Dementia Produced by Wessex LMCs in partnership with: Dr Nicola Decker, GP Alzheimer’s Society

This is designed as an interactive session to use in general practice to increase the understanding of a condition that affects many of your patients and has a significant impact on their family.

Dementia What is it? How common is it? What are the usual symptoms and signs?

Dementia – what is it? This is a term used to cover a number of conditions The term dementia describes a set of symptoms including memory loss, mood changes, and problems with communicating and reasoning. Dementia is not part of growing old. It is caused by diseases of the brain, the most common being Alzheimer's.

Dementia Two common forms: –Alzheimer’s disease (60%) –Vascular dementia (20%) –Mixed picture (10%)

Dementia - how common is it? Two thirds of people with dementia are women One in three people over 65 will develop dementia In the UK 800,000 people are known to have dementia Dementia is most common in older people but younger people (under 65) can get it too years: 1 in 1, years: 1 in years: 1 in years: 1 in 6

Symptoms and signs Dementia affects different people in different ways  Difficulty in remembering recent event but can recall things from the past  Finding it hard to follow conversations or programmes on TV  Forgetting the names of friends or everyday objects  Repeating yourself or losing the thread of what you are saying  Problems with reasoning  Confused even when in a familiar environment  A decline in the ability to talk, read or write

Common symptoms Memory loss –Common early symptom Mood swings Inability to follow a conversation

Common symptoms Disorientation in time and space Change in personality or behaviours This may cause a problem for family and carers

Common symptoms Difficulty with everyday tasks Poor judgement Misplacing things

Common symptoms Loss of initiative Loss of interest in hobbies Problem with words Wandering

Perceptions of what life is like for people with dementia… 58% thought quality of life was fairly bad or very bad 52% thought that care provided was fairly bad or very bad 61% thought inclusion in communities was fairly bad or very bad YouGov survey 2011

People with dementia feel that their community could help by: Better understanding of dementia and less social stigma More public awareness of the condition More local activities and opportunities to socialise More tolerance and patience from others More community spirit Source: Alzheimer’s Society Dementia 2012 Report

What is a Dementia Friendly Community? Where the greatest number of people: can live a good life can live independently and be part of their community are met with understanding and given support when needed

NHS Commitment to raising awareness Awareness – understanding symptoms, recognising signs, challenging behaviour; Knowledge of the condition – types of dementia, differences between dementia, delirium, depression etc Communications, listening skills and supporting people with dementia; Person centred care – sign posting to advice and guidance, medication, ethics, impact on families.

‘ Suffering’ from dementia Culture change –Society –Doctors –NHS …………to ‘ living well’ with dementia

What do you think are the main risk factors?

Risk factors for developing dementia Age Poor physical health Poor diet Smoking Excess alcohol Lack of physical exercise Genetics Learning disabilities

Modifiable Risk Factors BenefitsHarm Mediterranean DietDiabetes Cognitive stimulationSmoking Physical exerciseHigh cholesterol High midlife diastolic blood pressure

Diagnosis – the earlier the better Only 1/3 of people with dementia have a proper diagnosis. Early diagnosis means that: There is more time to plan ahead and support self management The carer is able to cope for longer The need for placement of the patient away from their home is delayed

What can we do? Become “dementia friends” (see ’Video about dementia friends’ if access to the internet is available)’Video about dementia friends Support national campaigns Become a ‘Dementia Friendly Practice’

Our role as a dementia friendly practice Maximise health and well-being and help people to remain independent Improve patient and carer experience Improve teamwork Improve clinical consultations – better prescribing & improved referrals Improved care planning for the future Improved quality of life for our patients Know & be able to sign post patients to available services

Becoming a……… Dementia Friendly Practice

Where can you find more information?

So………… What do we want to do as a practice?