(as published by Tristan Blythe, Group Editor, Thewealthnet)
Cognitive decline, such as Alzheimer’s or other forms of dementia, remains a somewhat taboo subject. It is, understandably, an area many find difficult to discuss.
However, the UK’s wealth management sector cannot afford to ignore it and the impact it has on a firm’s interaction with clients, according to David Durlacher, chief executive of Julius Baer in the UK and Ireland.
A news story this week about a man who shot his wife in a care home and was diagnosed with a mental illness called paraphrenia (http://www.bbc.co.uk/news/uk-england-essex-36865867) put me in mind of a patient I saw a few months ago.
My patient confidently told me that there were a group of little people (about 3 inches tall) on her garden fence who fire green arrows at her. She feels these arrows prick her skin and she is convinced they are loaded with poison which will kill her. The arrows penetrate brick so wherever she goes she is subject to a constant volley. Furthermore the little men read her thoughts, so she can never evade their clutches; they always know where she is. And they talk about her – commenting on Continue reading “Don’t forget the little people”
A few years ago the BBC wanted to film me because I was doing a clinical trial on Ginkgo biloba extract as a treatment for dementia. They turned up with a camera crew and demanded that I wear a white coat. I explained that as a psychiatrist this may not send the right message but they insisted as it would add credibility to the science I was discussing. Then, for additional visual effect, they asked I sit in front of a microscope. The last time I had done that was in the VI form! Still they insisted, so I asked my colleague and friend, a brain scientist, to borrow his microscope. It was HUGE! A massive piece of kit the size of a motorbike. Finally they asked that I look down the microscope at a slide of a person with dementia. My kind friend lent me a slide- one made by Alois Alzheimer himself with a slice of brain from his first patient, August Deter.
Why tell you that tale? When Alzheimer wrote about Auguste Deter Continue reading “Dementia: Looking beyond memory”
The NHS needs to reverse its misguided practice of incorporating old age mental health services into generic “all age” services.
According to recent research in the British Journal of Psychiatry (http://bjp.rcpsych.org/content/207/5/440), older adults have better outcomes if cared for in mental health services specifically set up to meet their needs. The journal asked me to write the accompanying editorial (http://bjp.rcpsych.org/content/207/5/375), and in it I outlined the reasons why I believe the NHS has been wrong to move away from services catering specifically for the needs of older people.
Over the last few years, some NHS trusts have incorporated old age mental health services into generic “all age” services. In these services an 18 year old and 80 year old person would be treated by the same team. There are three main reasons for this trend to ageless services: cost saving, misunderstanding of the Equalities Act and ageism. There are also three main reasons why older people should have their own dedicated services:
It was reported in The Lancet medical journal last month[1] that the prevalence of dementia in the UK has fallen from around 850,000 to 670,000. This figure seems encouraging, but the risk is that it brings complacency to the world of dementia care.
Although it is impossible to say with certainty, there are probably two separate reasons for this reduction. Firstly, the often quoted higher figure was derived by consensus of opinion from experts rather than plain science. This was not an entirely inappropriate method of estimation, because Continue reading “Keeping dementia on the radar”
It started with coffee in the lounge of the most exclusive and opulent club in the UK, the House of Lords. I was there meeting Baroness Elaine Murphy and Professor David Jolley – two old age psychiatrists who share my passion for better care of older people with mental illness. We had a meeting with the Law Commission later that morning about a planned revision to the Deprivation of Liberty Safeguards (DoLS) legislation, so we had arranged this get-together, amongst the oak panelling and the portraits, to plan what we were going to say…
Continue reading “DoLS: Bureaucratic, costly and badly in need of reform”
I worked exclusively for the National Health Service (NHS) for 30 years before combining my NHS post as a consultant old age psychiatrist with a part-time medical directorship in the private sector. Six months ago I joined Red & Yellow Care (R&YC), a private healthcare provider specialising in dementia and other long-term conditions prevalent in old age. Although R&YC and most NHS services provide first class clinical care, there are organisational differences, and none greater than the difference in operational efficiency.
Bureaucracy and excessive recording of data fetters the NHS. When I looked into this in my own NHS practice I found that for each hour a team member spent with a patient, they would spend two in front of a computer. This problem is widespread in the NHS. At R&YC this ratio is reversed, while quality is nothing short of excellent.
Contrary to popular belief, private practice is Continue reading “You can’t fatten a pig by weighing it”
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