No 8B Estate Agency Businesses and Dementia [Update 4 - 07/11/13]

This Post is exploratory and raises, firstly, the services needed by seniors in general possible concerns that an estate agent may have that arise from the need for a person with memory problems or dementia to move from his or her home. It is written by one who is not an expert! Legal advice should be sought as appropriate in the circumstances. [Post No8C will explore the options for selling or letting with property, together with something of the taxation consequences.]

[It may be noted that in many parts of the country only about 50% of those with dementia have been diagnosed with the the condition. In the area of the Dartford, Gravesham and Swanley CCG the percentage is targeted to become about 60% by 2015.]

Estate Agents may be approached about selling (or possibly, renting out) a home owned by a such a person. The approach may be made by: a) the person alone, b) by the person accompanied by a family member or the carer, or c) by a person with power of attorny - a family member, carer, friend or a professional.

The purpose behind such an approach might include the likes of:

• An intention to downsize into a smaller home or to a care home
• An intention to move to be near a member of his or her family
• An intention to move into a larger house with a family member's family. 

The first, perhaps basic, concern might be with the estate agency's staff having awareness of dementia and the need to conduct meetings discussions, telephone calls, visits, correspondence and the like in an appropriate manner. Managers and staff may need to be inducted, trained and developed in dementia awareness in terms of:

• the kinds of dementia [see Post No 18], and
• the symptoms as manivest in certain kinds of behaviour. 

The second concern is likely to be whether managers and staff have had training and experience concerning the legal capacity of the person wishing to sell (or buy) a property. Normally the person's solicitor would be expected to advise on such matters. 

If the person has been diagnosed, it may be that they do have legal capacity or that they made arrangements for lasting power of attorney to be held by another by a family member, etc [see Post No 17]. Where the dementia is advanced the estate agent may need to ascertain whether legal documents exist concerning estate and financial affairs and wishes of the person with dementia. This type of information will be available from the person with any valid lasting power of attorney or legal advisor.

At least one estate agency has developed an action plan under their town's Dementia Action Alliance. It emphasises the need for staff training in awareness of dementia and the kind of customer service needed for those with dementia. 

14 Personal Finance and Funding for a Person with Dementia [Update 2 - 03/11/13]

Personal finance and funding will vary with each individual's circumstances - so this Post is necessarily an overview. For some each 'stage' of life with dementia is likely to reveal a need for thinking about money.

This series of Posts examines the likely needs of two broad age-related groups where a person may be one of those who begins a life with dementia, namely:

1. the mature perhaps retired individual (say, 65 years or more) in their own mortgage-free home or renting in social or private housing.
2. relatively uncommon, the person who is of working age, perhaps supporting a spouse and children, with a mortgaged or rented home.

Approximately one percent of those with dementia are in the second group. The bulk are those over 65 years of age. Here each ten years of life results in more developing dementia, eg at 95 years nearly a third will have dementia. [You may like to note that only about 50% of about 800,000 with dementia have been diagnoseed.]

The main costs are likely to be centred on the following:

• early assessment, diagnosis and initial treatment
• longer-term clinical and other medical expenses (Generally, in the UK these are a cost on the National Health Service paid through national taxation.) 
• daily personal care costs and expenses
•  longer term care accommodation costs.

Sources of funds (income or capital) will depend on a person's estate, ie comprising the likes of the following:

• income from employment or business, including that of a spouse or partner
• income from pensions and state pensions
• the individual's home, ie owner-occupied house or flat  
• income and/or potential capital from property investments, eg house or flat,
• interest on bank or building society deposits,
• insurance policies - to mature or to cash in
• other kinds of savings, 
• premium bonds 
• shares, government bonds, and other like investments
• antiques and other chattels
• any entitlements to other state benefits, eg care costs.

8A Financial Businesses and Support for those with Dementia [Update 1 1/11/13]

Post 8 sets out the general background for businesses to be more dementia friendly in our communities - cities, towns and villages.

It has been announced today that about 170 national financial businesses, eg banks, building societies, are to adopt more dementia friendly business practices and operations so as to give support to those with dementia, carers and families.

Staff awareness and training programmes will be undertaken to ensure staff are able to recognise, and so discreetly help a customers with dementia. One example was the setting-up of Power of Attorney for the financial affairs of a person who is unable to cope with numbers, eg on a keypad, but otherwise can cope generally with matters. The dementia friendly aspect is that whereas this setting-up operation might previously have taken four days, it now be a matter of say 20 minutes.

