Dangerous nonsense

primary_care_training_dementia

'The world's older population continues to grow at an unprecedented rate. Today, 8.5% of people worldwide are aged 65 and over.  This percentage is projected to jump to nearly 17% by 2050.'  

More here..

I thought I'd get your attention first-thing on a Monday!

We know it, don't we?  What baffles me is the fact we are so casual.  We seem to think it doesn't matter.  We seem to think, something will turn up... something will fix it.

It is the first duty of government to ensure the wellbeing and safety of the people.  The fact they are prepared to keep shelving the issue of ageing borders on the criminal.  

Yes, people will tell us there are plenty of ways to grow old gracefully and happy and well but we all know there is something far more sinister lurking.

Dementia... robbing us of our loved ones and demolishing our plans for our sunset years.

I'm not sure what we are dealing with...  

Political denial that we are getting older and the pressures it will place on our public services? 

Wilful refusal to do anything meaningful about it on the grounds that it will sort itself out?  

Or, it is such a big problem... no idea what to do...

Here're some tough stuff I've learned in Australia;

  • There is nothing your doctor can do about dementia.
  • The drugs available are next to useless.
  • There is nothing in the pipeline that looks hopeful in the near future.
  • The condition does not get better.
  • The support for families, like in the UK, is patchy, fragmented, unreliable and the systems labyrinthine.

... yes it is bleak.  Until we face it, we won't deal with it.

I've had to travel half way around the world to find the person who speaks the blunt truth.

In a suburb of Sydney, in what was one a domestic house and now a clinic, you will find Dr Tuly Rosenfeld.  

In an office with three computer screens and memorabilia of a career of achievement and travel, the avuncular Doc Tuly, leans back in his chair and gives the medical establishment both barrels.

For a man who could pass as your favourite grandad, Doc Tuly packs a punch.  He is a man who has spent a lifetime in the Australian health system and isn't afraid to tell it as he finds it.  

Now working in private practice (the Oz health-service is a part public and part not), he understands the shortcomings of medical science and has developed a care navigator service; helping families find their way through the jungle that is dementia care... support, care, consistency, compassion and competence.  Legals, liabilities and legacy.

In Australia, wills written before diagnosis are set to be challenged; indicators of suspect competence might have been present years ago and gone undiagnosed... when they could have been.

I spoke with Tuly at length.  Here's a film of part of our meeting.  He's a must watch.

It's not just Doc Tuly.  I met two of Australia's leading research academics; Prof Perminder Sachdev and Prof Henry Borodaty.  They are just as blunt.  We're nowhere near prepared for what is just around the corner.

So, when I hear, back in Blighty, the Tinkerman has been dickering about with shallow speeches and warm words... it worries me.

What should we be doing?

First, early diagnosis.  There are indicators that tell us who is at risk.  Stroke survivors, obesity, booze, behaviour, family history.  Markers that can tell us 20 years ahead, who is likely to develop dementia.

In England we bunged GPs to diagnose dementia.  By the time they do, it's too late.  There may be no cures but there are things we can do to be ready, prepare and buttress families against what will happen.

Who will look after people with dementia?  Be clear, care services won't cope.  We have to recruit, train and support members of the family.  If it means giving up work, we must pay them.

Not everyone has family; yes I know, but for every one that does, it makes room for us to care for those who don't.

As all the experts reminded me; we've only been looking into people's brains for 30 years.  Is it any wonder we don't know what's going on.  

Pretending we do, pretending we are on top of this, pretending we have policies, pretending we have funding is dangerous nonsense.

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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.