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Helping to cope with the demands of dementia
WITH better living standards and medical care, the challenge facing Oxfordshire from dementia is now vast.
The county has always had a high proportion of older people and the number of 85s and over is set to rise from 14,683 in 2011 to 39,400 by 2035.
This will put massive pressure on families – both emotional and practical – as well as health services.
Just one year saw almost 500 more sufferers reported to NHS bosses. A total of 3,566 sufferers were recorded by NHS Oxfordshire on March 31 last year and the total was 3,936 on the same date this year.
The problem comes sharply into focus when people with dementia go to hospital with another issue, such as an infection or fall.
As dementia lead for Oxford University Hospitals NHS Trust, Dr Sarah Pendlebury is charged with not only ensuring patients with dementia are handled sensitively, but medics diagnose new cases.
The John Radcliffe Hospital doctor said: “A lot of patients who come here are elderly and frail, particularly those with an emergency admission.
“A significant number of our patients – about 25 per cent – haven’t had that prior diagnosis yet come to us and have a problem with thinking and memory.”
She added: “Sometimes people can be more focused on the physical illness aspects of an older person.”
Recent steps at county wards include the 2011 introduction of a standardised memory test which asks 10 questions including where they are and to name their address.
Dr Pendlebury said: “In theory it is in place throughout the trust, but it is getting trust staff to be consistent and embed it in the right process.”
The trust last year set up “dementia cafes” at the JR once a month to bring together patients, carers and staff to swap advice and information.
“Often it can be difficult for people to know what services are available, for instance in the community like carers’ groups.
“They can feel they are not the only one coping with that sort of challenge.”
Ten senior nursing staff have also been sent on specialist training at the University of Worcester and the trust has hired 20 psychologists and eight psychiatrists to support patients, with more planned.
Dr Pendlebury said: “We now have consultants whose role is to provide expert advice and diagnosis on patients with mental health problems.”
Those diagnosed in the community are also sent to trust memory clinics, where their condition is diagnosed and given, where appropriate, drugs like donepezil, marketed as Aricept.
But these only enhance brain cells that have not degraded and research has yet to provide enough understanding about what causes the condition to provide treatment that could stop cells being destroyed by Alzheimer’s.
City research includes a study at the NIHR Biomedical Research Centre – which brings together NHS and university researchers – of 8,000 stroke patients since 2007, to probe any link between conditions.
Dr Pendlebury said: “It is a huge challenge. We probably haven’t had any new drugs for the treatment of dementia for the last two decades.”
Yet she said: “I am optimistic, I think we have made huge advances on things like brain imaging to better understand the issues that contribute to dementia.”
Home cared for sufferer in the last three years of his life
CLAIRE Whitehead was delighted to open a sensory garden at the care home which looked after her husband in the last three years of his life.
- Claire Whitehead, second from right, cuts a ribbon to open a sensory garden at Heathfield House Nursing Home. Also pictured are the home’s owners Raj and Karuna Gupta, finance manager Debbie Behan and manager Alison Valentine
The retired consultant rehabilitation doctor, who worked in Reading, opened the new-look garden last month at Heathfield House Nursing Home, Bicester Road, Bletchingdon.
It cared for husband and dementia sufferer Burton Whitehead, from November 2010 until his death in September 2013 aged 83.
The 81-year-old said a clearer path to a tree her husband used to sit under and wind chimes would aid sufferers.
The Bicester resident, who moved to Oxfordshire in 2002, said: “It is about stimulation through seeing and hearing, it is lovely.” She said of her husband-of-52-years, a deacon and priest in Berkshire: “We were always very happy together in a very happy, simple way.”
The work was funded from £54,000 given to the home as part of the Department of Health’s National Dementia Strategy.
Home finance manager Debbie Behan said: “The new sensory garden is welcoming and more attractive to residents and family members and will encourage more outdoor activities.
“It provides a large welcoming seating area, a stimulation area with a water feature, sensory planting, a reminiscence shed and a potting shed and a petting area with chickens and rabbits where residents can interact.”
IT'S LIKE BEING MARRIED TO A DIFFERENT PERSON
JOY Watson first discovered her husband Roy, 72, had dementia three years ago.
The 70-year-old Chipping Norton resident said: “The first year was hell.
“He was shouting at me sometimes and panicking in the shops because he could not find his credit card.
- Joy and Roy Watson
“At first when we went to the doctor's we were told it was depression, but they did more tests at Banbury Hospital and said it was mild cognitive impairment.”
The condition, Mrs Watson said, affects the frontal lobe of her husband’s brain.
It contains sensitive systems from the cerebral cortex associated with reward, attention, short-term memory tasks, planning, and motivation.
His long-term memory has remained largely unaffected, she said, but he is often unable to recognise her.
She said: “It is like being married to a different person, it is just awful.
“He has hardly any conversation and has no idea about money or what day it is.
“Quite often he will still go to the shop and get a paper, but he will just forget about me and won’t say goodbye if he goes out.
“It makes you feel like a stranger in your own home.
“But because he is physically fit and healthy we are mostly just left to our own devices.”
Warning not to ‘bottle up’ obvious warning signs
- Dementia support workers, from left, Lois Greenhalgh, Frances Calydon and Gilly Fishleigh
DON’T bottle it up” is the message Alzheimer’s Society workers have been bringing to the county this week.
An information bus visited Faringdon Tesco Metro and Witney town centre on Monday and Bicester’s Sheep Street on Wednesday.
Dementia support worker for Vale and Didcot Lois Greenhalgh said: “Some people when they get dementia, it is very shocking, they might go into denial or they don’t accept that anything is wrong.
“They don’t have the insight to see that they are not coping.
“People have in their minds horrible ideas about ending up not being able to have a relationship and ending up in a nursing home.
“We are saying ‘don’t bottle it up’, talk to us about what it means.”
The charity provides one-to-one support to sufferers and carers, such as helping people ensure they are claiming benefits like attendance allowance, and runs carer support groups.
The bus will return to Witney, under the town clock, from 10am to 3pm tomorrow.
Transport help of a different kind is offered by Daybreak, a £12-a-day day centre run from The Clockhouse, Long Ground, Blackbird Leys, which picks up residents.
Director Andy Buckland said: “They deserve to have a good quality of life, they deserve to have a bit of fun and get out the house.”
- Contact the Oxford branch on 01865 876 508 or the national Dementia Helpline on 0300 222 1122.
Helping to keep the brain active
- Liz Stevens and with fellow volunteer Charlotte Martins,
RESIDENTS of Clanfield, West Oxfordshire, run Clanfield Cares to provide information and support about dementia.
Tomorrow it will hold an event at the Carter Institute in Clanfield that includes a brain teaser and games like matching two cards of the same object.
Volunteer Liz Stevens speaks from personal experience as her father Richard Bezis, 82, has dementia.
She said: “It is a way of keeping the brain active. We have also got information packs into all the shops. We want to signpost people to other organisations to get support.”
- THE Alzehimer’s Society estimates one in three people will develop some type of dementia and two in three sufferers are women. Dementia is an umbrella term, and there are many different types. Some of the more common types include:
- Alzheimer’s disease, the most common cause of dementia. It causes the chemistry and structure of the brain to change, killing brain cells.
Vascular dementia, where brain cells are starved of oxygen and die. This is more common after a stroke.
- Dementia with Lewy bodies, which are tiny spherical structures that develop inside nerve cells. Their presence leads to the degeneration of brain tissue.
- Fronto-temporal dementia, where the damage is usually focused in the front part of the brain. Personality and behaviour are more affected than memory.
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