In NW Kent, including Swanley, it is likely that the local branches of the national financial groups are beginning to be encouraged to become aware of the refreshed and new policies towards those living with dementia. Specific training on new approaches to operations is likely to come within months.

Profile 1B Dementia Buddy Scheme at Darent Valley Hospital

This post gives brief details of the Dementia Buddy Scheme at Darent Valley Hospital (DVH).

Generally, on being admitted to hospital dementia patients tends to have the following:

• to become very distressed,
• to be more confused than prviously 
• to stay in hospital more than their peers who do not have dementia
• to have more accidents whilst in hospital than their peers who do not have dementia.

At DVH initiatives to combat these propensities include the Dementia Buddy Scheme where about 20 volunteers have been recruited and trained to give support to patients with dementia who are in wards at DVH. The role is social and advisory and is non-clinical. However, the volunteers enable the hospital's nurses on the wards to devote more time to the clinical needs of their dementia patients.

The role includes supporting the patient's family and carer. Focusing on the dementia patient, social and practical activities undertaken by a dementia buddy typically include:

• social talking and reminiscing 
• music, dance and games
• help with eating and drinking
• reading newspapers and history books
• iPad work and other similar skills. 

The threefold purpose of the Scheme is ranges over the needs of a) the patient, b) the family and/or carer, and  c) the nursing and support staff. 

A number of patient-focussed objectives include:

• reducing the patient's distress and confusion
• helping to maintain cognitive capabilities
• reducing accidents 
• maintaining fitness and health with exercise and nutrition 
• reducing the stay in hospital
• reducing re-admissions.

For the family and/or carer the aims include:

• re-assurance that the patient's welbeing is at least maintained if not improved
• support for them is on hand, eg information and referral to needed support services.

Nursing and support staff benefit from trained 'specialist' volunteers in dementia care as follows:

• their time for clinical work is enhanced by their patients being less distressed, calmer and happier
• members of the patient's family and their carers being reassured and more aware of the benefits of treatment and social care
• being exposed to examples of care-linked best practice 
• generally becoming more dementia focussed in their own work. 

Finally, there tends to be a happier ambiance on the wards such that staff retention is enhanced.

13 Dementia Advocacy Services [Update 1 - 31.10.13]

Like most public services and professional organisations, the National Health Service (NHS) has a complaints system.  A later post will describe the twists and turns of complaints systems generally, including the NHS complaints system: whereas this post might meet a more pressing need for one of the following local independent services for advocacy on behalf of a person with dementia, a vulnerable member of the family or the care 

Although the emphasis in this post is on those with dementia, the local services may have a wider remit of support for others too.

As an example of what is available locally, there is the Invicta Advocay Network www.invicta-advocacy-network.uk a charity specialising in advocacy. Briefly the services offered include:

• Guidance and support for those with mental capacity to make decisions themselves or with     help
• Guidance and support for those without mental capacity to make their own decisions.

A similar charity in advocacy work is Advocacy Service, Age UK North West Kent.

In the UK the Dementia Advocay Network provides guidance, standards and training for individuals who wish to improve as advocates or to become dementia advocates. 

Reference: Age UK NW Kent  "Guide to Professional Advocacy". 

                                   

12.1 Some Legal Points on Housing and other Care Settings for Seniors with Dementia

When seeking accommodation, seniors with dementia have many of the concerns which other seniors have, but also have other needs particular to their circumstances. As a person's life with a diagnosis of dementia starts it may not be very different that that of the others. In fact the former may already be addressing the concerns touched on above. These are likely to include:

• the prospect of downsizing from a much loved home
• the types of accommodation needed: bungalow, flat, serviced accommodation, care home, rest home, accommodation in a family member's home, etc   
• the practical tasks faced in getting ready for such a move, namely: a) emptying the loft, b) reducing the quantum of furniture, and which items to discard,  c) identifying the criteria for the search for suitable alternative accommodation eg location, size, facilities, services, etc 
• the need to seek professional and other advice and services in respect of the last items.

Where a person has been diagnosed with dementia, it is a similar set of concerns but is likely to be laden with the following:

• having need to make decisions, so depending on how far along the dementia jouney an individual has reached he or she may find questions about mental capacity to act on certain decisions
• this leads to pointers as to whether there exists any valid legal documents, such as: a) a Will, b) a Lasting Powers of Attorney concerning property and finance, c) a Lasting Powers of Attorney concerning health, care and wellbeing
• if at a late stage of dementia, perhaps following a crisis, it is found that none of these exist or for some reason they are invalid. Here, if mental capacity is lacking, it may be necesssary for a family member, friend or professional to seek an order of the Court of Protection (UK). 
• Finally, an important point is that the wishes which might have been held earlier may not be known by the health and care team in assessing suitable treatment.
• Where valid legal documents are available the wishes of the individual must normally be observed  by those handling property and finance, but perhaps more importantly, prosessional medical and care staff are required to see that the wishes of the patient are addressed appropriately in accord with wishes as to treatment. Similarly, on death the deceased estate passes under the rules of intestacy unless there is a valid Will (see Post 12). 

