Anyone who lives alone – and over the next 20 years that could rise to nearly one in seven people in the UK – may be highly alarmed by the prospect of dealing with dementia.
By 2039, the number of people with dementia in the UK living on their own is forecast to rise from 120,000 to about 240,000, according to the Alzheimer’s Society. That sounds like a terrifying prospect.
But when I was a specialist social worker, I found it a lot easier to look after someone with dementia if they did live on their own, rather than with a partner. Hardest of all to support were people who were living alone and had concerned relatives who wanted to do more for them, but couldn’t.
This may not be immediately obvious. But with the right resources, people living alone with dementia can be supported at home effectively.
I was part of an innovative health and social care team headed up by a psychogeriatrician and social work team manager, with access to a specialist respite/day care unit and a specialist domiciliary team. We believed most people with dementia were less anxious in familiar surroundings, and we successfully used a combination of these resources to support people to stay at home.
The people with dementia who were the biggest challenge were not the people who were nocturnal wanderers. Nor were they the people who burned holes in the electric kettle by placing it on the gas hob, or risked blowing themselves up by turning on the gas fire and forgetting to light it. For them, we could always find a practical solution. Yet despite this, our team had very little success when the person with dementia lived with a partner.
The reasons are entirely understandable. Living 24 hours a day with someone whose loss of memory means they no longer recognise you, and their restless agitation and repetitive behaviour, especially at night, can be extremely wearing and distressing. We were, back then ( pre austerity) , able to offer day care and frequent respite care, but in these circumstances residential care was often the best option for both people involved.
We found it even harder to support people when they had a relative who didn’t live close by or visit regularly. When they did visit, they would witness increasing confusion and loss of short-term memory. Understandably, they were very anxious about their loved one and concerned about their ability to continue living in their own home. Despite our reassurances that our support package was effective – and that it would not rely on them – we often found relatives felt their loved one “would feel a lot better” if they were in a care home, receiving 24-hour care.
But we could see the impact of moving people with dementia to a care home, from other parts of our local authority. Too often, their disorientated behaviour, agitation and, in some cases, aggression resulted in them being sedated or having to live behind locked doors. The significant increase over the next 20 years in the number of older people with dementia will be a very big challenge to underfunded health and social care services. But the biggest professional challenge may not, in fact, be people who live on their own, just as we found.
Blair Mcpherson former social worker and director www.blairmcpherson.co.uk
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