03 February 2009

Walk-in dementia clinics

Yes. It's true. If you can't remember your GP appointment because you are becoming demented you can drop in to the walk-in memory clinic. You can see the method to this madness.

The lobby groups on this topic have some quotes. Here's one:

Research has shown that a brief four or five-hour programme of support and counselling at diagnosis can reduce institutional care by an astonishing 28 per cent or an average of 557 days compared with those not receiving such interventions. This is particularly crucial considering that much of the cost associated with dementia results from expensive care home provision.

Does anybody know where that comes from? Can it be true? The other sound bites are about how bad doctors are. But we are used to that.

Everybody wants to avoid getting dementia in later life. Nobody wants their nearest and dearest to develop dementia. And everybody wants the best treatment there is for dementia. And, as we know from today's stories, lots and lots and lots can be done. Everybody wants it to be Christmas. But it isn't Christmas all the time. It just isn't.

Sometimes it is difficult to point out to people who mean well that there are flaws in their arguments. There is not much point in early diagnosis if the services in place are insufficient.

Here's another quote:

Professor Banerjee admits the services in place now are not able to deal with the number of people who need them.

Here's a quote from the lobby group:

If community services were sufficient and specialist services similarly boosted, numbers could be managed, as early diagnosis would mean fewer people needing specialist care.

And the gentle retort from the professional:

It is a myth that a growth in community based memory services will mean a reduction in inpatient specialist care.

Sometimes it seems dementia is infectious. Now just where did Dr Grumble leave those keys? Source: HSJ.


Garth Marenghi said...

Here's the reference, I found it with some google searching:

Mittleman, M.S., Haley, W. E., Clay, O.J., & Roth, D. L. (2006). Improving
Caregiver well-being delays nursing home placement of patients with Alzheimer’s disease. American Academy of Neurology 67, 1592-1599.
The purpose of this study was to determine the effectiveness of counseling and support intervention for spouse caregivers in delaying time to nursing home placement of persons with Alzheimer’s disease and to identify the mechanisms through which the intervention accomplished this goal. A randomized controlled trail of counseling (6 sessions of individual and family) and support (support group, ad hoc telephone counseling available) was compared to treatment as usual for 406 spouse caregivers of community-dwelling patients with AD over a 9.5 year study period. Patients who spouses received the intervention experienced a 28.3 % reduction in the rate of nursing home placement compared with treatment as usual. Median time to placement was 557 days. Improvement in caregivers’ satisfaction with social support, response to patient behavior problems, and symptoms of depression collectively accounted for 61.2 % of the intervention’s beneficial impact on placement. The authors concluded greater access to effective programs of counseling and support could yield considerable benefits for caregivers, patients with AD and society.

This has been manipulated by the lobbyists into their statement.

So it's really about support and counselling for carers, not early diagnosis and a brief programme of support.

Dr Grumble said...

Well done, Garth.

Unfortunately these carefully chosen sound bites produced by people seeking publicity for their cause are never a good way to formulate policy.

Garth Marenghi said...

indeed, it's a very silly way to formulate policy,

it seems to be an increasingly prevalent technique though

Unknown said...

(The Ferret strikes again!)

There is not much point in early diagnosis if the services in place are insufficient.

1. say that about cancer and heart disease and childhood leukaemia! Go on. I dare you.

2. Yes there is, carers can be greatly helped, and they can learn how best to treat and approach the people for whom they care. After all, through the early stages, it will be carers who bear the brunt (together with the person with dementia).

Unknown said...

(Yes childhood leukaemis is cancer but I couldn't think of anything else!)

The Shrink said...

". . . you can drop in to the walk-in memory clinic."

Not in my corner, you can't.

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