In March I spent two days at the Faculty of Old Age Psychiatry residential conference in Nottingham – a great conference as usual and lots to think about.
Rob Howard was a star. He spoke about anti-psychotic drugs and made a number of important points:
- We should remind ourselves that antipsychotics work in dementia as antipsychotics.
- Even a great antipsychotic is useless without therapeutic engagement.
It’s not rocket science.
Another star was John O’Brien. What struck me forcibly from his talk on NICE is this: he told us that there is a guideline on the diabetic foot. Alongside this we have a single guideline on dementia, the whole of dementia (currently being updated) – how broad is that? If this isn’t an example of institutional ageism I don’t know what is. (Would you get away with one guideline to cover the whole of cancer- I don’t think so, do you?) But hey we’re old age psychiatrists – we’re used to being grateful for what we get (just like our patients!)
I went to two workshops on the first day. The first was on end of life care and dementia. This was practical and focused. With colleagues I was presenting a poster at the conference on a Living and Dying Well with Dementia app to which I made a small contribution (it’s worth a look – see a promotional video if you’re interested at https://vimeo.com/114686591). The second was on couples living with dementia. I was interested to learn about an intervention being developed at the Tavistock Centre for Couple Relationships, particularly about their use of videotaping and grounding the intervention in everyday life (read about the Living together with Dementia intervention here). Two ideas that resonated with me were:
1. The negative cycle – how we (family/ professionals/ public) unwittingly disempower people with dementia sometimes with the best of intentions by expecting less of them and maybe taking over from them things that they could still do,
2. Working with couples and people with dementia, instead of just carers – something that is close to my heart as a family and systemic psychotherapist.
The conference was buzzing with enthusiasm and ideas, and I was too!
PS read more about ageism here.
PPS I haven’t mentioned James Warner the Chair of the Faculty of Old Age Psychiatry. He has provided a clear lead at a very difficult time for the specialty and he’s another very bright star indeed.