| dc.description.abstract | <Background>
Neurodegenerative (NDDs) are a public health concern and a leading cause
of disability and dependency among the elderly. Regions like Asia, Latin
America and Africa are currently witnessing rapid demographic aging. It has
been estimated that, globally, about 10 million people develop NDD each
year, and nearly 60% of these estimates reside in low- and middle-income
countries. In most developing countries, older people, whether or not
widowed, typically live with their families in multigenerational households.
The care network has often been developed with a family centered approach
in people with NDD where multiple socio-economic challenges play into
account. The priorities should be made clear to identify the barriers available
in Asian countries in providing quality care for people with NDDs. Thus,
this review sort to gather information published in the Asian countries with
regards to the challenges in caring for people with NDDs.
<Methods>
Original research articles, abstracts, reviews, and letters to the editor,
published in the English language, during the last five years (2019 to 2023)
were searched on databases (Google Scholar, PubMed, ResearchGate,
Hinari, etc). The studies conducted in Asian countries were considered.
Search terms such as “neurodegenerative disorders, challenges in NDD
care, dementia care, NDD in Asia, and Alzheimer’s disease” were used during
the thorough literature search. Reference lists of included full papers were
also searched online, if relevant. Articles published in languages other than
English, studies conducted in non-Asian countries, and literature older than
five years from the date of publication were excluded from the review. The
included literature was thoroughly considered for the aim of the study, study
setting, study design, main findings and conclusion.
<Results>
Twenty-four publications were considered relevant according to the
inclusion criteria. Most of the publications were found related to dementia
care (ten papers). Few others (four papers) have considered caring for people
with Alzheimer’s disease and Parkinson’s disease (two papers). This review
found studies published in India, Sri Lanka, Nepal, Bangladesh, Indonesia, and
Pakistan with regards to NDD care. Three main themes were identified as the
‘challenges’ in caring for people with NDDs, according to the main findings
of the published literature. The themes included “Informal caregivers involve
in NDD care”, “Lack of specialized training for healthcare professionals in care
of NDDs” and “inadequate social/health services available for NDD care”.
Under the informal caregivers involved in NDD care, it has been noted that
less empowerment of caregivers, limited knowledge/resources/skills in caring
for people with NDDs, no formal preparation of caregivers, late presentation
of people with NDDs to healthcare services, caring responsibilities at home is
shared by all members, etc. as challenges.
With regards to the second theme, this review notified the inadequacy of
specialized training of healthcare professionals in NDD care. The challenges
included the wide range of differences in attitudes towards NDDs and inadequate knowledge of dementia among nursing staff, unavailability
of national policy on healthcare professional education and training to
improve dementia care practice, lack of integrating education and training
of dementia care in the undergraduate programs of medicine and nursing,
deficits in the knowledge of dementia and a low level of positive attitude
among the healthcare professionals who work in hospital settings where
people with dementia are cared for, etc.
This review further captured that Asian populations have fewer available
facilities in the health sector for the care of people with NDDs. There are few
assisted living facilities or institutions that provide long-term care in lowincome
countries. Some countries even do not find cost-effective services
available for people with NDDs. In most settings, families do play a vital
caring role in looking after older adults with NDDs. In addition, inadequate
resources and funding provided by the government organizations,
insufficient workforce, unavailability of special palliative care services, etc.
were identified.
<Discussion>
The inadequate training of healthcare professionals in NDD care reflects a
systemic issue in Asian countries compared to the developed nations in the
world. This needs to be addressed through comprehensive education and
training programs. Bridging the gap in knowledge and fostering positive
attitudes among healthcare professionals can significantly improve the
quality of care provided to individuals with NDDs.
Additionally, the scarcity of specialized facilities and services for NDD care
in low-income countries poses a significant challenge compared to highincome
countries. Lack of access to assisted living facilities and palliative
care services further compounds the difficulties faced by patients and their
families.
Overall, addressing these challenges requires a multi-faceted approach
involving policy changes, education initiatives, and increased funding to
improve the quality of care for individuals with NDDs in Asian countries.
<Conclusion>
Low and middle-income countries encounter significant gaps in providing
quality care for people with NDDs. The main challenges include informal
caregiving, inadequate specialized training of NDD among healthcare
workers, and the gaps in social/health services available for the care of
people with NDDs. Establishing promising initiatives such as specialized
training for healthcare workers, setting up cost-effective or free-of-charge
training services for family caregivers, running special care units for people
with NDD at every main hospital in the country, and establishing social
services with a trained workforce, conducting more research to improve
evidence-based practice could be suggested to fill up the gaps. | en_US |
