Doctors failing to diagnose one in three dementia cases: GPs take average of three years to pick up illness

GPs take an average of three years to diagnose the disease in patients 

Doctors are failing to detect dementia in hundreds of thousands of patients, a major study has found.

It suggests a third of those affected by the illness do not realise it because they have not been given a formal diagnosis.

The Cambridge-led research, the first of its kind, found even those who were eventually diagnosed had to live with the disease for an average of three years before it was finally detected by GPs.

Those who were eventually diagnosed had to live with the disease for an average of three years before it was finally detected by GPs.

The Cambridge-led research, the first of its kind, found even those who were eventually diagnosed had to live with the disease for an average of three years before it was finally detected by GPs

Many suffer from dementia for more than six years before it is picked up – while others die without finding out.

The research will raise serious questions over the Government’s dementia strategy. Ministers have pledged to make the UK a world leader in tackling the condition.

A major study earlier this month said dementia was one of the reasons that life expectancy had stalled for the first time in 100 years.

The Alzheimer’s Society says early diagnosis is vital. But researchers behind today’s study believe some GPs think telling patients and families will only cause anxiety, as there is no cure for dementia.

Another reason is that many sufferers live alone, meaning no one notices if they become more forgetful, confused or start behaving differently.

Others are worried about the stigma of dementia and fear losing friends, their independence and their driving licence.

A major study earlier this month said dementia was one of the reasons that life expectancy had stalled for the first time in 100 years

The research by Cambridge, East Anglia and Newcastle universities, which is still ongoing, hopes to provide one of the most accurate pictures of dementia diagnosis rates to date. 

It involves 7,796 over-65s in England who were interviewed between 2011 and 2013 for two to three hours. Results were then analysed to see which patients had dementia.

Controversially, the researchers did not tell patients if they tested positively. Instead, they waited to see how much time elapsed before the disease was diagnosed by family doctors.

Earlier this year the researchers contacted the GPs of 458 patients they had identified as having dementia. 

The nine risk factors 

Nine risk factors including obesity, smoking and high blood pressure have been blamed for dementia in one in three cases.

A report last week was the first time scientists have been able to show how much of the disease is preventable. They warned the public should not see dementia as ‘an inevitable part of ageing’ but take responsibility for reducing their own risk.

In the journal The Lancet, senior experts recommended a major crackdown on high blood pressure which could help prevent one in 50 dementia cases. Ensuring universal education to age 15 would cut the number of dementia cases by 8 per cent, the report added.

In middle age, treating hearing loss would have the biggest impact, cutting cases by 9 per cent. Stopping smoking in over-65s would stop 5 per cent of cases and treating depression would prevent 4 per cent.

Even a 1 per cent reduction in dementia cases would mean that 8,500 fewer Britons suffer from the disease. 

They found more than a third – some 37 per cent – had yet to be given a formal diagnosis by the GP. 

There was not even any mention of symptoms in their notes. Of the patients who had been diagnosed, there was an average delay of three years between researchers identifying the illness and GPs picking it up. 

The researchers calculated a fifth of dementia patients wait six years or more for a diagnosis. Another fifth die before being told they have the disease.

These early results were presented at the world’s largest Alzheimer’s conference in Docklands, east London, last week.

The full research will be presented at the end of the year.

Dr George Savva, lead author from East Anglia University, said: ‘Many of these people have been living with dementia for six years without diagnosis.

‘Doctors thought there’s no point in diagnosing because there’s nothing we can do.

‘We don’t have a lot of evidence as to whether diagnosis helps and the broad consensus is that many people don’t really want to know. But there are drugs that can certainly help some people for some time, although not everybody and not much.’ 

Dr James Pickett, of the Alzheimer’s Society, which is funding the study, said: ‘We know people who get a diagnosis can get access to drugs, help and support, they can plan for their future and they can avoid reaching a crisis point.’

East Anglia researcher Clare Aldus said diagnosis ‘helps them understand what is going wrong – a diagnosis can bring some relief’.

Separate figures last week suggested approximately one million Britons are living with dementia. This number is expected to double by 2051 due to the ageing population and obesity, which raises the risk.

