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Dementia means dementia – especially for the dementia industry

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The phrase “Brexit means Brexit” epitomises a political farce of the highest magnitude, as no-one, not least Jean-Claude Juncker, knows what Britain ‘leaving’ the European Union will look like.

 

Brexit could mean leaving the single market altogether, halting involvement with the Customs Union, or even withdrawing from the jurisdiction of the European Court of Justice. No-one knows yet.

 

An equally fatuous assumption in the Prime Minister’s Dementia Challenge, where the Prime Minister in question was David Cameron, was that ‘dementia means dementia’.

 

In a world where the CEO of a dementia charity would now become the most influential person in dementia, not a hardworking FY2 grade working in an overloaded memory clinic in a large teaching hospital, dementia was reborne as a lucrative brand and industry.

 

The boon to PR agencies and marketing gurus was not felt by the managed decline of social care and social work, to all extent airbrushed from all policy documents on dementia from the current administration of the UK.

 

The systematised demise of health and social care systems, where experts were valued not rubbished, ran in parallel with the assumption that ‘there is no magic tree’. But as Noami Klein of ‘shock doctrine’ fame correctly pointed out on the Andrew Marr Show this morning, this myth was well and truly busted with the multi-billion pound recapitalisation of the banks after the global financial crash.

 

Whatever the ‘divorce bill’ for the European Union, we’ll pay it. But – to pay the workforce properly to optimise care and to prevent burnout, hmmm… “Cost neutral” dementia friendly communities, with dementia-friendly mail-order catalogues and obliteration of the supply of social housing, could easily pick up the pieces.

 

The pathway of top directors in dementia charities and social enterprises earning lucrative salaries in the dementia industry is deliverable only if some volunteers with dementia act as ambassadors with their travel expenses. There’s no money left for social work or social care, or for nurses, in Lewisham, but there is miraculously money for research and development in a California-based Pharma start-up.

 

It would then become all too uncommon for specialists in dementia to get routinely omitted from discussions or conferences on dementia, with engagement officers and ambassadors ‘too busy’ networking or promoting their charities and social enterprises to talk to clinicians or practitioners working daily in dementia care.

 

Like there are a hundred and one permutations to leave the European Union, there are over a hundred different causes of dementia. The idea that GPs could simply ask ‘have you had memory problems?’ to diagnose dementia was sadly a bit of fake news which took hold after the Prime Minister’s Dementia Challenge.

 

Every clinician with competence in dementia knew that the visual hallucinations in Lewy body dementia or the profound behavioural changes in frontal dementia would not easily get caught by this particular working definition of dementia, however good the marketing of young onset dementia charities.

 

“Virtue signalling” from dementia charity never has had it so good: loosely defined as “many people say or write things to indicate that they are virtuous”. So, intergenerational dementia might mean sitting together in a heavily branded “dementia friendly church” or teaching 3 year olds how to diagnose dementia in primary school (when senior clinicians have been inexplicably failing for decades), not asking very high-income youngsters to pay their taxes.

 

Of course, given the actual complexity of dementia, it is indeed impossible to talk convincingly of a single cure for dementia, even if the refashioning of existant drugs such as trazodone might be hyped up as the brand new cure somewhat beyond reasonable expectation.

 

But it is this promise of the bright future for dementia, for a ‘world without dementia’ or ‘ending dementia’ as espoused by large charities, which is the promised land. Meanwhile, one is encouraged to right to be resentful to pump money into promoting health and social care, in much the same way you should get rightfully get angry at paying your subsidies to the European Union.

 

Bring on the ‘twiddlemuffs’ and the audio playlists to improve the wellbeing of everyone with dementia. As far as I feel, the cure for dementia was a lie so large it should have been put on the side of a bus, but this is a world where anything goes, including reinforcing tower blocks with combustible cladding to give people council tax rebates.

 

@dr_shibley

 

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