January 5, 2009: joined-up thinking?

Monday 5 January 2009

Alphabet D Did you see the government's announcement that it intends to train GPs to look for early signs of dementia in their older patients?
Marianne TalbotMarianne Talbot

I have mixed feelings about this. It will raise awareness of dementia, which is good. But what on earth does the government intend to do about those who, as a result of this, are diagnosed with dementia earlier than they might have been?

After all, in its wisdom the government also announced recently that the only drug available to those with early dementia - aricept - is too expensive to be provided on the NHS.

Is this what passes for 'joined-up thinking'?

I remember when mum was first diagnosed. Actually no, I don't remember this. The diagnosis for some reason was given to my brother. He decided not to upset anyone with the information. (I have asked this question before but what on earth does one make of brothers?)

But I do remember the consultant talking to me about 'the diagnosis', and the hollow in the pit of my tummy when I asked her to explain.

A diagnosis of dementia is - er - a real downer. At least in 1999 mum was given aricept, so we felt we were doing something. But even so, mum plunged into a deep depression, from which, oddly enough, she emerged only as the dementia started to bite. This enabled her to go into a decent state of denial.

It would have been far better, to my mind, if she hadn't been told at all.

On the other hand, it was better that the rest of us knew (notwithstanding Richard's protective instincts). At least it meant we could start planning.

But planning what exactly? There's little chance of being accepted at a residential home once you have a diagnosis of Alzheimer's. They will take people who are simply forgetful, but they double lock their doors against anyone with a diagnosis.

So this leaves you looking at nursing homes that admit the demented. But there are few things more frightening, if someone you love has just been diagnosed with dementia, than looking around such a place. Even mum's lovely home takes a strong stomach if you are unused to dementia.

I was able (and willing) to bring mum to live with me. But I am the last to say that everyone should do this. I was very lucky in the relationship I had with mum. And anyway, few people have lives that make taking on an elderly parent, especially one with dementia, feasible.

Wouldn't it have been better for the government to sort out how to care for those with a diagnosis of dementia before training GPs to make such diagnoses earlier?

Written by Marianne Talbot

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