Image: Rosie O'Beirne/Flickr
There are now about 800,000 people living with dementia in the UK. Ensuring they can live well has never been more important.
But as Chancellor George Osborne MP unveiled his budget, interesting details emerged of how a particular Conservative council is deciding to balance its own budget.
Essex County Council has just finalised plans to axe £200,000 funding for Mundy House, the only dementia day care centre in South Essex.
This week local Tory councillors said people living with dementia should instead treat their own condition and advised them to attend one of four one-day workshops in a “dementia cube” visiting Chelmsford, Harlow, Basildon and Colchester to learn how to do so.
60 people people living with dementia have been attending Mundy House in Basildon, typically arranged through social services, once a week or more.
However the centre will now close at the end of this month.
Day care centres provide company and activities for people with dementia. A person with dementia attending a day centre can also provide carers with a much needed break.
How could Essex councillors think it acceptable to offer a “Dementia awareness campaign” as an replacement for day care provision?
In national policy, “self care” is a philosophy which tries to encourage people with dementia in living well independently. It might include promotion of actions that people take daily to stay fit and maintain good physical and mental health.
It might also include the prevention of illness or accidents, as well as the effective care of minor ailments.
In my book “Living well with dementia” I review the evidence for interventions to improve the quality of life of people living with dementia. I feel very strongly that shutting of Mundy House Day Care Centre is a massive step backwards for the cause of encouraging people with dementia to live actively and independently.
The NICE guidelines in England for some years now have emphasised the critical importance of leisure activities in ‘supporting people to live well with dementia’, re-stated in last year’s guidelines.
After Mundy House is shut, enrolment into a residential care centre, which is far more expensive, may be the only “choice” for these people.
Sadly Essex may be a taste of things to come.
Dementia experts warned last year that Government cuts of £1.8 billion to the social care budgets of local councils and mounting pressure on doctors’ surgeries forcing people with dementia to fall back on Accident and Emergency departments for care. There were 220,000 A&E visits by people with dementia last year, a record number.
Cuts to mental health budgets also impact on people with dementia. Funding for adult mental health services fell in real terms for the first time in a decade in for 2010-11 (the last year for which we have reliable spending data). Ed Miliband raised it in yesterday’s Prime Minister’s Questions, in a batch of questions on the parity between physical and health services.
The negative effects of cuts to mental health services are far easier hider to hide. The patients are vulnerable, and the measurable outcomes have been difficult to define traditionally, compared to the effects of cuts of physical health services.
The Department of Health, working with the voluntary sector, launched a one year £2.4million programe “to create one million Dementia Friends by 2015”. But less than a year later the organisation “Dementia Advocacy Network”, which had been providing essential grassroots advocacy guidance, closed down after 12 years.
Think tanks talk of “co-production”, of the importance of “neighbourhood level support systems – families and communities, and how they can be rebuilt".
This approach can work successfully in practice.
For example, as described on the official 'Dementia Challenge' website, the Healthy Living Club at Lingham Court promotes the wellbeing of its members including people with dementia, their carers and friends.
Co-ordinator Simona Florio says: “None of us refers to the people who participate as ‘users’ of a ‘service’ provided for them. It is experienced by all of us as our community.”
But as funding cuts bite, is the language of respectable-sounding policies like ‘self-care’ and ‘co-production’ being used to disguise quite different reality on the ground?