Seven ways to make our cities better places for those with Alzheimer's
Jeremy Laurance is a writer on health issues. He is former health editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.
Friday 17 August 2012
We cannot rely on medical advances to solve the problem of dementia. The few drugs that help stave off the disease have limited effectiveness and new drugs will take decades to develop.
But, improving care and understanding of the condition can deliver immediate results. Creating dementia-friendly communities is a step in that direction. Under the "Dementia Challenge" announced by David Cameron in May, the target is to have at least 20 cities, towns and villages in the UK working together by 2015. The aim is to make it automatic to consider the needs of people with dementia. One of the greatest problems experienced by people with dementia is fear: fear of being unable to cope in the high street, handle a bank transaction or find their way through a station. The stigma associated with the condition prevents many from asking for help – so they stay at home, isolated.
1. Help in the High Street
Appleton's Pie shop in Ripon, North Yorkshire, established in 1867, was one of the first businesses in the town to declare itself dementia-friendly. A quiet area away from the till has been set aside for the four specially-trained staff to help customers with their purchases, count out the right change and to mark the brown paper bags with the date of purchase.
Anthony Sterne, co-owner of the business, said: "A friend who runs a business caring for people with dementia explained to me how they can be trapped at home because they don't feel safe to go out. We have tried to make the experience of coming into our shop more comfortable by doing a few small, basic things to help.
"It is a very busy shop so it is good to have a quiet area where we can be less rushed, provide receipts and be very careful about change. One carer told us they kept finding purchases squirrelled away around the house with no means of knowing when they were bought so we mark the bags with the date."
2. Safety at home
Kent Fire and Rescue Service has a specialist team that offers free home safety visits to vulnerable elderly people to ensure they can stay safe and independent in their homes. It provides free fire-proof blankets and gadgets to turn off the cooker automatically if it is left on, or prevent the bath becoming overfilled.
Spokeswoman Sandra Michael said: "We were asked for help by a woman whose husband had dementia and would warm his pyjamas in the microwave and, when she took that away, on the top of the toaster. We fitted lockable covers over the electric sockets in the kitchen. That could give them another couple of years of independence."
3. Support on the move
Transport Police operating at York railway station, who frequently deal with elderly, confused travellers, have been trained to offer support, including how to give directions in ways that are simple to follow. They are organising a day trip by train for people with dementia and their carers, to give them confidence when travelling.
"A lot of people worked on the railways in York and a lot of people travel by train so the station may have a resonance for them. They may go to the station thinking they are going to work or meeting a friend. They gravitate towards it," said Janet Dean, of social care consultants Aesop.
4. Navigating the supermarket
Major businesses including Waitrose, Tesco, Nationwide and Lloyds bank have signed up to become dementia-friendly companies. Supermarkets are experimenting with "greeters" who stand at the front of the store, welcome customers and help them with their shopping by navigating the aisles and locating items. Lloyds and Nationwide are working together on how to tackle forgotten pin numbers, and establishing a "dementia friendly protocol" – a set of principles that it is hoped all banks, building societies and insurance companies could sign up to. A first meeting involving 25 financial services organisations is planned for September.
5. Dementia tourism
City officials in York believe they can capitalise on the city's status as a tourist destination to help people with dementia. With clear signs and helpful tourist guides, York offers those with memory problems or suffering confusion a greater sense of safety in navigating the streets.
"A woman in her 60s who likes to go walking went missing," said Ms Dean. "Her husband called the police who put out an alert that was transmitted to bus drivers across the city. She was found on a bus at the end of the line by a driver who was parking up for the night."
6. A different kind of sport
Leisure services have held an open day for people with dementia to invite them to come and try new activities including "carpet croquet" adapted for indoor play, a racquet game called Boccia, and Zumba Gold, a dance routine to maintain fitness.
"In the early stages of dementia, when people start to lose capacity, they may find themselves excluded from the golf club or no longer welcome at the bridge club," says Ms Dean. "They need activities that can be adapted and simplified. Often there is not a physical problem but a fear of being unable to participate. Guided cycle tours can be organised for those who can still pedal but have lost the confidence to go out on their own. They may fear getting lost and being unable to find their way home – having a guide solves that problem."
7. GP receptionists
There is a move among GPs to retrain reception staff to help patients with dementia make appointments.
"Those who have first contact need awareness training," said Ms Dean. "It is about using clear language, not asking complicated questions, and taking time. We live in a fast paced society and this is about slowing down. Patience, kindness and understanding will get a better response."
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