Review 2 "The Journal of Dementia Care" [Vol 21 No 2]

Forty pages of text with very few advertisements give the reader a wide coverage of topics on care for those living with dementia.
Three pages of News brief the insights into many topics which I need -

• +Dementia Friends
• +Dementia Champions for NHS and social care staff  (cf Dementia Friends Champions)
• List of 21 Research Projects 
• and many more.

Seven pages of Networking gives an interesting series of comments and insights into what idividuals are doing in many fields. At one year old, the impact of the @Dementia Challenge is explored by six individuals. 

Two items on  Life Story Work , and others items give awareness and knowledge - one was very well referenced.

Care Practice gives the reader a) writing and dementia b) garden design for dementia, and and c) mattering in dementia contexts. separate 

Finally, the magazine gives three sections on "Sexuality, Dementia and the Care Home", Resources, and a Research Review. 

Published six times a year the Advisory Board is well embedded in universities, clinical practice and business aspects of dementia. 

ISSN 1351-8372

Contact : Hawker Publications, 2nd Floor, Culvert House, Culvert Road, London SW11 5DH,  

Telephone details 02 7720 2108 

12A Dementia and the Need for a Will and Other Documents [Update 10 - 22.12.13]

A person with dementia in the end of life (EOL) phase should be receiving appropriate care, in an appropriate place, and in accord with his or her wishes. Hopefully, he or she would have made arrangements to be in place so as to cover important decisions about their care, place, and their finances and property. If the individual is young the decisions may affect a young spouse or partner and any children. The decisions can only be known and acted upon in law by the family, carer, doctors, health and care workers if there is a Will, and powers of attorney, etc covering property, finances and, in particular, health and welfare (care) matters.

The above and other pre-EOL matters which might be listed. [see Post 12B]. They include:

• Will
• Lasting power of attorney for a) property and finance, and  b) health and care 
• Decisions on refusal of treatment
• Funeral arrangements 
• Donations of organs and pacemaker, etc
• Family records and history for future generations
• Messages for family members and friends 
• Decisions about distribution of sentimental items
• Declutting of papers, records and chattels
• Trusts and other arrangements for vulnerable members of the family, eg children, vulnerable adults.

A lawyer who specialises in family law, estate planning and the like might be expected to give advice on the likes of the following documents:

• Will
• Lasting powers of attorney for financial and property affairs (see a later Post)
• Lasting powers of attorney for health and welfare (see a later Post)
•  

Will

It is surprising how many individuals do not have a Will (or "mirror" Wills in the case of a couple). 

A Will is a formal legal document which states the wishes of an individual (testator) as to the likes of the following:

• distribution of his or her estate after death 
• provisions for a spouse or partner and any children 
• gifts to other persons, etc. 

Formal Preparation of a Will

When preparing a Will certain formal conditions are required by law, including

• the testator must have mental capacity to make a Will 
• provision for one or more executors who will administer the estate in due course
• a signing of the Will by the testator
• the witnessing of the act of signing by two persons.

A Will is normally prepared by a solicitor or legal executive after an explanation of the testator's intentions - where necessary, with guidance on how the law affects the intentions. 

Absence of a Will 

Unless an individual has made a Will his or her intentions for his or her estate would most probablty not be met.   This is likely in the following kinds of circumstances:

• no Will was made 
• the Will is void as a result of re-marriage taking place after it was made
• the testator did not have mental capacity at the time the Will was signed 
• the Will is otherwise invalid, eg it is defective in form, eg not witnessed. 

In any of these circumstances the deceased's Estate will pass under the Rules of Intestacy.

Finally, even if a Will has been made, it may be disputed and contested in law because, for instance, no provision was made for the deceased spouse or children who are minors. Here one or more aggrieved parties may seek a deed of variation.  

Solicitors for the Elderly
Many solicitors may advise or act on these matters but in the 1990s a national body was set up, Solicitors for the Elderley. It authorises individual solicitors, barristers and legal executives requiring of them the following:

• to have a specified number of years of advising seniors
• to pass a qualifying examination on the relevant areas of law
• to comply with the SFE Code of Practice.

