WHEN will Scotland finally take some serious steps towards tackling the dementia time bomb? When thousands more people are suffering from the disease? When the health and social care system breaks down once and for all? When we can no longer afford to care for our elderly population? All of these scenarios are well on the way to happening unless the nation takes some profound, systemic, consistent and well-funded action to prevent the time bomb from going off. It is not too late. Yet.
The dangers of the alternative – not doing enough – have already been spelled out by experts on dementia and those who have experienced the condition close up. The number of over-85s is expected to increase by 110 per cent by 2034 – and an older population means more dementia – and yet the country’s leading expert Professor June Andrews said recently that there is an increasing risk that more people will have to endure sub-standard care that is under-funded and under-staffed.
Some progress has been made. For a start, much of the stigma around dementia has gone and we are much more likely to talk openly about it. The Scottish Government has also laid out several strategies for improving care and support, one of the most important of which is the aim of developing dementia-specific education and training for health and social care professionals.
But where is the evidence of a systemic approach to tackling dementia – reforms which recognise that the condition will affect more and more of us so should be a guiding part of policy in almost every area? In an interview with The Herald today, the broadcaster Sally Magnusson, who wrote a book about her experiences of caring for her mother when she had dementia, says the men and women of her generation have to fight now for the way they want to be treated in 30 or 40 years, and that fight must mean changing the way we live so that we care better for dementia patients. It must also mean trying much harder to prevent or delay more people from developing the disease in the first place.
One idea that has great merit has been proposed by the Scottish Conservatives. The idea is a register of dementia-friendly tourist destinations which sufferers and their carers could consult; the Conservatives have also suggested that the Government could support businesses to introduce measures to make their premises more accessible for dementia sufferers. It could be a “quiet room” for respite, for example, or erecting clearer signs to help people find their way about. None of the measures need be very expensive, but applied not just to hotels but many more public buildings, they could potentially make a big difference to the day-to-day experiences of patients.
There are other steps we should be taking. Dementia check-ups, for example, should be routine as we get older – they can be done on a computer in around 10 minutes. Often by the time a patient has a diagnosis, it is too late to prescribe the drugs that can slow the condition, so anything that can be done to identify dementia early is critical. Prevention can also save money by delaying patients going into institutionalised care.
We should also be doing more to improve community health and social care and keep people out of hospital, which can make patients frailer and more confused. The Government has already started to tackle this area by setting up Health and Social Care Partnerships, but, as usual, the policy has been beset by a lack of money. Crucially, some of the improvements that could be made to our approach to dementia would not be expensive. Others would actually save money. But the strategy as a whole will not work unless the Government admits the uncomfortable truth that sooner or later it will have to pay what dementia care actually costs.
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