David Thomas is a full-time carer.
My father is elderly, and suffers from a range of health problems which inevitably led to hospitalisation. Since my wife and I were already facing a search for a new home, and my job had just about reached a full stop, it was time for a change. We moved in with my father – and I stopped work to look after him while my wife continued to work.
I had just joined one of Britain’s biggest industries. I was a carer.
The decision to become a carer is actually an easy one. The desire to help a parent is very strong. Compassion leads the way, and you know you are doing the right thing. But you are on your own, you will make mistakes and learn from them – but there seems to be nobody you can go to for help. My brother and daughters live away, so we had no support: it was just the two of us.
By luck, I found out that a Carer’s Support Worker would be at my GP’s Surgery. I had no idea such a person existed, and was intrigued enough to return. My eyes were opened. She gave me so much information that it took me a while to process it. There is so much support out there you wouldn’t believe it if only you knew about it. She got me registered at the Surgery as a carer, and I came away with an astonishing variety of leaflets.
I found out that there is a place called the Carers Support Centre – an organisation that exists to support carers. I have attended three courses run by them that have proved to be invaluable. Meeting other carers is more important than you could ever realise; there are other people out there in the same boat as you with the same worries, fears and insecurities.
The real challenge is to get the message out there so that all new carers have access to information. How many people out there are struggling away unaware that help is available? How many carers are even aware that they are carers, they just get on with it out of love and a sense of duty.
As time went on, my father’s health deteriorated, and he has been in and out of hospital. His mental faculties have reduced – and deep down we knew what was coming and weren’t surprised when the diagnosis of dementia came. Having got the diagnosis of dementia, what happens next?
There is no practical support out there, and you are not referred to anyone. Maybe this is because his diagnosis was made in hospital and not the community. I was sensible enough to take advantage of a Dementia Training Course, which has at least given me some tools to enable me to provide a decent level of care. My fear is that not all carers are so informed.
He has spent a lot of time in hospital. My father’s treatment largely consists of courses of antibiotics. He is not the best patient in the world, and gets aggressive when he is stuck there. Could this be done in the community? Is there any need for him to be hospitalised at all? How many sufferers are in hospital because there is no alternative? The Royal College of Nursing estimate that 25 per cent of hospital beds are taken by dementia sufferers, and it is evident from my visits that the hospital is largely populated by elderly patients. As many as one in three of them go on to suffer from dementia.
I am not a GP, and I do not know what happens when a diagnosis of dementia is made – or even if every GP does the same thing. My father has other health problems, and has been receiving visits at home from a District Nurse. They are a wonderful team out there in the community, providing an excellent level of care and are a perfect example of what can be achieved.
Using the District Nurse Team as a model, could Dementia Teams be set up to provide care in the community for sufferers? When a diagnosis of Dementia is made a referral to a Dementia Team would be made. They would be able to make contact with the family and make judgements on what needs there are and what support is needed.
Regular follow-up visits would ensure that the patient was having the best possible care. In times where hospitalisation would have occurred, this team could provide that care at home. I accept that it would be unreasonable to think that we could prevent all dementia sufferers from being hospitalised, but if we could keep half of them out of hospital it would free up 12.5 per cent of hospital beds.
Is it affordable? I think so. The Dementia teams would be funded out of the savings made by sufferers not being admitted to hospital in the first place. 12.5 per cent of hospital beds not being utilised in every hospital would free up a lot of budget. Would the £55 that is to be paid to GPs to diagnose dementia be better used to support sufferers in the community?
This is not an issue that will go away and really should be addressed – and I hope that David Cameron’s announcement yesterday of a new multi-million pound will make a difference. There are 700,000 Dementia sufferers in the UK and two thirds of them live at home, supported by carers. Carerstrust estimate that over the next thirty years the number of carers will increase by 3.4 million.
I know that this leads to the much wider question of how we best care for our elderly population – but for those suffering withdDementia we can do more. It may well be the case that this extends to other elderly patients too; chats I have had with professionals in Hospital would indicate that this is the case. How many beds could we actually free up and how much money could be saved? My suspicion is that there are a lot of elderly people stuck in hospital because there is no alternative.