading cause of death globally, with 1,574 cases in Brunei in 2019 expected to increase by 365% by 2050. Is the Ministry planning for early detection screening for dementia and a resilient long-term support system?

YANG BERHORMAT MENTERI KESIHATAN

ANSWER:

Dementia is a disorder that affects brain function, including memory, thinking, communication, and the ability to carry out daily life. It is not a normal part of the aging process, although the risk increases with age.

The primary signs of dementia include:

• Difficulty remembering information, especially short-term memory
• Confusion about time, place, or identity of others
• Difficulty communicating and finding appropriate words
• Trouble making decisions and solving problems
• Changes in behavior and emotions

Dementia is not just a health challenge but also a social issue affecting individuals, families, and society. Therefore, a whole-of-nation and multi-agency approach is essential to ensure holistic care and comprehensive support are provided to dementia patients and their families.

The Ministry of Health plays a major role in prevention, treatment, and support for dementia patients through the following initiatives:

1. Healthy Lifestyle Campaign - Encourage preventive measures by reducing the risk factors of dementia, through health programs such as Brunei on the Move to promote physical activity, health screening programs to detect the same risk factors as other non-communicable diseases, such as hypertension and diabetes, and also manage elderly health programs at several Elderly Activity Centres and Wargamas Organizations in the country in collaboration with the Ministry of Culture, Youth and Sports;

2. Memory Clinic Services - Provision of specialized clinics managed by geriatric, neurology, and psychiatry specialists for the diagnosis and management of dementia patients;

3. Multidisciplinary Support - Treatment and rehabilitation of patients are also supported by a multidisciplinary team including Physiotherapy, Occupational Therapy, Psychology, Social Workers to assist patients and families in obtaining the necessary help;

4. Dementia Support Group Activities - A small-scale pilot program for selected patients. The Ministry of Health also collaborates with Universiti Brunei Darussalam in adapting the WHO iSupport approach. It is a skills and training program, as well as a self-help tool for dementia patient caregivers;

5. ICOPE Training: Holistic Care for the Elderly - ICOPE (Integrated Care for Older People) training is a WHO initiative aimed at strengthening comprehensive elderly care. This program is in the training phase and will be expanded to community levels. Main Focus:

   • Early screening and management of health deterioration such as cognitive function, mobility, hearing, vision, and mental health.

   • Preventing functional decline and maintaining the ability to live independently.

   • Supporting healthy aging and enhancing the wellbeing of the elderly so they can continue to enjoy a better quality of life.

6. Collaboration with Brunei Dementia Society – which includes organizing public awareness campaigns to increase understanding about dementia, caregiver training to help family members and volunteers understand the best ways to care for dementia patients. Additionally, various activities and roadshows have been organized with the Brunei Dementia Society, including:

   • Health talk sessions for the elderly at all PKWE branches and WARGAMAS Organization on a scheduled basis; Alhamdulillah, these Health Programs have received encouraging responses from the elderly across the country;

   • Mass media campaigns through radio and social media regarding dementia;

   • In 2023, an international dementia conference in collaboration with Alzheimer’s Disease International was held, where participants from inside and outside the country shared knowledge on this issue; and

   • Media briefing sessions and distribution of posters and banners in conjunction with the Dementia Day 2023 celebrations in government departments, selected supermarkets, private companies, and other public places.

7. Future Planning:

   • Enhancing carer’s training to ensure quality care;

   • Increasing community-level support by implementing social prescribing in collaboration with the Ministry of Culture, Youth and Sports. Social prescribing is a mechanism where patients are connected with various social and community services to enhance health and wellbeing according to their individual needs;

   • Improving the environment and infrastructure in public places to be more conducive for dementia patients and carers through the Age-Friendly Communities and Environment Program in collaboration with WHO;

   • Providing suitable facilities for Adult Day Care centres focusing on frail elderly, including those with dementia, offering a holistic approach including medical treatment, physical therapy, and social activities; and

   • Raising public awareness about dementia through appropriate platforms and in conjunction with annual Dementia Day celebrations.

8. Whole-of-Nation Approach: Towards More Holistic Support - Dementia is not just the responsibility of the health sector but requires integrated support from the entire society. With this approach, we ensure that dementia patients and their families receive comprehensive support, enhance public awareness, and strengthen the elderly care system in this country. Early awareness and integrated action are key to ensuring that dementia patients can continue to live with love and an improved quality of life.