Ministers have pledged to improve dementia care since Labour issued a National Dementia Strategy in 2009 and former prime minister David Cameron launched the Dementia Challenge in 2012.

GPs were urged to improve diagnosis rates and hospital doctors had training to better detect the illness. In 2014, the NHS paid GPs an extra £55 for every new dementia case they recorded. The scheme was scrapped the next year.

A Department of Health spokesman said it is investing £50million to make hospitals dementia-friendly and £150million to develop a national Dementia Research Institute.

An NHS England spokesman said the number of people with a formal diagnosis has ‘dramatically increased … with approximately 150,000 more people able to access early support’.

SOURCE: MailOnline, Rosie Taylor and Sophie Borland

It seems the Alzheimers Society spokesperson has the right idea, that early diagnosis offers access to drugs and future planning that may avoid sufferers reaching crisis point.

How to Help a Parent That is Refusing Elder Care

One of the most heartbreaking things that adult children deal with is an aging parent that refuses in-home care. Not only is it heartbreaking, but it can also be the most frustrating. You’ve heard these stories before. Mom claims she doesn’t need help bathing and dressing, even though she struggles to do it herself. Dad doesn’t want anyone driving him to his appointments even though the doctor recommended it.

You know your parent needs help, but how do you help a resistant loved one get the personalized elder care that they need? On one hand, you don’t want to force the issue until they completely shut down, and on the other, you’re worried that something might happen if they don’t.

Freedom Home Care, Highland Park’s in home care agency, knows that this is a difficult situation. Fortunately, there are a few things our home care experts suggest that could be helpful in starting the conversation with your senior about outside care in a way that feels right to them:

Help Can Be Empowering

Many times older loved ones feel like accepting care diminishes their own power. But if you’re able to help them see that a little help around the house actually frees them up to do more of the things they love, then there’s a good chance they won’t feel like there’s a decrease in personal power.

Figure Out Their Motivation

Boston-based Geriatric care manager, Suzanne Modigliani says to try to determine what’s motivating your mom or dad’s behavior. Is this just a habit they’re displaying? Perhaps there’s a larger underlying issue.  Could it just be a fear they’re expressing?

Try To Put Yourself in Their Shoes

Another thing experts recommend is thinking about how it might feel if you thought you were going to lose your independence. Would you also be inclined to push back and resist change? Seeking to understand where they’re coming from allows you to approach the situation with a little more empathy toward your parent.

Listen to Their Concerns

Set aside a day to join your loved one in doing something they like to do. While you’re enjoying the moment and everyone’s defenses are down, ask your mom or dad what concerns them most about aging. This not only helps break the ice, but it also gives you more insight into how your loved one feels about care giving.

Utilize Your Resources

Research different agencies that offer help for adult children with aging parents. An organization like the Area Agency on Aging has trained elder advisers that can help you locate the resources in order to best serve your loved one. These agencies are also there to remind you that you’re not in this alone.

Is This a Battle Worth Fighting?

Donna Cohen, Ph.D. a clinical psychologist and author of “The Loss of Self: A Family Resource for the Care of Alzheimer’s Disease and Related Disorders” says to pick your battles. If your parent is not at risk of endangering themselves or anyone else, allow them to make certain decisions about their life. They may in some ways still be capable of taking care of themselves. Make time to sit down with them and decide what those things are.

 SOURCE: Freedomhomecare

Some really helpful points to consider in this.It can be really difficult to put yourself in someone elses shoes especially when emotion is involved.

Dementia care improved by just one hour of social interaction each week

Increasing the amount of social interaction for people with dementia living in care homes to just one hour a week improves quality of life when combined with personalised care.

A large-scale trial led by the University of Exeter, King's College London and Oxford Health NHS Foundation Trust found that the approach also saves money.

Previous research has found that in many care homes, residents have as little as two minutes of social interaction per day.

The new research, funded by the National Institute of Health Research and published today in the journal PLOS Medicine, upskilled key care home staff to deliver person-centred care. That involves simple measures such as talking to residents about their interests and involving them in decisions around their own care.

When combined with just one hour a week of social interaction, the programme improved quality of life and reduced agitation and aggression in people with dementia.

