Prof McMillan, who was a member of the Working Party on Dementia for the Nuffield Council on Bioethics in the United Kingdom which examined the ethical issues raised by dementia, said it was often not until someone with dementia had reached crisis point that all the services were alerted.
The problem was that the area of care was not well funded and it was regarded as a social, rather than medical, condition and not picked up by the healthcare system in the same way a diagnosis of cancer would be.
Finding better ways to support people with dementia was important because the incidence of the condition was expected to double every 20 years due to the rapidly ageing population.
In New Zealand, the number of people with dementia was estimated at 40,766 in 2008.
By 2026, that number was expected to be 74,321 and by 2050, 146,699.
People should have access to good-quality assessment and support from the time they, or their families, became concerned about symptoms of dementia.
The total financial cost, estimated at almost $713 million in 2008, was also expected to burgeon.
Prof McMillan noted the economic value of informal carers in 2008 was estimated at $29 million.
Supportive and ethical care included recognising the person with dementia had rights.
Just because some behaviour might not be understood by others was not a reason for it not to happen.
In the case of wandering, for instance, which was quite a common behaviour, instead of concentrating on the likelihood of harm, the risk-benefit could be weighed up.
"All of us have an interest and right to do things which have a degree of risk."
Prof McMillan, formerly of Dunedin, was in the city to address the New Zealand Bioethics Conference at the weekend on the findings of the Nuffield report.
In an interview, he said there was a need for people to be much more aware of dementia and more supportive of those informal carers who carried huge burdens.
Lack of awareness was one of the reasons that funding for research on dementia had not kept up with that for cancer.
People were much more open now in the way they discussed cancer compared with 30 years ago, but that had not yet occurred with dementia.
In the United Kingdom in 2007-08, spending on cancer research totalled $248.2 million, compared with $32.4 million on dementia.
Prof McMillan said he was optimistic, but "we have to start thinking seriously and supporting the good things happening, now".
The Nuffield report promotes the concept of solidarity - recognising the citizenship of people with dementia and acknowledging the responsibility of all to their fellow citizens.
The idea was that all were "in the same boat", Prof McMillan said.
Prof McMillan's current research interests include work on the ethical questions surrounding self-management of chronic mental illness.
Dementia
Estimated number of sufferers in New Zealand. -
2008: 40,766
2026: 74,321
2050: 146, 699
