Rising life expectancy lengthens poses new challenges in Luxembourg
In a leafy garden in the centre of Luxembourg senior citizens sit in the sun, listening to competitive shouts from players at the neighbouring football stadium. This is not your average retirement home.
Beim Goldknapp, in Erpeldange, is the only specialised residential centre offering long-term accommodation for dementia patients in the country. It is one of several critical support solutions established by the Association Luxembourg Alzheimer for patients suffering debilitating loss of memory and other mental abilities and their entourage.
Knowledge about and methods to treat dementia have improved considerably in the 30 years since the not-for-profit was established. Thanks to subsidies from the National Solidarity Fund, anyone can benefit from this specialised care regardless of their financial situation. The difficulty comes however in finding and training staff to treat the over 50 different kinds of dementia and communicate effectively with the patients.
“In almost all cases, when someone has dementia they have problems with communication,” Ala’s Lydie Diederich explained, adding that even patients who speak several languages generally revert back to their first language. Around 7,000 people in Luxembourg are thought to be living with dementia, equivalent to 1.34% of the population. Thus far most of Ala’s patients have had Luxembourger origins, “so it’s very important the current personnel should speak Luxembourgish. That’s causing more and more problems,” she added.
Luxembourg’s multicultural demographic, meanwhile, forces Ala to offer care solutions in other languages as well. “We need people who speak Portuguese and Italian and, eventually, English as well. So far, we’ve only had one English speaker in our day centres but it’s becoming more complicated,” Diederich said.
The number of dementia diagnoses is on the rise, thanks mainly to longer life expectancy. We frequently hear of studies suggesting that multilingualism, healthy living and even a glass of red wine a day can potentially delay the onset of dementia. The Luxembourg health ministry focuses on awareness raising to encourage healthier lifestyles.
But there is no cure and the number of people living with dementia is only set to rise. An Alzheimer’s Disease International study reported there were 46.8m people living with dementia globally in 2015, a number which would more than double to 131.5m by 2050. The social challenge this creates will be costly. The OECD recently forecast the annual 2018 bill of dementia care at $1trn.
According to the Luxembourg government, dementia was the first cause of dependency in 17.6% of people receiving long-term care insurance in Luxembourg. While financial support through long-term care insurance is generous, it remains to be seen if it will keep pace with the future developments needed.
Growing demand for long-term residential care means Ala must extend Beim Goldknapp. And it wants to open a second long-term residential home in the south of the country. Even if 70% of the construction costs are state-funded, the organisation must make up the shortfall. Then there is the rising cost of staff, currently covered by care payments and training which Ala gives to external bodies. “We will reach a point where we have to ask if we can continue,” Diederich said.