Dementia report examines roadblocks, solutions to care
A Government study on dementia care in Bermuda highlights inconsistent awareness and stigma around the disease, coupled with service shortcomings.
The Dementia Integrated Care Pathway Report listed caregiver strain and shortage, disjointed care pathways, institutional limitations and financial inequity as the main social drivers of improper care.
The report proposed a pathway that employed public awareness campaigns, early detection, and various diagnostic and care protocols.
It also listed required actions as enhancing regulatory standards for long-term care providers, introducing more sustainable funding models and creating local bodies for dementia care training.
The report was released on Sunday by the Ministry of Youth, Social Development and Seniors in collaboration with the Bermuda Health Council and Ministry of Health.
It was reported that as many as 3,657 people were dealing with dementia according to Bermudian medical records, although official numbers were difficult to find because of limited resources for data collection.
The report said: “It is unclear if all persons indicated as having dementia had a clinical diagnosis.”
It defined dementia as “an umbrella term used to describe a range of cognitive and behavioural symptoms”.
The symptoms could include memory loss, problems with reasoning and communication, changes in personality, and reduced ability to carry out daily activities such as shopping, washing, dressing and cooking.
The report said that, while memory loss was a common symptom of getting older, dementia was more severe and “not an inevitable or normal part of ageing”.
It referred to the 2020 Lancet Commission on Dementia, that said 40 per cent of dementia cases could be prevented or delayed by eliminating exposure to 12 known risk factors.
These included high blood pressure, smoking, obesity, excessive alcohol consumption, diabetes and physical inactivity. Other risk factors included hearing impairment, head injuries, low education, depression, social isolation and air pollution.
A 2024 revision of the commission boosted that number to 45 per cent of dementia cases, and added untreated vision loss and high levels of low-density lipoprotein cholesterol, known as “bad cholesterol”, to that list.
The report said that about half of costs associated with caring for someone with dementia came from informal caregivers, such as family and friends, who worked an average of five hours a day.
It said: “Bermuda's GDP in 2021 was $6.3 billion; 1.5 per cent of that GDP if aligned with the current global spend on dementia care, would result in a cost of $94.5 million in Bermuda.”
The report said that as of 2023, the average long-term care cost was about $92,000 per year for every resident, with a range of $84,000 to $144,000.
It added that the cost of care in the hospital was “significantly higher” at more than $1,000 a day.
The report said: “These figures emphasise the urgent need for structured, government-supported funding for dementia-friendly home care services, respite programmes, care homes and infrastructure in Bermuda.”
It added: “While community programmes, 18 care homes and a dementia services pilot programme exist, service delivery remains fragmented.
“Key challenges in dementia care also include limited transportation to services, inadequate respite care and inconsistent caregiver training.
“Access to specialists and diagnostic tools remains restricted and notable policy gaps hinder adequate service provision.”
Erica Fulton, the executive director of health charity Dementia Bermuda, welcomed the release of the Dementia Integrated Care Pathway Report as a necessary recognition of the problem and commitment to fixing it.
She said the report’s findings that more than 3,600 people could have dementia was “genuinely significant” and put Bermuda on the high end of international dementia rates.
She added: “This is exactly why dementia needs to be treated as a core public health and social care issue, not a niche ageing concern — and why serious, coordinated planning is needed now.”
Ms Fulton said: “This is not a marginal issue. It represents thousands of individuals, and many more family members, grappling every day with a progressive neurological condition that profoundly affects memory, judgment, independence and quality of life.
“Against that backdrop, we are heartened to see the publication of the Dementia Integrated Care Pathway.”
Ms Fulton said her organisation joined others in the report’s development and saw it as an “important and necessary step”.
She added that public recognition of the disease and its difficulties mattered to those who helped in its management.
Ms Fulton explained: “It signals that what they are experiencing is real, serious and finally being addressed at a system level.
“At the same time, we are acutely aware that some people may feel cautious or even sceptical.
“Too many individuals and caregivers have struggled for too long with limited guidance, fragmented service and little clarity about where to turn for help.
“That is why this moment must mark more than the publication of a report. For the ICP to truly make a difference, it must be followed by clear implementation, sustainable funding and policy alignment over time.
“Dementia is a complex challenge with no single solution and meaningful progress will depend on how effectively we translate this framework into action.”
Ms Fulton said that the progress would require collective effort, teamwork and the attention of those involved.
The report listed strategic priorities such as creating a national dementia plan, formalising care standards and training, including dementia care into primary and community services, and providing financial protection for families.
Tinée Furbert, the Minister of Youth, Social Development and Seniors, said the report was necessary given the impact on individuals and their loved ones.
She explained: “Dementia affects not only those living with the condition, but also the families and caregivers who support them every day.
“This Dementia Integrated Care Pathway is about bringing clarity, co-ordination and compassion to a system that has too often left families feeling overwhelmed and alone.
“It provides a foundation for a more responsive and inclusive approach to dementia care in Bermuda.”
Alexa Lightbourne, the Acting Minister of Health, added: “Dementia is one of the most urgent public health challenges facing Bermuda and the Dementia Integrated Care Pathway is essential to delivering a coordinated, person-centred response.
“A clear, structured mechanism for early identification, prevention and integrated care is critical, given the pressure dementia places on our health system and long-term care services.
“This pathway provides a practical framework to close service gaps, reduce stigma and better support individuals and families, ensuring that no one faces this journey alone.
“By embedding dementia-friendly practices across our health and social systems, we can protect dignity, improve quality of life and ensure our seniors are supported both now and for generations to come.”
• To see the report in full, click under Related Media
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