Why no Admiral Nurses in Devon?

Dementia touches many families - one in 20 people over 65 and one in five by 80 years - and so thanks to our local branch of Senior Council for Devon and, especially for the lead given by Yvonne Waldrop, for arranging the meeting last Wednesday, April 1, at Exmouth Pavilion. It was an excellent meeting with an interesting range of speakers.The highlight was to hear Professor George Giarchi make the case for a personal care-centred approach. He said that "people with dementia have lost so much and need to be treated as an individual who is confused and depressed". There is no treatment for dementia and not enough NHS workers with sufficient time for both patient and carer. He felt that many GPs fail to diagnose dementia and, consequently, the family have difficulty in understanding what is going on and where to get help.The professor was given a warm reaction when he championed the role of carers - friends and family - who were expected "to fill the large gap" in services. They needed support, information, help in managing difficult behaviour and a break from what he called "sympathy fatigue". In the later stages, carers were bound to need respite breaks.Ted McGuinness represented the national charity 'for dementia', which champions action for better services, gives training and promotes and supervises Admiral Nurses. These are NHS nurses who have shown commitment and received extra training to work in specific ways. The service they give to carers is free and involves practical advice, information and how the carer might deal with their emotions. Admiral Nurses also give advice and training to other professionals, including GPs, and to people who provide day and residential services. The advice line open to all is 0845 257 9406.Several of the audience questioned why there were no Admiral Nurses in Devon? They appeared to fill the gap between the excellent, but under resourced, Older People's Community Nurses, who had to give time primarily to the patient and the carers who needed help in their own right. The answer lies with ourselves! Those able and willing to lobby and champion for services to change.Jennie Richards from Devon Primary Care Trust explained the National Dementia Strategy, which gives a comprehensive set of 17 objectives for the PCT to deliver. It will take much work and probably years to put the solutions in place. There are planning meetings taking place in which people can be involved in improving the services. Public action is very important because John Rom, the representative from Devon Partnership NHS Trust, considered that there were too many staff resources in beds and only one-third in community work. However, some in the audience can recall changes to services in neighbouring areas of East Devon - Stowford Lodge ceased to have beds about four years ago - but many would question where the parallel investment in community services went. Unless we are vigilant, beds will be closed and some money taken out to make cost savings. The thorny issue of respite was mentioned, but not seen as a responsibility of the NHS, but passed on to the local authority to come out of the Council Tax. Even supposing there were sufficient private facilities, the good ones are very expensive and the cheaper tend to use poorly qualified staff. Since dementia is a medical matter and since the carers are proxy workers for the NHS, they should be able to expect a break from (often) continuous duty once in a while.The NHS beds should remain, they should be free, and used for emergencies, periodic monitoring and planned respite for carers who are exhausted or become ill.Alan Worthington, Pine Cottage, Marley Drive, Hulham Road, Exmouth