The Silent Epidemic

Some of you may have heard a recent visitor from the UK – Graham Stokes, a Neurologist. He spoke to many groups about the huge increase world wide in dementia that is going to happen oveer the next 40 years.

He cited many factors amongst them an increasingly long lived population, the “Baby Boomers” population bulge and better methods of diagnosis. It is not that rates of incodence of the condition are increasing, just that there will be a larger group from which people will develop the disease.

He made it very clear that this is not a psychiatric condition but a neuorolgical condition, something that we are not always clear about even now.

The points he made were very clear. There will not be enough beds to cope with the level of need.

There will need to be better supports for families and carers in the community. It will not be possible to rely on “The Family” to automatically take on the very real burden of care because our society is changing so much. Women tend to marry men older than themselves and if a marriage is not providing what they want many are now divorcing in their 50's and 60's. Second relationships do not have the same level of establishment so if a partner becomes ill there is not the same commitment to taking on caring for them.

We have another change in that children are economically dependent on their families for much longer. A combination of student debt, economic conditions in general and a much later date for settling down compared to previous generations.

We are already seeing calls for the retirement age to be raised. A result from this will be that in some cases people who might have taken on care will still be at work.

None of this paints a pretty picture but there are things that can be done. And we need to start now before the full force of this epidemic hits.

Dramatherapy can help both the person diagnosed and their families and care givers. It is much easier to cope with the memory loss if the person is not depressed withdrawn or angry, if they communicate although not from the past. Using this therapuetic approach benefits the individuals,and their families and enables them to stay in their community for longer whether it be home or the retirement village they have chosen.

We can do something that is positive in all directions, personally, socially and economically.

But we need to act before we get overwhelmed.

All those people who paid for the infrastructure we have now deserve better.

Today's teenagers will not be thinking about this yet but when they do get old – and they are likely to live even longer, they might just be grateful for having good standards of care well established.

Happy Families

This is a quick reflection on how families cope when a beloved member gets dementia. It takes a while to work out what is happening. When we are close to people we often don't notice changes for a long time. Eventually we realise that things are not as they should be. Diagnosis is not always easy or clear cut. We can get aggravated by behaviours that we think are unnecessary or could be controlled with a little effort. It is all too easy to get into a pattern of being irritated, angry and resentful. We forget who the person was for most of their life and see them only as how they are now.

Sometimes when someone has a terminal illness people feel it is almost easier to behave as though that person was already dead and gone from their lives. This can also happen with dementia.

And yet how much time and pleasure in that person's company is stolen from families if this happens?

We need to be supporting families who struggle to care for a dementia sufferer. At least in a hopsital setting, staff work in shifts, have a life outside and however poorly paid at times have the choice of being there. Likewise the amazing community groups who offer respite care at day centres. They still have the opportunity to be elsewhere.

Families have no such choice. Regardless of the relationships that existed before – good, bad or indifferent, there is an expectation that the family will provide.

It is much more likely that a family will find the energy and willpower to do this if they can interact with their relative with dementia in a meaningful way, a way that gives them something positive not just frustration and grief.

Dramatherapy can give that positive contact. Of course it isn't going to bring back the original person but they will see someone interesting with something to say, original ideas and thoughts and a person in their own right.

We hope that in time this method will be available to family members to enhance their relationship or even build a new one.

Everyone deserves the right to make the best of a really tough situation, not just have to keep coping with what must seem a hopeless situation.

There is a better way.

The Past is Another Country

One of the hardest things any person or family faces when someone they love has dementia is that the person they love is physically there but the personality is gone. Many struggle with this. They believe “If only” the person tried hard enough or was reminded enough memories would return. It can become an agonising struggle for all. There is no chance of any outcome other than frustration on both sides and increased anxiety for all.
It is understandable that often people walk away or find contact very difficult.
One of the most positive aspects of drama therapy in these circumstances is that it offers a relaxed, fun way to reconnect. Often we base our knowledge of older people on who they are right now, forgetting that they have lived long, full lives. The recent upsurge in interest in genealogy shows that many of us are interested in the past yet how many of us really know our parents and older relations? We may think we do because they may well have repeated many stories but it is often amazing to find out just what they have achieved.
Last year the community based group we worked with had a huge and varied history. Fortunately the people working with the group knew them well and had recorded their individual histories.
It is these earlier memories that are clear and thus accessible. These are the memories that people share when we are developing stories with them. It is so much more powerful if we know what these memories relate to.
It is almost miraculous to watch someone engage who has been totally detached and uncommunicative. When we enter their world, even if it is one from many years ago, we are there with them. It is familiar to them so not a source of worry. It puts them in control at a time when the world may feel very confusing and scary. I loved the quiet man who got asked to do a song in one of the plays and produced not just a pop song but a stunning operatic aria. His family knew of this but felt it might be painful for him to remember as he now no longer sang. The smile on his face as we all applauded said this was an area to talk about with joy. Each person had huge talents and their own fascinating experiences.
An additional bonus is that when families get involved they can continue a relationship that is positive and not a burden. They sometimes learn new things about a person they thought held no surprises. They get to enjoy being with the person again. Being relaxed and happy is something we all benefit from.
Making it easier for them to stay at home for as long as possible can only be an advantage. A more positive relationship is good for the individual but think what it could do for loving but currently exhausted care-giving families.
This is one of the areas we are keen to do more research in. This method is non invasive, does no harm and is fun. And it improves daily life for all using it.
There is nothing to lose for any of us and everything to gain.
We hope to offer a programme for people and their families in the community soon so keep watching – get to know your family and have as much fun as you can.