Professor Clive Ballard, of the University of Exeter Medical School, who led the research, said: "While many care homes are excellent, standards still vary hugely. We have previously found that the average amount of social interaction for people with dementia was just two minutes a day. It's hardly surprising when that has a knock-on effect on quality of life and agitation.

"Our approach improves care and saves money. We must roll out approaches that work to do justice to some of the most vulnerable people in society. Incredibly, of 170 carer training manuals available on the market, only four are based on evidence that they really work. That is simply not good enough - it has to change."

The trial involved more than 800 people with dementia across 69 care homes in South London, North London and Buckinghamshire. Two 'care staff champions' at each home were trained over four day-long sessions, to take simple measures that such as involve talking to residents about their interests and decisions around their own care. Importantly, the approach also saved money compared to standard care. Researchers say the next key challenge is to roll the programme to the 28,000 care homes in the UK to benefit the lives of the 300,000 people with dementia living in these facilities.

Dr Jane Fossey from the Oxford Health NHS Foundation Trust, said: "Taking a person-centred approach is about getting to know each resident as an individual - their interests and preferences - and reflecting these in all aspects of care. It can improve the lives of the person themselves and it can be rewarding for carers too. We've shown that this approach significantly reduces agitation and saves money. Rolling out the training nationwide could benefit many other people."

The results are the findings of the Improving Wellbeing and Health for People with Dementia (WHELD) trial, the largest non-pharmacological randomised control trial in people with dementia living in care homes to date.

Dr Doug Brown, Director of Research at Alzheimer's Society, said: "70% of people living in care homes have dementia, so it is vital that staff have the right training to provide good quality dementia care.

"A person-centred approach takes into account each individual's unique qualities, abilities, interests, preferences and needs. This study shows that training to provide this type of individualised care, activities and social interactions can have a significant impact of the well-being of people living with dementia in care homes. It also shows that this kind of effective care can reduce costs, which the stretched social care system desperately needs.

"Alzheimer's Society is committed to improving dementia care through research. That means getting interventions like this put into practice, and funding further research to improve the quality of life for people with dementia in their own homes, care homes and hospitals."

Source: MedicalXpress, University of Exeter.

Clarksville home care worker accused of using client’s credit card

NASHVILLE, Tenn. A Clarksville woman who was employed as a home care worker has been charged with exploiting and defrauding one of her clients.

After receiving a referral from Adult Protective Services in May 2016, TN Bureau of Investigation (TBI) Agents began investigating a complaint of financial exploitation by a home services worker. At that time, Lamelia Bellamy provided home care to a client in Nashville.

Agents developed information that Bellamy fraudulently used the victim’s credit card to make purchases in Sumner County without the woman’s consent.

On March 7, 2017, the Sumner County Grand Jury returned indictments charging Lamelia Bellamy (DOB 08/04/1979) with one count of Fraudulent Use of a Credit/ Debit Card, one count of Knowingly Exploiting an Adult, and one count of Obtain, Possess, Buy or Use Personal ID of Another.

Bellamy, who has been held in Montgomery County on unrelated charges, was transported to Sumner County on February 2. She was booked into the Sumner County Jail and released after posting a $10,000 bond.

Source: ClarksvilleNow.com

Calls for football authorities to provide care for ex-players with dementia

Calls are being made for the authorities in football to provide care for former players who are living with dementia or Alzheimer’s disease as a result of their career.

Former Liverpool striker Ian St John is the latest to raise the issue of dementia as a possible result of heading heavy footballs in the 1950s and 1960s.

The 78-year-old told BBC Radio 5: “People of our era, the balls we played with were big, heavy things,

“To lift them up to take a throw-in you’d have to do special training, and the conditions we played in - snow, rain and mud - and we trained with these things as well, every day, heading practice as well.

“Whether this problem of dementia hastens the end of your life or not I don’t know, I’m not a medical person - but what I am saying is these were my pals, these were the guys I played with and they have got these problems.

“If someone needs special care as a result of their career and their career was football, then football should pay for that.”

The call comes after two former Canaries players - Duncan Forbes and Martin Peters - both became victims of Alzheimer’s disease.

Last year the Football Association announced it was planning to explore whether heading footballs can create a greater risk of developing brain illness in later life.

Mr Forbes made more than 300 appearances for the Canaries, and first showed signs of Alzheimer’s around 2005.

