Dementia need not lead to despair


People are living longer and thus the risk of developing some form of dementia in old age is increasing. Put like this, the future for elderly people is gloomy. The media doesn’t help, feeding us with sad stories of decline and the consequent stress it imposes on carers.

But it doesn’t have to be like this. Indeed, I was heartened recently in reading Dementia: Hope on a Difficult Journey, by Dr Adrian Treloar (Redemptorist Publications). Dr Treloar, a consultant and senior lecturer in old-age psychiatry, is also a Catholic and writes “from that perspective”. Nonetheless, he would like his book to offer help to readers of other faiths.

Why did he choose to specialise in old-age psychiatry? He explains that he was a GP before moving into this field, adding that “seeing what can be done for people with dementia, while also seeing how poor and inadequate care was often the reality, was a strong motivation.”

Intrigued by his comment that “We are ourselves dignified by the care that we offer to the sick”, I ask him to expand. Dr Treloar believes that “the care which we offer to the most vulnerable members of a society is one way in which we can judge that society.”

In his book, he reminds us that “Carers need support too.” What, I ask, can be done to help the current army of carers who are struggling on their own? He is clear that “Carers do a huge amount and, as a result of what they do and experience, they have their own set of needs. Support can come from statutory requirements for carers’ assessments and other statutory support.” He emphasises: “We all have responsibilities to do what we can to help others in the vital work they do.”

What does he mean by describing dementia as “not just a medical illness but a social and spiritual illness”? Dr Treloar reminds me that dementia “involves the whole person; it therefore affects the whole of what we are, our relationships and indeed our lives.”

In an arresting comment in his book, he states that “We are more than the abilities we have.” I ask him to give me an example of how this truth has been made evident to him in his work. He responds earnestly, “I have seen some wonderful examples of people with the greatest disability and most advanced dementia continuing to provide in extraordinary and wonderful ways for those who care for them.” He reflects, “Put another way, when a person finally dies, even though they had become so disabled, there is almost always a real gap left behind at their passing.”

Finally, having read of doctors and nurses being reprimanded for praying with patients, I wonder how he would respond if he felt that a patient might like him to pray with them, despite not having clear religious beliefs. Dr Treloar responds, “Generally as a doctor I would not do this. But if there was a specific request from a patient for prayers, then with great care, discussion and thought, it might be right to offer to remember that person in prayers. Most often, we would recommend that a priest or pastor see that person.” He emphasises that “there is clear and right guidance that we must never impose our beliefs in any way” but adds, “That said, it is also most unfortunate if, as a result of such caution, we do not in the end offer spiritual support to those who are dying of and with dementia.”