IPA - Mexico Develops a National Plan to Address Dementia
IPA Bulletin
Psychogeriatrics Around the World: Mexico Develops a National Plan to Address Dementia
National Advisory Team Tackles Service Delivery, Education, Research and Legislation
DAVID RESNIKOFF
Latin America is a vast and heterogeneous
region, approximately ten
times the size of Europe, with a population
estimated at 500 million people.
México is the only Latin American country
in North America with 31 states and a federal
district that is the national seat of the government.
The 1995 census recorded 90.5
million inhabitants, and the growth rate
between censuses (1990-1995) was 2.2 percent
per year. The growth of the elderly population
is an essential dynamic component
of modern México. By the year 2010, this
portion of our population will reach 8.8
percent (INEGI, 1996).
This demographic explosion has many
implications both for today and the future,
creating a huge demand on education,
employment and health services, especially
for the underprivileged and our aging
population.
The Mexican family has survived as a
powerful and conservative institution, and is
very important for political stability.
Traditions and moral and religious values are
passed on through the family. The extended
family provides a supportive structure to the
young and old. Nevertheless, a number of
factors have greatly affected the familial
structure in recent years:
Demographic changes
Migration to urban areas
Illegal migration to the United States
Westernization
Diminished religious influence
Taking these factors into account,
together with the recent changes in our
political structure, and with a new ruling
party after 70 years, the scenario is changing
toward a more humane and politically sound
system that will take into account the needs
and future demands of our society.
In the year 2001, the Ministry of Health
began development of a National Plan of
Health and the mental health of our citizens
became a national priority. The need to
develop public policy related to the dementing
illnesses, particulary with regard to our
elderly—was urgently
needed. A national advisory
team that could promote
a plan for tackling
this problem was created. I
was asked to develop the
team structure that within
six months would produce
a National Plan for
Alzheimer Disease and
Related Disorders. The sixmember
team will complete
the work on the plan
within the next year and a half.
The Components of the National Plan
The plan covers four major areas: service
delivery, health education, research and
legislation.
1. Service delivery. This refers to the measures
needed to promote quality and presence
in our services, especially at the primary care
level, promoting coordinated management
of patients with intellectual decline and their
families.
We need to create services for each community
for prevention, early diagnosis, treatment,
rehabilitation and respite, with support
of specialty/secondary units for more precise
diagnosis and cases with special needs. At the
same time, there is an urgent need to promote
social services to assist the families in
need, with help and feedback from non-governmental
agencies such as the Alzheimer’s
disease support groups and associations.
2. Health education. Health education within
the program includes all aspects related to
the improvement of preventive measures
applicable to the dementing illnesses. We
are developing novel ways to deliver educational
programs via the Internet, along with
“train the trainers” educational packages. Clear objectives of the plan will seek to
achieve the following:
Promote changes in the curriculum of
educational programs to include the dementias
in medical faculties and postgraduate
training programs in psychology, nursing
and social work training programs.
Promote the development of a Diploma
in Intellectual Decline and Dementias as a
formal two-year course for medical and
paramedical personnel.
Develop PSD training packages for nurses,
primary care physicians and families.
Develop public awareness programs.
3. Research. We are aware that without formal
research no public policy can be established.
With very limited resources in our
country we must find the means to optimize
the economical resources and establish
guidelines and needs for specific areas of
priority. Policy changes in the area of the
dementing disorders will require support
accordingly.
4. Legislation. To be able to consolidate the
National Plan for Dementias, there is an
urgent need to consider legislative changes
to promote patients’ and health providers’
rights. I am aware that the plan we have
produced must have short- and long-term
objectives. We know that results will not be
seen in the next few years. Clouding the success
of this enterprise is one major obstacle:
the lack of resources. Additionally, the
bureaucracy can also limit the possibility
of success.