His wife, Janette Forbes said: “As Duncan was a centre back he used to head the ball all the time. In training he even used to head a medicine ball – the theory was he would be able to head a football further. There is no doubt in my mind that this has caused his problems nowadays.”

The connection was brought to
the public eye in 2002, when 
former England striker Jeff Astle died of a degenerative brain disease at 59.

A coroner concluded that Mr Astle’s death was an “industrial disease” due to heading the ball.

SOURCE: Eastern Daily Press, Dominic Gilbert

‘Our nan faded away': Furious family slam care home after 98-year-old gran died weighing same as small child.

Winifred Burns died of chronic constipation at a nursing home in Cornwall where residents 'were treated like numbers without dignity and respect’ 

A family has slammed a "chaotic" care home where their 98-year-old gran "wasted away' and died weighing the same as a small child. Winifred Burns died of chronic constipation at a nursing home where residents "were treated like numbers without dignity and respect", an inquest heard. At the time of her death Mrs Burns weighed just 31kg which is about the same as a nine-year-old girl. Her weight had dropped from 38kg within a matter of weeks.

She was left to die alone in her room and in pain in February 2015 at a home where she had been transferred three months before, a coroner heard.

Winifred's care home had been failed by inspectors and was under investigation by care officials. The coroner acknowledged that Ponsandane nursing home in Penzance, Cornwall, had been "chaotic" at the time. But in her ruling at the hearing in Truro she said there was no "intentional" neglect.

Speaking after the inquest daughter Debbie Jackson and Winifred's granddaughter

Hayley Brown, said she had simply "faded away" after being moved to the home. Mrs Jackson said she found it difficult to understand that her mother received the full adequate care she was entitled to when she had wasted away within weeks.

She said: "Mum had such a twinkle in her eyes. She was terrified of being alone, which is why she absolutely loved being with people.

"She should have been looked after much better.”

"She was 98 and was not going to live forever. But she should not have died alone and probably in pain like she did."

The inquest heard Mrs Burns suffered chronic constipation, which may have built up over weeks leading to her death, but remained undetected and acted upon. Recording a natural causes conclusion, coroner Emma Carlyon said she was satisfied that neglect was not a contributing factor in Mrs Burns' death. But it was revealed that the nursing home had been under investigation over safeguarding issues for at least twelve months prior to Mrs Burns' death. This was reinforced when the Care Quality Commission (CQC) inspected the home and failed it, recommending several urgent improvements to be made. Julie Barton, the manager of the nursing home, who took over the role weeks after Mrs Burns' death in 2015, told the inquest that a "negative culture" existed among staff at the time. 

She said: "There was a negative culture where staff treated residents like numbers and not like people with the dignity and respect they deserved.

"The staff who didn't meet our new work ethics were dismissed and those who stayed and were not part of that culture flourished.

"It has taken a lot of hard work but the home is now a happy place."

The coroner was told that the laxatives and special food supplements she was prescribed at St Mary's Haven stopped after her transfer to Ponsandane. A pathologist said her constipation was so acute that it might have built up over days and weeks, leading to a large bowel infraction. In turn it led to a twisting of her bowel, which then compromised her blood supply. The inquest heard how her chronic constipation might not have been easy to identify because there was still some bowel movement. The finding led to Dr Carlyon accepting that there was no intentional neglect involved in her death. 

She said: "I didn't find that neglect was a contributing factor to her death and it is more probable than not that Mrs Burns died of natural causes.

"I was saddened to hear how chaotic things were at the nursing home at the time of her death.

"I am re-assured at how things have changed and how the culture has changed and it is now a happy place.

"I am re-assured to hear that improvements have been made and continue to be made."

Jon Edgecumbe, the chief operating officer at Swallow Court group, which runs the care home, said: "Concerns raised after Mrs Burns' death were reviewed and acted upon. We worked with the CQC and Cornwall Council to make the required improvements.

"Since the safeguarding issues of 2015 we have worked to minimise the risks to residents. It was a chaotic time, the staff were good people struggling against the circumstances. Ponsandane is now a happy and warm home."

Source: Daily Mirror, written by Olivier Vergnault and Oliver Milne.