Page last updated at 00:02 GMT, Tuesday, 3 February 2009

Invaluable support of memory clinic

By Jane Elliott
BBC News health reporter

Richard Elston
Richard undergoes a test of his memory

Remember these three words; apple, table, pear.

Now spell the word 'world' backwards.

What were the first three words?

Speaking to Richard Elston before he takes this simple test at a specialist memory clinic one would have little clue that he has moderate Alzheimer's.

The 63-year-old chef chats fairly fluently about his family and career in catering.

But by using distraction techniques, such as asking patients to spell words backwards, assessors can tease out - and then measure - his memory lapses.

Today there is good news for Richard: he has been on the drug Aricept for a year now, and the tests show the rate of his deterioration has slowed.

But for many other Alzheimer's patients there has, until now, been patchy access to the sort of specialised support the condition requires.

It is estimated that 2-5% of people over the age of 65, and up to 20% of those over 80, have the condition - for which there is no cure.

On Tuesday the government is to announce a new strategy, which aims to bring speedier diagnosis and better access to specialist centres.

All GPs in England are set to get training to spot the early symptoms of dementia, and ministers also want to set up "memory clinics" to help the growing number of patients live as normally as possible.

Help and support

Some specialist memory clinics, such as the Rice centre (Research Institute for the Care of Older People Centre) in Bath, where Richard is treated, already offer assessment, support, information and advice to carers and to those with memory problems.

I feel that they know us and that they are watching over us
Paula Elston
The assessment includes formal neuropsychological testing in the form of structured questions and tasks.

The experts may also carry out blood tests to look for medical causes.

The staff can offer counselling and support as well as treatment.

Richard and his wife Paula say they have found the support invaluable.

"For me, I find the memory clinic wonderful," said Paula.

"I feel that they know us and that they are watching over us. We come every three months and they are so kind and understanding.

"I think Richard found the first two or three visits very hard, but now he quite enjoys it."

Drawing
By performing simple tasks doctors can assess deterioration in memory
She said that the couple had first noticed Richard having problems about two years ago, and that these had got gradually worse.

"We noticed things like him having problems using a microwave," she said.

"He used to be in catering, but could not remember how to programme the microwave - but then you think it is a one-off.

"Or we have a double oven and he would put one oven on and then use the cold one - little things like that.

"I was hoping it wasn't Alzheimer's, but I was was not surprised by the diagnosis.

"Richard never mentioned before the diagnosis that it might be Alzheimer's but when he was told what he had, he acted as though he had considered it."

Losing skills

Richard said he had been advised not to drive and said he knew he was losing certain skills such as the ability to tell the time or use money properly.

But he says he has noticed a benefit after taking Aricept.

It is a huge practical, medical and social problem with lots of consequences for everyone
Professor Roy Jones
Rice
"The drugs have helped immensely," he said.

"I have some good days and some bad days, but by and large I feel very well.

"I really did not like to say I had a problem, but now I have got used to it.

"It is not a nice thing to have - but I always say I have got to look on the bright side."

Paula has also used the Rice centre to take a carer's course, which enabled her to get advice about finance and benefits to which she may be entitled.

The staff also arranged for a solicitor to give advice on getting powers of attorney, in case a partner becomes unable to make important decisions.

They also arranged psychological counselling for both Paula and Richard and put them in touch with support groups.

Important role

Professor Roy Jones, director of Rice and a geriatrician, said clinics like the Rice centre were very important in the treatment of patients like Richard.

"People can get advice to see if they really do have a problem. If they do, they can have it managed and treated," he said.

"Richard has moderate Alzheimer's. The likelihood is it will get worse because it is progressive.

"But with drug treatment we can buy people time and they shouldn't deteriorate as fast."

Professor Jones said he welcomed the news that the government was taking an interest in dementia.

However, he added it was vital that enough money was provided to back up its proposals.

"All of these things cost money and that is the real issue.

"Is the money going to come in with the strategy to support what we need to see?" he said.

"It is a huge practical, medical and social problem with lots of consequences for everyone and for society.

"So it important that we provide good services for people with dementia. and that we provide support for the families."

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SEE ALSO
Dementia: Facts and figures
03 Feb 09 |  Health

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