• No more war 21 May 2018 | View comments

  • 21st May 2018 | By David Jolley

    I have read again the inspirational articles from Jill Manthorpe and Steve Iliffe in the Journal of Dementia Care. They provide an illuminating review and analysis of the literature on dementia and our current situation. From this they call for a revision of policy priorities - from throwing money and resource on research for a cure, toward a focus on healthy life styles which reduce incidence, and informed and sustained care, including palliative care.

    Within their review they draw comparisons with approaches and attitudes to cancer, including the use of metaphors of heroics, conflict and military triumphs. These they see as possibly appropriate in the case of cancer – perhaps underpinning the success of fund-raising schemes – but not right for dementia. So it was interesting this week to find a headline questioning the good and pointing to the adverse effects of the war metaphors in cancer care: https://www.theguardian.com/society/2018/may/15/pressure-to-stay-positive-may-be-a-negative-for-cancer-patients-charity

    One aspect of the fighting and war model is that individuals with the disease feel pressured to fight and to become survivors. The reality is that many will succumb – so is this a condemnation of their resolve or prowess? It reflects denial and clinging to a curative model, when palliation will be kinder and more useful: https://www.theguardian.com/commentisfree/2015/mar/22/saying-youre-fighting-a-war-on-cancer-could-make-you-lose-it.

    There are effective treatments for some cancers – and progress is being made with surgical techniques, medication and other therapies. Dementia is a more complex condition. There are essentially no success stories arising from the investment of billions of pounds world-wide in pursuit of a curative treatment. Less inflammatory dialogue will be more appropriate – encouraging health-giving life styles which are common to dementia prevention and promotion of general health – and a positive palliative ethos in the years with dementia, including death. This centres a great deal of control in individuals, families and communities in finding and using the tools which work. More satisfactory than waiting for an illusory magic bullet.

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