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  • Hoping 22 March 2016 | Comments (0)

    21st March 2016 | By David Jolley

    We are having an Easter Bonnet walk in the park on Wednesday with children from the local school sporting sponsored hats – Sponsorship for the Marie Curie Foundation. This is to rekindle a relation between the school, park and Marie Curie Foundation which began 20 years ago when the mother of children at the school became terminally ill.

    A Field of Hope – thousands of daffodils – was planted and bloomed magnificently for a few years but has latterly waned. We want to see hope re-established and sustained into the future.

    We planted 2000 daffodil bulbs in the autumn, 1000, snowdrops and 1000 bluebells. The yield is disappointingly sparse. Maybe we chose the wrong part of the park, maybe the very wet season has drowned the bulbs.

    Nothing to be done though other than to press on – We can celebrate Spring and what daffodils we have this year and photographs of the most successful years. We will wear hats and make a donation to Marie Curie and learn something from them about cancer and their work. We will be thankful for new picnic benches and hear something about the history and natural history of the park from a local expert. We will walk the park together and talk of realities and hopes.

    Perhaps there is more to be learned about hope and coming to terms with the wonders and frailties of biological systems, including human beings, when things do not go quite as we wish. Living with bad news and finding a new way will see us through.

    We are wanting to learn more about The Dementia Roadmap. Salford is nearby and has one and has a good reputation in dementia services. Their Roadmap is fronted by a scene featuring a tram! Perhaps there is less flexibility in Salford than the A-Z might suggest.

    It seems such a good idea – but who does what and how are the maps actually used? Can we see evaluations? Why are there only 17 maps registered to date?

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    14th March 2016 | By David Jolley

    Tuesday was our first outing under the Conversations banner of Dementia Pathfinders. We had the use of Bowdon Vale Methodist Church schoolroom and the warm hosting of the chapel, their stewards Jane and Sarah, and the committed involvement of the Reverend Ros Watson. Cakes and liquid refreshment (tea, coffee – Fairtrade – with and without caffeine, and juice). Balloons to mark the way – including blue, red and green as in the Pathfinders Logo. Car parking arranged.

    Phew – Can we play a CD? No problem.

    Who will come? There have been emails, telephone calls and words of mouth - but will anyone come? Maybe there will be more than we have room and refreshments for.

    Keep Calm – This is important but DON’T PANIC

    The leading article in the current Bowdon Church newsletter is headed: ‘Are you listening to me?’ Catherine Cleghorn, the Ordinand, shared her pleasure at being in receipt of careful listening from a friend: ‘something that I certainly don’t experience all the time’. This gave us a firm and apposite steer to have confidence to offer people time and space to share their thoughts, take them back and rearrange them; to use the time and company to be fearlessly creative.

    A quote from the previous Minister at the humbly located Bowdon Vale Chapel took us further down that road (or path!): ‘reaching into the community, seeking to fill the gaps which remain between elements of existing provision: fill a gap where nothing is provided – ‘Mind the gaps’

    Those of us who have travelled by tube recognise the refrain – It is good to find how helpful it is in this different context.

    We had a lovely afternoon of talk and thought. We have listed things which are sound and identified areas of uncertainty and weakness and will look at these carefully and plan actions.

    Today is warm and we have sunshine. How strengthening the change is as we emerge from so many days of cold and wet. How extraordinary that the crocuses can shake off the damp and stand so proud and radiant to such a short timescale.

    Walking with Tilly our Whippet, I lingered to look up at a knobbled old tree bathed in sunshine. Pleased enough to dwell on the shapes, colours and shadows, I was given more as a Nuthatch worried about in search of insects under the bark. She had not made a sound. I might have missed her if I had been walking at pace.

    My wife says that this is a lesson in living.
     

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    07th March 2016 | By David Jolley

    The Guardian newspaper has run a series of articles about health and health services, including mental health and mental health services over the past two weeks.

    By Thursday of this week niggling between medical practitioners and clinical psychologists had gripped the correspondence columns.

    David Enoch, a venerable and wonderful man, now in his nineties wrote: ‘I declare from 60 years as a physician in psychological medicine, that the medical approach has been extraordinarily successful. I experienced the old regime of the 1940s and then the golden era of psychiatry, with the discovery of successful antipsychotic, antidepressant and anti-anxiety drugs and the establishment of ‘talking cures’.

