Wednesday, December 16, 2009

Caring for Demetia Patients.

This post should not be seen as a criticism of the Powys teaching Health Board. This morning I attended a meeting in public of the Powys tHB, which was held away from its Brecon HQ - in Newtown. I wanted to listen in on the discussion about the future delivery of older people's mental health services. I left the meeting engulfed in a cloud of despair. Those of us who have watched Gerry Robinson's recent programmes on the BBC, looking at how we care for the elderly mentally infirm, will not yet have fully recovered from the awfulness exposed. This morning's discussion only made matters worse.

Last May, Powys tHB decided to issue a consultation paper, outlining its plans to 'modernise' its older people's mental health services. Actually, its not about mental health - but about dementia. Personally, I do not regard dementia as a mental illness. It's as much a physical illness as breaking a leg or bowel cancer. Dementia is about the physical degeneration of brain cells - which in turn impacts on mental capacity. Whatever, the thrust of the Board's recommendations was to ensure sufferers remain at home for as long as possible. After watching Gerry Robinson, everyone will sign up to that. But let's not pretend this is easy - or cheap. I fear that, in reality, it will mean more people are just left to fend for themselves. But its still better than the hell many old people are currently being put through. So far, so good. The Board decided to implement the training programme needed to facilitate this change immediately.

Now for the contentious bit. For the last 10 years, the only residential provision managed by the tHB in North Powys has been a 10 bedded residential unit (located in the grounds of Newtown Hospital) named Fan Gorau. In the main, this has been used to accommodate patients with dementia at various stages - perhaps awaiting a place in a specialist EMI home, or some other treatment. The Board decided that Fan Gorau was not fit for purpose, and recommended that it no longer be a residential unit. Instead, the Board proposed to earmark three beds at the Shelton Hospital for the mentally ill, over the border in England. As a result of public objection to this proposal, the Board is now recommending an alternative solution. Fan Gorau is still to close as a residential unit, but dementia sufferers who can no longer remain at home are to be accommodated in a general ward in Newtown Community Hospital rather than being moved to Shelton. The main rationale behind this proposal is that dementia sufferers remain within easy reach of those who might visit them.

Personally, I see this solution as fraught with problems. Fair play to the the Board members. They were concerned about it as well, and deferred a final decision until next month - allowing for consultation. Over recent years, I've spent quite a lot of time in residential, nursing and EMI care homes. Because of the serious quality of life issues for other residents, separate accommodation is being increasingly developed as a discrete part of care homes. The Powys tHB recommendation flies in the face of what is happening elsewhere. It really worries me. I repeat, this is not a criticism of the Powys THB. The Board in between very hard places. Put bluntly, our society does not put a sufficiently high value on caring for our elderly people. Massive amounts of money has been, and is being put into extending life, and b***** all into making that extension a meaningful existence. Its an imbalance that needs to change.


jb said...


Well said

Dr. Christopher Wood said...


Glyn Davies said...

JB and Chris - But it is only half the story - outlining the problem. What really matters is whether anything gets done about it.