Will the dementia DES benefit patients? Yes
Dr Alec Turnbull argues that the proposed DES for case-finding dementia patients will improve the quality of their last years
What would we want if a failing memory hampers our daily functioning? We may choose to ignore and deny it, or opt for a full check-up with our own GPs. The more senior amongst us may already have been asked by our medical advisors if there are any memory concerns. The challenge is changing the current culture of ‘wait and see’ into organised pro-activity, empowering people with dementia and carers as well as improving life quality.
Should this mean a more proactive approach to dementia case-finding for over 75s, and selected over 60s with known risk factors? I believe so. An annual check-up assessing general health, sight, hearing and mobility should include mental health and cognitive assessments. We know that the current estimated 800,000 cases in England and Wales will rise to over a million by 2025 given the age explosion. Allowing arguments over definitions of screening and current statistics to deflect national policy away from widespread action could diminish initiatives already underway.
Life quality can be helped by social and therapeutic measures, for both people with dementia and carers, even though life expectancy and disease progression may not change in most instances. In vascular dementia, lifestyle options of diet, smoking cessation and exercise could assist with appropriate therapies in stabilising the condition.
The increased emphasis on finding undiagnosed cases of dementia in the form of the proposed DES will contribute improved statistical information and help shape future service needs. National primary care activity of this nature will form part of the groundswell of culture change needed to encourage new links between people with dementia, families, carers, voluntary agencies such as Alzheimers Society and Age UK, social services, housing departments and clinicians. People with dementia, and their carers and families, will benefit from the opportunity afforded by levels of milder cognitive impairment to make fundamental property and future care decisions.
Our patients will need effective memory and old age psychiatry support to complement the already-increasing primary care suspected diagnosis rates. They and their carers will benefit from appropriate therapy, including future drug advances and psychological methods. Their lives can be enhanced by a range of effectively commissioned services such as dementia cafes, reading groups, reminiscence therapy, active living , peer support and dementia advisors which can follow a formal diagnosis.
Let’s support Alistair Burns MP in his discussions with the profession about the DES. If we use our voice to champion these proposals, and other concordant improvements in the health and social care landscape, we can support our patients and their families to live well with dementia.
Dr Alex Turnbull is a GP in Wigan with a specialist interest in dementia. He is also a spokesperson for Alzheimer’s UK.