Sunday, 14 April 2013

Death, Dementia, Drugs and Daffodils

I was sad to hear of Margaret Thatcher’s death last week. And sadder still to witness the hugely divisive response her death evoked. I only met her once and that was in a large group, but like Tony Blair, who I also met once, she had a hugely powerful presence in the room and drew you in whatever once political beliefs. She endured much ill health in her later years, and in 2005 her daughter revealed that her mother was living with dementia.

Thatcher’s husband Denis, had died in 2003 and she was said to have missed him dreadfully. However, unlike the 62% (over 250,000) of people with dementia who live on their own, she was unlikely to have been lonely. Last week the Alzheimer’s Society published their report Dementia 2013: the hidden voice of loneliness – and it’s a compelling read. This report looks at how well people with dementia are living. 70% of those living with dementia said they had stopped doing things they once did due to lack of confidence, not ability or opportunity. Most felt anxious or depressed and 35% said they had lost friends since being given a diagnosis.

Despite the current Prime Minsters Challenge – to fund more research into dementia; to address the quality of dementia care; to increase the public’s understanding of dementia; and to create more dementia friendly communities – this report shows that many people with dementia feel disconnected from society and that for many of those who live alone, they are truly isolated.

In a related story this week, I got to read the Prescriptions Charges Coalition report: Paying the Price. More of which in a moment, drug treatments for some kinds of dementia (Alzheimer’s) have made a significant difference to the quality of life for many people in the early stages of living with dementia. However, up until 2011, people were denied access to these drugs on the basis that National Institute for Health and Clinical Excellence (NICE) declared the drug clinically effective but not cost effective. The NHS spends £8.8b a year of drugs although £500m is thought to be wasted due to ineffective use of medicines.

What the Paying the Price report showed however was that many people today cannot afford to get their prescriptions filled. On the 1st April 2013, prescription charges in England rose again to £7.85 per item (prescriptions are free in Wales and Scotland). The report showed that 35% of those participating in the survey (4000 people with long term conditions) had not collected at least 1 item due to the cost. It’s got to be wrong in this day and age, particularly where in other parts of the UK there is no charge, that people in England have to stop or ration their medication because of cost. In health economic terms it also doesn’t make sense. The more difficulties individuals experience in managing their own care the more likely it is that their health care needs will require further intervention and increasing the cost to the NHS and society as a whole.

Yesterday was a gardening day. I planted last year’s Christmas tree, trimmed back the ivy, swept the drive, and made a start on clearing the beds of dead leaves and the general debris left over from the winter. The whole garden has burst into bud. Standing there for a pause, I thought the daffodils this year have been magnificent. Each seems to me to be like a drop of sunshine.