• Not the NHS Continuing Care story 13 May 2016 | View comments

  • 12th May 2016 | By David Jolley

    I thought that this week would be devoted to NHS Continuing Care – I was involved in an Independent Review Panel on Monday – but best leave it for a little while as the passions cool.

    Susan Benbow has been blogging for much longer and her recent posts have pricked me: www.oldermindmatters.com/blog

    Susan always researches her blogs very thoroughly and provides useful links to sources I have usually not heard of or otherwise overlooked. The most recent tells of her attendance at the Faculty of Old Age Psychiatry meeting in Nottingham. The Group/Section/Faculty has been my life from 1974 onwards. It was there I saw Felix Post demonstrate the most elegant of Chairmanships, guiding the energies of Brice Pitt, Tom Arie, Klaus Bergmann, Sam Robinson, Gary Blessed, Carrick Macdonald, Peter Jefferies, and others to marvellous effect.

    I have not been to the last two residential conferences – and these years there is only the one meeting per annum for ordinary members – we used to meet every 3 months and the Group and Section acted then as a very important and effective mutual support device as well as lobbying force. Somewhere in amongst that is my reasoning and sadness.

    Susan remains more positive – she mentions particularly the sound contributions of Rob Howard – anti-psychotic medication is actually good treatment when people with dementia have psychotic symptoms. She tells us that John O’Brien thinks we should have more NICE guidance about dementia. Belief in paperwork over personal and clinical commitment is not for me – ‘If all the world were paper and all the sea was ink’– Uncle Mac on Saturday mornings – You learn from these wise and kindly men.

    And she tells us of the positive buzz amongst those present and the inspiration coming from leading figures – It has to be good – Quite like the old days.

    The thing which exercises me most is her pointer, with approval, to a paper from Andrew Balfour which tells of therapy from the Tavistock Clinic: Living Together with Dementia: a relationship intervention for couples living with dementia (I have taken out some of the capital letters) http://www.tccr.org.uk/images/TCCR_summary_of_the_LTwD_approach_Nov_2015_-_FINAL.pdf

    There is something almost unbelievable about THE Tavistock turning to dementia. I am sure somewhere I remember being taught that Freud felt psychotherapy was not possible in the face of dementia or other organic brain disorders, perhaps someone will correct me. I am happy enough to associate myself with the view that people with dementia and their families are people and just as much in need of a psychotherapeutic approach when things get tough as anyone else. But I am a bit troubled that the push for early diagnosis has created stress and worry for people and opened up additional opportunities for a therapy industry to exploit.

    Looking on dementia as a world phenomenon of considerable prevalence – should we be raising expectations that responses like this will be made available to everyone?

    An interesting aside within the paper refers to the PSSRU studies which make clear how expensive it is to look after people with more advanced dementia – more expensive in the London area then elsewhere in this country. These are the basic facts of life which relate to undeniable need – Need which is so often denied

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