Piffle, padding and procrastination ...

By Doris Daly - 04/08/2008

The Department of Health is developing a national strategy for dementia services and aims to draw on evidence from a wide range of reports and stakeholders. This fuelled sixteen venues across the land called “listening events” that involved 3,000 people plus an “External Reference Group” (who are they?) - all of  whom are to be “listened to” by the D of H to put into effect the D of H’s recommendations.  

But these are not recommendations on dementia itself - but on the D of H’s ideas set out in the document provided for a discussion to outline their “strategy document”.

The London Congress Centre hosted the London “Listening" venue on June 19th. It was introduced by Professor Sube Bannerjee, Professor of Mental Health and Ageing, institute of Psychiatry, Kings College London. All very impressive.

Subee Bannerjee is a very accomplished lecturer - and he certainly did lecture the assembled throng. He outlined “our vision for the positive transformation of dementia services over the next five years.” There was nothing new there. His final strategy was to "provide a framework within which local services can deliver improvements to dementia services" and so on and so forth. He then finished up with another strategy “to provide a guide to high-quality health and social care services to inform the expectations of those affected with dementia.”  

So there you have it, Strategies and Guides -  a Band Aid delivered yet again to paper over the cracks.

Suitably anesthetised, those assembled in Congress House sat in anticipation of the uncovering of the New and Improved book of Revelations. With their derigeur pens and flip charts at the ready, they spent the afternoon agreeing with the sixteen point strategy like conditioned children out of Huxley’s Brave New World. The self interest individuals were easily recognisable by their calls for extra cash and the expansion of their contracts of employment. But surely, as they are all duplicating their services, a cull of their numbers would be of much more value?

That the Poor Law valuation is alive and well was ably demonstrated by this conference - despite EU regulations. No one has the foresight or the creativity to plan for the future - instead, short term plans which never get implemented will spew from the strategists in ever increasing waves of wasted paper.

Meanwhile the same old poor house Care Homes staffed by care workers without a qualification and on minimum wages will "store" our elders until they have the goodness to shuffle off their mortal coil and make way for the ever increasing flow of clients bound for their last refuge. The only difference is that they are referred to as "clients' instead of  “inmates”.

Even the Alzheimer’s Society, who have cornered the market in dementia, do not actually provide hands-on work. They create endless streams of brochures (who is paying for them?), creating the impression that the demented and those who care for them are merely a product to be marketed.

Amazingly, the Geriatric Society has not been consulted at all to my knowledge. Yet surely this organisation that is committed to the hands-on care of the elderly should be foremost on the National Strategy consultation? It is a national disgrace that they are sidelined when they are the grassroots experts in the field.  

Dementia is an incurable disease. It is also terminal and should be treated as such. The damaged brain will not regenerate. Drugs may halt the process but the side affects and the duration of the respite is hardly worth the cost.  Psychiatrists can only diagnose and then only once - so what is their actual function in the care of the demented?

Hospices and end of life care is never mentioned - whilst other terminal illnesses have realistic solutions. We are all mortal and we should address this fact. The quality of life and a pain free dignified end is what any civilised people should aspire to, and demand.   

In my view, if there is a way forward, then care of the demented must be independent of the Community Mental Health budget. The mentally ill do not have a terminal disease. They need on going psychiatric, social care and hospitalisation. But the demented require a very different range of medical, social and nursing care which must be funded directly and separated from Mental Health care if we are to see progress, not strategies, in this human catastrophe.   

The National Dementia Care Strategy will reconvene in September to assess the outcome of this codology of a consultation. Why not get involved and have your say? It just might make a difference.