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Dementia Palliative Care: It’s time to start talking


The World Health Organisation (WHO) defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”[1]

I’m really pleased that Dementia is now internationally recognised as a life-threatening / terminal condition as this means that Dementia palliative care can be taken seriously. My interest in dementia palliative care came from caring for my mother, who is living with dementia. At one stage she was very ill; her memory plummeted and her communication was next to nothing. I had difficulties accessing services and I had poor knowledge of what was available for her, and the fact that she was from Africa created further cultural complications. I went through an emotional roller coaster; I had no clue what my mother’s preferences of care were when she was not able to contribute to discussions, and when we thought that she was about to die, Continue reading “Dementia Palliative Care: It’s time to start talking”

A Guiding Hand


‘Red & Yellow made me feel supported; like I wasn’t facing the challenge alone.’

My father has lived between Africa, India and London throughout his life. He has a long standing diagnosis of epilepsy and around 2 years ago was diagnosed with the onset of dementia. In September 2014, it was agreed that he should come back to London a couple of weeks sooner than his scheduled trip from Africa, to have some medical check-ups as he was unwell.

His health took a turn for the worse and he rapidly declined after Continue reading “A Guiding Hand”

DoLS: Bureaucratic, costly and badly in need of reform


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”

You can’t fatten a pig by weighing it


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”

Opening our doors to more people in dire need of better care


A while back a patient, her husband and son invited me for tea. It was a privilege to converse with this charming and hospitable family, and it was very insightful to receive first hand feedback on Red & Yellow Care’s service provision.

The husband thanked us for the bespoke and responsive nature of our service. His wife had needed a range of assessments and tests, and each appointment had been organised within a matter of days and with a high degree of flexibility. The initial referral was on a Monday, a home visit by one of our consultant psychiatrists on Tuesday evening, a blood test on Thursday, a follow-up consultation with a consultant geriatrician on Saturday, an MRI scan the following Thursday morning, the outcome of the scan communicated by phone that same day and the full diagnostic report sent by the following Monday. The entire Continue reading “Opening our doors to more people in dire need of better care”

Women and dementia


The newly published Report Women and Dementia provides the first official recognition that dementia disproportionately affects women. This imbalance arises as a result of it being women who do most of the caring (both as family members and as paid staff), and also because age is the major risk factor and more women live longer than men. While in truth I can’t think of why it has taken so long for this thinking to be documented, I welcome the report in finally drawing much needed attention to this marked gender imbalance.

From relative obscurity half a century ago, with the Prime Minister making it a priority at the G7/8 meeting in 2013, dementia has really shot up the national agenda. The successful Dementia Friends and Dementia Friendly Communities campaigns led by the Continue reading “Women and dementia”