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  • 25th March 2019 | By David Jolley

    I have been reading Jackie Pool’s book: ‘Reducing the symptoms of Alzheimer’s Disease and other dementias’ for the Dementia Newsletter of Christians on Ageing.

    It is a very personal account, sharing with us from the start that her grandmother had begun to act strangely. The family and Jackie as a child did not know of dementia but explained the change as ‘she has gone senile’.

    So it was – It is interesting how many people who have devoted themselves to the field have been motivated by experiences within their own family. The wonderful Moira Low, who founded the Wolverhampton branch of the Alzheimer’s society was drawn to it after a career in teaching, by the illness of her mother, and the earlier experience of her grandmother. The family who have given us the Sunrise chain of care complexes were driven to invent better care for their mother in exasperation at the failings of all options open to them in the USA. So many people who come to talk with us at Dementia Conversations have shared similar stories – moving them to begin care agencies, a specialist shoe fitting facility and more.

    England’ senior nurse, when asked to speak about dementia did not refer to the literature or NHS websites but to her personal experience of living with and caring for her mother. There is nothing like it for knowing and feeling the condition – 24 hours a day – endless searching for answers and peace.

    This must go some way to explaining the powerful feeling of unity within the dementia care community. This is more than a career, or even a personal calling. This is personal. This is family.

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    Death study 18 March 2019 | Comments (0)

    18th March 2019 | By David Jolley

    I have been pleased to contribute to training days organised by Wigan and Leigh Hospice over the past five years. The hospice has pioneered and developed a scheme of extended hospice/palliative care to nursing homes in the area. This brings the skills and wisdom of the hospice to a wider community of people as they approach death. Care Homes are the most common site of death for people with a diagnosis of dementia so that although not exclusively for people with dementia, this scheme is particularly beneficial to individuals living their last months with dementia and their families – and the staff of the care homes. It is a model which is gaining more support across the country than that which we explored – a specialist dementia service – from Willow Wood Hospice in Ashton under Lyne. There are virtues in both. An amalgam of best practices is entirely feasible and may be the future. In addition to the benefits in improving the experience of last months for all parties, these schemes reduce wasteful and inappropriate use of acute hospital beds, investigations and futile and inappropriate treatment.

    This week’s session was notable for the inclusion of a presentation by Professor Peter Fenwick a retired Neuropsychiatrist. I met him many years ago when he contributed to a course on EEGs (Electro-encephalograms) at the Institutes of Psychiatry and Neurology in London. In the way of things I had imagined his life being confined to the EEG laboratory and the study of wiggly lines generated by the electrical activity of the brain as transmitted through the skull and its coverings. In recent years, he and his wife and other researchers, have been studying aspects of the experiences of people at the point of death. We heard of deathbed visitors, a waiting place, non-dual consciousness, transformation of consciousness, a new reality, and terminal lucidity in people with chronic schizophrenia or dementia. I might understand more in reading the Fenwick’s book: The art of dying. Curious.

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    12th March 2019 | By David Jolley

    We have become quite accustomed to the routines of funerals. Most involve attendance at a church service followed by a shorter ceremony at the crematorium or cemetery. We are church people, so it is that the church is usually central to this special day.

    Increasingly this is not the case for the population as a whole. Many now die declaring they are ‘of no faith’, so some form of dignified celebration of their life, in keeping with their wishes and views, is organised at a non-religious venue. Cremations with no funeral service are becoming more common https://www.co-operativefuneralcare.co.uk/arranging-a-funeral/funeral-choices/direct-cremation/.

    The deaths of people of other faiths are celebrated in keeping with their traditions.

    Family and friends, including the church community are also fairly busy welcoming new babies. The traditional welcome into church communities is at a Christening service. The number of Christenings per annum has fallen by about 50% in a decade – only 15% of babies currently receive a Church of England baptism. The procedure requires a church community to come together and for the family and wider church to welcome the child as a member of the Christian faith, supported by their parents, God Parents and the church.

    Statistic on statistic plots the decline of religious belief in Europe, so that individuals who have been christened are in a minority, as are the families who are taxed to support them to grow in the faith. How meaningful or realistic will such a commitment prove? The power of fashion and peer pressure is frightening.

    Yet as we grow old there is need to review personal experiences, personal priorities and beliefs. Reading Karen Armstrong’s ‘A history of God’ is not easy. But very early on she tells us (p 10) that ’creating gods is something that human beings have always done.’ (‘Creating’ might be questioned. ‘Recognising’ might be an alternative).

    ‘Our current secularism is an entirely new experiment, unprecedented in human history.’ (p 4).

    The roots of certainty or uncertainty are set early. That is not to say that people cannot revise their position later in life – but this is an option not taken by many https://academic.oup.com/psychsocgerontology/article/56/6/S326/610642.

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    4th March 2019 | By David Jolley

    As I spend quite a lot of time working with other volunteers to maintain our local park, I was interested to read Tom Bawden’s article in the i 26.2.19 ‘Green spaces boost children’s mental health. His source is a fabulous paper from the University of Aarhus: https://www.pnas.org/content/early/2019/02/26/1807504116.

    How can you argue with the immaculate work of authors with names which speak of carefulness? The study combined findings from high resolution satellite pictures of Denmark since 1985, which are used to compute a vegetation index, and the Danish Civil Registration System linked with the Danish Psychiatric Central Research Register. What a wealth of data – based in a long tradition of Scandinavian epidemiology research which was exploited all those years ago by David Kay. The findings indicate that living in proximity to green space during the first ten years of life is protective against the development of mental health problems in adolescence and early adulthood. It does not yet stretch as far as the disorders of late life because we are only 34 years on from when satellite data became available for the first time.

    This work adds to the literature which documents the general health benefits of green spaces in the lived in environment: www.sciencedirect.com/science/article/pii/S1618866715001016.

    Green space is an antidote to air pollution. There is a literature which has pointed to increased mental health problems associated with raised air pollution: https://bmjopen.bmj.com/content/6/6/e010004 (another Scandinavian study - this one from Sweden).

    Returning to green space – review of studies across the life course do find a positive relationship between time lived in a green environment and sustained cognitive function: http://public-files.prbb.org/publicacions/d1c87730-740f-0134-7241-00155df14f0e.pdf.

    Air pollution in London is associated increased incidence of dementia, especially Alzheimer’s disease https://bmjopen.bmj.com/content/8/9/e022404.

    So time and money spent on our parks and other green spaces are more than justified. First is the provision and maintenance of such resources – the worth of which was intuitively known to philanthropists of the past. The next is to foster activities which encourage people to use them and feel at home in them for exercise, entertainment and relaxation.

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