dr. Nori Graham, dr. med., spec. psih., (Združeno kraljestvo)
Dr Nori Graham received her medical education at the University of Oxford and University College London. She is Emeritus Consultant in Old Age Psychiatry at the Royal Free Hospital, London where she worked from 1980-2000 and where she developed an innovative community orientated service for older people with mental illness. For most of her career she has also worked in the voluntary sector. She was the National Chairman of the Alzheimer’s Society for England from 1987 – 1994 and Chairman of Alzheimer’s Disease International (ADI) from 1996 – 2002. She is now Vice President of both organisations. From 2001 to 2010 she was consultant adviser to Nightingale House, a large, not for profit residential and nursing home in South London. She is a member of the Partnership Board of the Age Action Alliance. She is an Honorary Fellow of the Royal College of Psychiatrists. She is a Non-Executive Director for the Residential Care Services of Care UK. She has an honorary doctorate for public services from the Open University. Her most recent publication is; Nori Graham and James Warner Understanding Alzheimer’s Disease and other Dementias. BMA 2014
Health and Social Care for People Living with Dementia: Recent Trends
Countries throughout the world are facing large increases in the number of older people, especially the over 80s. This is a cause for celebration. Most older people can continue to enjoy a good life, contributing to the family, community and society. But older age does bring with it an increased risk of chronic physical disease and dementia, social isolation and a loss of independence.
Throughout the world most older people live in their own homes supported by their families. This is what families want. There is a risk, however, that family members caring for people with dementia and other chronic conditions will be burdened quite beyond what can reasonably be expected of them. It is for this reason, and indeed because some people with dementia do not have any family members at all to look after them, that there is a universal need for family support services.
What are the best ways to provide a system which meets the needs of this rapidly growing number of older people with complex physical and mental illnesses and, of equal importance, their families. Policy makers need to give this matter urgent attention, especially for those people who develop dementia. In these cases, a first requirement is a diagnosis of dementia. In most countries, there is still very low awareness of dementia; only a small proportion receive a diagnosis. Even when a diagnosis is made, the impact of the disease on the person and their family and the importance of post diagnostic care and support are not recognised.
In this talk, I shall outline ways of increasing recognition of the symptoms of dementia and the raising of awareness about it. I shall then go on to talk about how to achieve appropriate and adequate provision of joined up medical care and social support services of high quality. At the present time, medical specialists, particularly neurologists and psychiatrists take the main responsibility for assessment and diagnosis. This is quite inappropriate. There should be a major shift of responsibility so that the work takes place in primary care This means that primary care doctors and other primary care disciplines should receive much better training in the assessment and care of people with dementia and other chronic diseases than is the case at present.
The growth in the numbers of older people in every country throughout the world is so huge that this shift to primary care should take place in all countries, large or small, developed or developing. Neurologists and psychiatrists should not worry about this shift in role; with the rise in the number of complex cases, they are going to be busier than ever.