    He was taking exception to the claim by Richard Bentall, a psychologist, that a narrow medical approach has been ‘extraordinarily unsuccessful’

    A narrow approach is likely to have weaknesses and limitations but the medicine and psychiatry which David Enoch describes, and is illustrated by his own impressive career, has been broad church and is robust – hence the good outcomes which we should not easily deny or dismiss.

    We have seen the closure of mental hospitals because fewer people are left damaged by untreated major illnesses. We have seen a reduction of suicide rates, especially in older people. We are in the midst of further efforts to counter stigma and ignorance of mental illness and to encourage a reasonable share of resources to be directed to the care of mentally ill people of all ages.

    Improvements have depended upon the charisma and energetic devotion of people like David Enoch, harnessed with the equally determined passions of other professionals and ordinary people who have been touched by mental illness.

    Andrew Spooner, a GP in a small town, writes a personal view in the BMJ March 5th

    ‘I am besieged by rules in the form of guidance from NICE, professional bodies, specialist colleagues, pharmacy advisers and many others’

    ‘I no longer feel as though I have the autonomy to offer guidance suited to individual requests’

    ‘Recently the system requires me to recommend care which I think is wrong’

    ‘Informing patients that a guideline or requirement is wrong would be professionally dangerous’

    ‘When I strive to follow system requirements, patients become unhappy and I am blamed for not delivering personalised care’

    ‘Other professionals can substitute for me only if they follow tight protocols, further reducing the patient’s autonomy'

    David Enoch retired from clinical practice only very recently. I doubt he ever let rules prevent him from providing what he considered to be the most appropriate care for an individual. Neither should we or anyone else. The danger of the plethora of guidelines and their adverse effects singly or in combination should be recognised and the virtues and value of independent clinical practice recognised and celebrated.

    This coming week will see the first ‘Conversation’ under the auspices of Dementia Pathfinders at Bowdon Vale for Rev Ros Watson and me. First steps into another world. Wish us well.

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    Old Friends 01 March 2016 | Comments (0)

    29th February 2016 | By David Jolley

    I have been pleased to have sight of the January issue of the newsletter produced by the Faculty of Old Age in the Royal College of Psychiatrists

    http://www.rcpsych.ac.uk/pdf/Old%20Age%20Psychiatrist%20(64)%202016.pdf

    The Faculty, through its origins as the (Special Interest) Group and Section, has been my lifeblood from the early 1970s and still provides friendship and kindred thoughts which sustain me.

    The new issue of the newsletter is the first to be edited by Helen McCormack, Sharmi Bhattacharyya and Anitha Howard. They have taken over from Claire Hilton who has been an inspirational editor, leading the newsletter out of the wilderness and into the light – producing good quality and interesting articles from a range of backgrounds and to a predictable time-table. It is established as a ‘must read’ within the sea of competing possibilities for attention.

    As befits a first edition, this is a blockbuster, dominated by a series of short essays which reflect people’s thoughts and feelings about giving their lives ‘in service of old age’ (Tony Whitehead). Every piece has depth and value and is worth reading and thinking about.

    I am pointing, though, to the articles from Alistair Burns and Susan Benbow.

    Alistair’s support of the newsletter is wonderful. He is established as the national and international face of dementia care and has widened his role to include other mental disorders of later life. Brilliant.

    Here he modestly draws attention to the recently published report of the Mental Health Task Force:

    https://www.england.nhs.uk/mentalhealth/taskforce/

    Worthy as this is, in my unconstrained life of semi-retirement, I found it long and lacking in the fire needed to make me seize it as the banner to be used in leading toward a better life.

    Alistair points much more engagingly to his three current foci – (he claims not to be a Methodist lay preacher, but uses their formula of threes) – depression: with statistics and clinical illustration, loneliness: depression in another language, and Ageless Mental Health Services – the vote being overwhelmingly for special services for older people.

    So we know what we are about and have ideas on how we might do it.

    Susan Benbow brings together a career in mainstream Old Age Psychiatry with a long-term affinity for Psychotherapy – Not a mix to be come across often, but certainly exemplified by Don Williams and a few notable others in the past. Not a question of either/or – but of bringing to bear relevant skills and attitudes to the spectrum of human experiences which we encounter. 

    For people in general, patients and practitioners she quotes Antonio Machado:

    ‘There is no path: You make the path as you walk’ 

    What could be a better fit in our Pathfinders project?

    Keys for Susan Benbow’s illumination and sustainment are: patients, families, complexity and colleagues. We might find these secure fellow-travellers too. In the freedom of ‘retirement’ she explores further through therapy, teaching, safeguarding and research – with clinical sessions at Gnosall ensuring here steer is secured in reality

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