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Don’t ignore legal responsibilities around clients with dementia, Julius Baer’s UK CEO warns wealth management sector

(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.

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Don’t forget the little people


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”

Ageless Design


The term ‘design for the elderly’ has always annoyed me, partly because if feels vaguely discriminatory and partly because the term the elderly is so imprecise. It also annoys me because the key to all good design is to have an in-depth understanding of your customers and what they want from what you are designing.

So, who are ‘the elderly’?

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Let’s talk about sex


A 45 year old man develops a neurological condition rendering him multiple physical health difficulties and depression. He has been married for five years. At an initial assessment from a health professional, he is asked about the impact these changes are having on his relationship with his wife, and whether he is interested in and still able to have a sexual relationship with her. When problems are detected, an open discussion takes place regarding what help he might benefit from, and whether it would be useful for him and his wife to receive help as a couple.

So why don’t we ask older people later in life about their sexual lives and sexual relationships? Why don’t we ask when we know that changes in physical and mental health often impact on sexual functioning? What are we afraid of?

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The many ages of psychiatry


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:

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Psychological therapies for older people – why ageism is old hat


As a Consultant Clinical Psychologist who’s worked with older people in the NHS for many years, I’ve lost count of the number of times I’ve heard the following questions at a first appointment: Was I sure I could see them for psychological therapy as there must be people younger who really needed help instead? Was I sure there were enough resources within the NHS for them to be helped? Did I really believe change was possible at their age?

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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…
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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”