Minister for Health and Care Services introduces the new Norwegian Dementia Plan 2025

Alzheimer Europe spoke to Norwegian Minister for Health and Care Services, Bent Høie, about the new Dementia Plan 2025 and the measures it commits to over the next 5 years. In addition, we also asked Secretary General of Nasjonalforeningen for folkehelsen, Mina Gerhardsen, to share her thoughts on the new Plan.

As Norway publishes its Dementia Plan 2025, can you outline the key areas of focus for the Plan?

The goal of the Dementia Plan 2025 is to build a more dementia-friendly society, where people with dementia are cared for and integrated in the community. The Dementia Plan 2025 includes four main priority areas:

1. co-determination and involvement 2. prevention and public health 3. good and cohesive health and care services 4. planning, competency and knowledge development.

Demensplan 2025 was launched in December 2020 It is well known that when the elderly population increases, more people will develop dementia. It is estimated that at least 100,000 Norwegians currently have a dementia disease and a sharp rise in cases is expected in the coming years. This has an impact on the demand for health and care services and we must find sustainable solutions for the future. Dementia is a significant public health problem and there is a need for greater focus on the prevention of dementia.

The main challenge outlined by the Norwegian Directorate of Health is that there are still too many people with symptoms of cognitive impairment who are not being assessed and diagnosed. To illustrate, the register data shows that only 45,000 people were registered with a dementia diagnosis in 2018. This is a low figure, considering that the number of people with dementia in Norway in 2020 is an estimated 102,000. A timely diagnosis and post-diagnostic follow-up were one of the main priorities of the Dementia Plan 2020, however, continued focus on this issue will be necessary. This involves encouraging people with possible symptoms of dementia to seek help and helping healthcare personnel to become more skilled at identifying signs of cognitive impairment.

Another frequent comment we received during our work on the new dementia plan, is the lack of activities, both for those living at home and for residents of nursing homes. In the Dementia Plan 2025, we will continue to focus on activity initiatives. It is important to ensure that the content of services is experienced as both attractive and meaningful. It is also important for the services to function as respite for family members.

The Dementia Plan 2025 will focus on these and several other areas.

What lessons have been learned from the previous Dementia Plan 2015 and Dementia Plan 2020?

We have good experiences with national dementia plans. A stand-alone dementia plan contributes to raise awareness of dementia. It recognises the value of people with dementia and their families in society. It is also a platform for policy change and provides the basis for action.

This is the third dementia plan in Norway and our new plan is based on the results and experiences from our last two plans. There has been a positive development since the Dementia Plan and through the Dementia Plan 2020, there has been an increase in the number of municipalities that have interdisciplinary teams with competency in dementia, national professional guidelines for dementia were published in 2017 and from 1 January 2020, the government introduced a requirement for municipalities to offer adapted day activities for people with dementia. Even though there has been a positive development, many challenges remain and there is still a need for national action.

We are continuing many of the measures from the Dementia Plan 2020, in addition we have new measures and the scope of the plan has been expanded. The Dementia Plan 2015 and the Dementia Plan 2020 were limited to municipal health and care services. There is still a need to develop good and flexible municipal health and care services. However, it is also necessary to include specialist health services and other sectors in society. Dementia Plan 2025 therefore also includes the specialist health service.

How were people with dementia, their families and carers involved in the development of the new Plan?

The Dementia Plan 2025 has been developed in cooperation with people with dementia and their families and carers. We have held dialogue meetings and participated in meetings organised by the National Association of Public Health. Through the National Association of Public Health, we have had meetings with peers, people with dementia and relatives. As an interest organisation for people with dementia and their families, the Norwegian Health Association has a unique experience base.

Is there an allocated budget to implement the actions/commitments within the new Plan?

The municipalities and the regional health authorities are responsible for organising their health and care services, including services for people with dementia. This means that services will generally be financed through block grants for the municipal sector and basic allocations to regional health authorities.

In addition to the general financing of the services, there will be allocated annually NOK 45 million to follow up the plan and the research efforts from the Dementia Plan 2020 are continued. New initiatives may be added during this period.

What do you believe is the key to the successful implementation?

The share of older persons, particularly those aged 80 and over, is expected to increase significantly in the years ahead, and the incidence of dementia increases with age, and it is estimated that the number of people with dementia will double by 2040. These challenges place great demands on the management, planning, organisation and administration of services in the years ahead.

A key element is to ensure long-term planning in the municipalities and regional health authorities. We hope that the strategies and measures of the Dementia Plan 2025 will help to put dementia challenges on the agenda for municipalities and regional health authorities, and that people with dementia and their families and carers are involved in planning processes.

Secretary General of Nasjonalforeningen for folkehelsen, Mina Gerhardsen, reacts to the publication of the Norwegian Dementia Plan 2025

What is the reaction of Nasjonalforeningen for folkehelsen to the newly published Dementia Plan 2025?

We welcome the plan and have worked intensely for the realisation of a third Plan, as many of the objectives in the previous plans had not yet been achieved. We also appreciate the good work that has been done in the process of writing the Plan, where the Ministry has had many meetings with people with dementia and their carers. Their voices resound throughout the document. It is a good plan, but it also lacks resources and financial back-up to implement the commitments it contains. This is especially clear as new research showing dementia prevalence in Norway is 25% higher than previously presumed.

Are there any measures you are particularly pleased to see included?

We are pleased with the fact that this Plan, unlike the two which preceded it, includes the national specialist health care service,

as part of the health services that should be optimised for people with dementia, as well as social inequality and a public health perspective on prevention and the inclusion of research as a key tool for combatting dementia.

Does Nasjonalforeningen for folkehelsen have a role in the governance or oversight of the Plan?

As a Non-Governmental Organisation (NGO) in Norway, we do not have a natural role in overseeing public services, but we will continue to voice issues on behalf of people with dementia and their carers. We do have a role in implementation of some of the programmes described in the Plan, but sadly we have yet to receive public funding for this work.

Following the publication of the Plan, what are policy priorities for Nasjonalforeningen for folkehelsen?

Faced with the high and rapidly raising numbers in dementia prevalence, our main goal is to campaign for a large raise in public and private funding of dementia research. At the same time, we realise that finding an effective treatment or cure can take long time; better dementia care and a dementia friendly society are needed for those living with dementia today. In order to achieve this, Norwegian municipalities need more resources, we need to educate more health workers and we need to develop more and better care technology.