• Journeying on (2) 18 February 2016 | View comments

  • 18th February 2016 | By David Jolley

    The journey of last week took me to a study day on ‘Mental Health in Palliative Care’ which was organised by Wigan and Leigh Hospice and presented at the Leigh Sports Stadium. 

    I have been to Leigh only once before and that was to a Sunday morning study day at the medical institute which was a beautiful facility accessed via a stunning terrace-house façade. I had learned it is possible to get to Leigh from Altrincham by wriggling through Warburton, over the toll bridge, onto the A57 and then cross country: no motorway driving! The map told me I should turn right onto the A57 and then left onto the B5212 which would take me to Glazebrook, then Holcroft to turn right on the A574 Warrington Road, left the A580 East Lancs and right on the A579 Lowton St Mary’s Road which becomes Atherleigh Road. That would take me to an island from which I should turn right onto Sale Way and the Leigh Sports Village. So – a bit of a wriggle – but what fun and what a pleasure to outwit the motorway grid. No accompaniment by SatNav Sal – I struggle to cope with the technology unless someone sets it up for me. But an outline map in my head of where I am going, checked against a handwritten sheet in BIG WRITING which rehearses the roads and turnings. Success is a thrill. But it was more than that – a rainy day was interrupted by sunshine travelling between the fields of the B5212. These fields and houses were new to me – startlingly green and fresh with the rain and low-angled bright illumination. 

    And there were rainbows. Rainbows are special and tell of something wonderful.

    The Leigh Sports Village is based in the Leigh Rugby Stadium. Parking is in the nearby supermarket carpark. The people attending were drawn mainly from hospices and palliative care services around the North West. The programme for the day was bravely relevant in addressing the importance of mental health in palliative care and palliative care for mental health services. We need greater recognition of the relationship between these two worlds which should know each other. 

    • Helen Millar reviewed the management of palliative care needs amongst people with established serious mental disorders. Wow.
    • The effervescent Professor Marie Lloyd Williams took us through the importance of depressive states amongst people known to be dying, illustrated and given depth and understanding by her own studies. Marvellous. 
    • Alison Colclough took us to the growing community of people who are homeless in this country – making reference to the studies and experiences of St Mungo’s in London, but further illustrated from the streets of Cheshire. Here mental illness is common and death comes early. We were transfixed. 

    There were more presentations on mental health services and treatment options for psychiatric problems amongst people approaching death.

    My half hour looked at ‘Dementia and end of life care’. It was a chance to reflect on care at the end of life and deaths amongst people with dementia. Chance to reflect on the current shroud of fear which surrounds ‘dementia’.

    In the 1960s mental health services for people with dementia were based on mental hospitals with large wards and skeleton staffing: death would come within weeks or months of admission.

    Powick Hospital

    https://www.youtube.com/watch?v=UzjeBaBFWqw

    https://www.youtube.com/watch?v=ZJU4X60ce30

    Thanks to Claire Hilton for these links

    Roger McGough was a young man and wrote about death and his preference for how and where it should come to him:

    Let me die a young man’s death. In The Penguin Modern Poets: The Mersey Sound 1968

    In recent years his thoughts have turned to the prospect of becoming changed by dementia in the years before he dies. Dementia and Alzheimer’s disease are the greatest fear of people in their 50s and beyond

    A fine romance. In The Awkward Age. Penguin 2010

    So this is where campaigns to advertise the importance of dementia have taken us 

    In the 1960s we were learning for the first time something of the social dimension of life amongst people surviving to experience dementia and frailty, summed from multiple pathologies, at home.

    Bernard Isaacs, Maureen Livingstone and Yvonne Neville. Routledge and Kegan Paul, London 1972

    And we had become painfully aware of the institutional neglect of older people in mental hospitals. This awareness through the publication of serial scandals was the springboard to do things differently, to do things better.

    Barbara Robb: Sans Everything. Thomas Nelson and sons. Camden 1967

    D J Jolley and T H D Arie (1978) Organisation of Psychogeriatric Services. BJPsych 132  1-11

    So much has been done, yet so much remains to improved

    https://www.youtube.com/watch?v=odYUhcphqpQ

    It is encouraging to know people’s personal stories of good times into and out of dementia

    Tony Husband: Take Care Son. Constable and Robinson Ltd. London 2014

    And one of the very best developments is the involvement now of hospices in the spectrum of services reaching out to people with dementia and their families. Fabulous people to meet in Leigh – part of the impressive network of independent thinkers and practitioners who populate this sector.

    Tapley M, Regan A and Jolley D (2013) Hospice: putting the heart back into dementia care. Journal of Dementia Care 21 (5) 14-15

    It was a good day. This is a good journey with showers and sunshine, rainbows and hope.

     

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