Today the government has published a Dementia ‘atlas’, a map of England showing which areas provide the best care for people with dementia and those that don’t.[i] Part of the criteria is how many dementia patients are able to die at home, instead of in hospital. Patients dying at home and their families need help from carers and nurses who are trained in end of life care and understand dementia, and from what we hear, there are far too few of them. They are also costly. For example, Admiral nurses are wonderful, but they do not come free of charge.
Health Minister Jeremy Hunt is quoted as saying that the atlas is designed to drive improvements across the country, and ‘by publishing the current levels of care, we are shining a spotlight on areas where there is still work to be done, whilst highlighting where we can learn from best practice.’
Do you sense the deja vue ? For over two years, from 2013 to 2015, Mr Hunt castigated GPs for not pushing patients for early diagnosis so they could receive ‘tailored care and support’. GPs protested that not only was there was a higher risk of misdiagnosis at that stage, but there was no tailored care and support for those who had been diagnosed already. Eventually the royal College of GPs published a national survey of GPs which showed that 70% confirmed that there was indeed, no ‘tailored care and support’ in their region.
At a national Christian festival a couple of weeks ago I asked people who were on the dementia journey whether or not they were getting good support from social services. Most said that no, they weren’t; they were paying for help themselves. Earlier this year at a national Bible week I took two sessions on dementia, and at one point, asked how many participants were receiving help from social services. Not a single hand went up, and the expression on their faces said it all.
Last month the president of the Directors of Adult Social Services warned that we were now at a tipping point – there simply isn’t enough money available. Councils in inner city areas have seen a rise in demand as their population ages, while their funding has been cut by as much as 26% over the last few years. So it’s hardly surprising that the worst performing local authorities in the atlas are in the inner cities. Even so, Mr Hunt is to ‘name and shame the parts of England which are failing dementia sufferers.’[ii] He refers to ‘learning from best practice,’ but comparing apples with pears won’t do it.
Because the fact of the matter is that without the money to pay for the services, Councils in inner city areas won’t be able to provide them. Dementia patients will continue to die in hospital because their Councils don’t have the resources to provide for them in their own homes. It’s like labelling elderly patients ‘bed blockers’ because they are occupying hospital beds when they are medically fit to go home, but physically unable to cope. And as everyone knows, these delays are caused by the lack of social care available.
Naming and shaming poorly performing local authorities won’t help, either. It seems to me that the real scandal is the shifting of the blame on to Councils who are have had their funds cut and are still being expected to produce the care people need. It’s like having to make bricks with no straw – and now, as then (Exodus 5:7) the results are inhuman.
[ii] Daily Telegraph, 16 August 2016
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in the 1970’s the National Institute for Social Work ran a series of excellent courses on Dementia Care. In Northern Ireland the purpose built homes were ahead of the time, and have never been taken up as a model. Again the voluntary sector is leading the way in the UK – why – maybe because they are not afraid of the unknown or getting their hands “dirty”. Today on TV “research reveals” that table tennis is a great therapy – How much did this research cost? Money better spent on care and support methinks!
Mark: We’ve introduced a new model of care in our homes – trialling it at the moment. It’s called Hummingbird, because carers speak frequent notes of encouragement to residents with dementia. I was in the home in Wantage, yesterday, just sitting awhile and watching it in action. It’s brilliant! You see them coming to life! It means specialist (and expensive) training for carers, and having more carers. And about the table tennis research – exactly as you say!