A few weeks ago I went to see Still Alice and cried. Despite close contact with people with dementia it was a shock to see a middle-aged woman with the condition, her rapid decline and the impact her illness had on those around her. As a woman in my fifties I was also frightened by what the future might hold.
After the film I found myself calculating now many useful years I have left. I even started to look up advice on how to help keep dementia at bay: learning a new language, exercising more, drinking less and eating well. Sadly none of these are a cast-iron guarantee of a dementia-free old age – and the latest research suggests, counter-intuitively, that being overweight in middle age and old age may reduce the risk of dementia.
While research into prevention and cure is ongoing we should be reassured by the progress that is being made in understanding how to care for people with dementia. However, much of this knowledge is not reaching those who provide day-to-day care. Many health and social care professionals lack training in dementia and sometimes our well-meaning actions cause unintended distress. Trying to convince a patient that his wife is dead when he believes he needs to catch a bus home to her is often counterproductive.
Our ritual and routine sometimes get in the way of providing imaginative dementia care. Yesterday I read about a structured programme of sensory activities that aims to ensure care home residents with advanced dementia enjoy the best possible quality of life. An important part of the programme is touch but the authors noted that staff had a problem relinquishing their gloves to provide the ‘loving touch’ that is integral to this approach. We will publish this article soon.
This week we have published a fascinating article that describes the concept of the “time machine” to help care staff understand the lived reality of people with dementia.
We all have a timeline of memories from early childhood to the present, with significant events such as the birth of a sibling, starting our first job and getting married. As dementia progress people move back along this timeline, losing recent memories first. Understanding where people with dementia are on their timeline can help you interpret their behaviour and respond to it appropriately. Ultimately the process is about holistic care and knowing your patient rather than assuming there is one way to ‘manage’ dementia; this requires education and a high level of skill.
Our newest learning unit is on differentiating dementia, delirium and depression in older people. These are vital skills to ensure older people are not misdiagnosed and fail to receive appropriate care.