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Mental Health Newsflash!  

South and West Devon

Is Alzheimer's just an older age disease? 

Unfortunately the answer must be no. Cases are coming to light where the pre diagnosis symptoms of the illness are showing at a much earlier age. In one 1994 case documented recently, Ruth, a lady of 44, experienced short term memory loss and exhibited an unusual lack of confidence. The initial diagnosis was that she was suffering from a stress-related condition, but after two and a half years, two hospital stays, two MRI and one CAT scan she was finally diagnosed as having a non reversible Alzheimer's related condition. Her husband described his situation as being left alone in a state of complete distress. In 2005 Ruth is 54 and her husband is 55.  

I use this illustration to air my concerns about the seemingly clear-cut line between the services to those whom we define as adult, i.e., up to the age of 65, and those we define as the older person, i.e., those over 65 years of age.  Of all diagnosed cases of dementia, statistically 55% will have an Alzheimer's related condition and the great majority of these patients will be over the age of 65. Of those under the age of 65, only one third will have Alzheimer's disease. In the younger person, illnesses such as Pick's disease, vascular dementia or dementia with Lewy bodies are more common.  

My point is that I feel that we should be careful to be flexible to a certain degree about this manufactured cut-off point between the ‘adult’ and ‘older person’. We would be failing people like Ruth and her husband should we place them in the realm of adult treatment when common sense tells us that they clearly need the type of support and carer training afforded by the older person sector. I feel sure, having spoken about this with local managers and consultants, that they are aware of this possible situation and flexibility will be shown.  

‘Mental illness’? 

Some may have read the report of the discussion I had with Ms Jan Anstis regarding her objection to the use of the word ‘mental’. (Janet's newsletter October 2004). In that item I said that the description ‘Mild Cognitive Impairment’ might be more acceptable and indeed more useful.  

Imagine my surprise therefore when I recently read a report, published in early December 2004, on the progress of a computer-based diagnostic programme which is being used as a self-diagnostic tool to screen people of over 55 years of age for signs of ‘MCI’. This it turns out stands for Mild Cognitive Impairment! Should have claimed copyright, Jan!   The article was quite interesting actually and I may well include my thoughts about it in the next newsletter.  

Regards to all. Jim Delves.  

Just a line to say I'm living, That I'm not among the dead;
Though I'm getting more forgetful And mixed up in the head.  

I got used to my arthritis,To my dentures I'm resigned,
I can manage my bifocals But, God, I miss my mind!  

For sometimes I can't remember,When I stand at the foot of the stairs,
If I must go up for something Or have I just come down from there?  

And before the fridge so often My poor mind filled with doubt;
Have I just put some food away Or have I come to take some out?  

And there's times when it is dark, With my nightcap on my head,
I don't know if I'm retiring Or just getting out of bed.  

So, if it's my turn to write you There's no need for getting sore;
I may think I've already written And don't want to be a bore.  

So remember that I love you And wish that you were near.
Now it's nearly mail time I must say goodbye my dear.  

Here I stand beside the mail box With a face so very red;
Instead of mailing you my letter I had opened it instead!   Anon.

Briseham Inpatient Unit closure

As I’m writing this and despite the fact that over a month has passed since the summary closure of the Briseham inpatient unit, no mention of any sort of consultation has been made by the Devon Partnership Trust (DPT). I can therefore add little to the report of the closure that I made in my last contribution (January edition) to Janet's newsletter.  

We do have the Sainsbury report being finalised very soon. Hopefully there will be constructive developments arising from this. I will report on the progress being made with the implementation of the Sainsbury report recommendations as and when I have them.

In my position as carer representative I have made myself available to any person who has been affected by the closure and have spoken with the local Mental Health Team Manager on a weekly basis to try and ensure that no major stress has been caused to any of the carers whose charges were in the Briseham unit.  

Chadwell Centre (Paignton) has stepped into the breach providing day care, but despite this two cases of distress involving carers have been brought to my notice - in both of these, an acceptable, although not ideal solution, has been found. Day and respite care places have been found within the NHS; some carers, however, are having to travel a greater distance should they wish to visit their loved ones, which is in itself an inconvenience.  

I have been asked to give my opinion as to how Briseham should be replaced. I wish I could think of a clever solution but one escapes me. Almost daily, in the local press, there have been letters condemning the closure and, knowing how busy Briseham was only less than a year ago, I find it difficult to believe that the system can continue without showing signs of strain and that the same level of care can be given as before.

I did have the chance to speak with the chief executive of the Devon Partnership Trust, Mr Iain Tulley, who telephoned me only a day or two after my last newsletter contribution had been submitted. Mr Tulley accepted that the final decision to close the unit had been his; he gave the main reason as being that the staffing levels needed had been impossible to maintain, in particular over the Christmas period. This had made the unit unviable and in some respects it would have been unsafe. I am grateful to Mr Tulley and accept that he did make the effort to contact me directly. He left me in no doubt that the "Buck stopped with him". In fairness to him I should add that I am aware that he is in a difficult position having only picked up the reins of the DPT weeks before. I don’t think that I can add anything to what I said about the staffing position in my last news letter contribution, however, and still maintain that the uncertainty surrounding Briseham contributed to its demise.  

I emphasise again that I will take any case of distress caused to any carer by the closure of Briseham directly to the local mental health management. My phone number and email address are always with this newsletter item.