More details are available on the following website: http://www.solicitorsfortheelderly.com/

Footnote: This mention of Will Aid - see www.willaid.org.uk/ which, I understand, runs in November every year, and allows individuals or couples to obtain a Will or mirror Wills respectively at relatively low prices.

Profile 1A Dementia Services at Darent Valley Hospital (DVH) [Update 1 - 28.10.13]

See also Profile No1[25.10.13] for a brief description of Darenth Valley Hospital (DVH).

The prevalence of dementia in the area of the NHS Dartford, Gravesham and Swanley Clinical Commissioning Group (CCG) is now about 51% - some 49% of those living with dementia are, therefore, not currently diagnosed.  In line with national diagnosis standards the CCG has commissioned services so that the rate is targetted to rise to about 66% by 2015.

All this is important since those living with dementia who may be expected to go to DVH are likely to increase in the immediately foreseable future. They will be going fort the following reasons:

• a non-dementia related crisis in their health 
• a routine consultations with a consultant on health matters which are non-dementia related
• a person with memory problems who may be referred to the hospital's memory clinic after assessment by say, their GP
• after an event where a person has been found lost, they may be taken to the memory clinic at the hospital 
• after an event where a person has been found lost - wandering - they may be taken to the memory clinic at the hospital or, temporarily, to the secure unit for an assessment, etc 

In addition it may be noted that any patient over the age of 75 who is admitted for more than 72 hours will normally be assessed for memory problems. If the possibility of dementia should be indicated, he or she will be referred for diagnosis.

[The Dementia Buddy programme of volunteers at DVH is an important developoment which is being rolled out to other hospitals in Kent (see Post 13) when published shortly)].  

Profile 1 Darent Valley Hospital - Dementia Care Settings, Services and Staff [Update 1 - 18/11/13]

Related Posts
Profile 1A for dementia-related matters for admittance at Darent Valley Hospital (DVH).
Profile 1B  for the volunteer Buddy Scheme at DVH.

Introduction
DVH is the principal hospital within the area of Dartford, Gravesham Swanley Clinical Commissioning Group (DGSCCG). Most of the population living in Swanley are likely to be admitted there.

Numbers
The number of people with diagnosed dementia in the area of the DSGCCG is 1256 (July 2013), which means there are likely to be another 1200 or so who are not diagnosed. (The latter are more likely to require admission to DVH as a result of a crisis.)

Patients with dementia who are admitted to hospital with non-related conditions, eg a stroke, or following a severe injury in dementia- related crisis, eg a fall, will be cared for in the specialist ward for the illness or a dementia ward.

Accommodation
DVH has specialist units for dementia, including:

• several  dementia wards
• a memory clinic for those with memory problem - providing assessment, diagnosis and, if appropriate, treatment 
• a secure unit temporary admission for those who may harm themselves or other treatment.

The dementia wards and other care facilitities have been or are being redesigned and redecorated to make them more dementia friendly. This initiative is in line with policy and funding under the national Dementia Declaration (see Post No 5).

Key Staff

In the last few years personnel concerned with the treatment and care of those living with dementia at DVH have been appointed, or further trained and developed. The key staff for dementia include:

• consultants
• nurses, at least one of whom is a specialist dementia nurse 
• a group of volunteers known as "Dementia Buddies"
• NHS who have become Dementia Champions (seemingly a different role to that of Dementia Friends Champions) .

DGSCCG (July 2013) Dementia - The forgotten disease, DGSCCG

Review 1 "The Dementia Diaries" [ Update No 2 04/11/13]

Four youngsters. Brie, Fred, Sarah and Sam wrote the 28 entries in The Dementia Diaries. With nearly 100 pages this booklet deserves to be a best seller. Yes a best seller! When the second volume arrives in the world's  bookshops the words "International Best Seller" will not be a cliche. It is now available on Amazon.

From the first page I had smiles, laughs out loud, tears in my eyes and numerous moments of reflection! The book is described as a "novel of cartoons". Written and illustrated by Matthew Synman (and, I suppose, the now famous four), we have been given a gem.

The four grandchildren tell us, in their own words, of life with a grandpa or grandma who begin to have memory problems, minor crises, bouts of wandering, and who are eventually assessed and diagnosed as four of those living with "demensias" (which became "dementia" in a later diary entry - after some googling).

The book vividly describes in various ways, but without jargon, the clinical symptoms of dementias in the words of  grandchildren of about 9 to 14 years.  In addition we are given by each diary author some insights (with illustrations and comments) into life as young persons.

All adults have been through childhood - those who can remember will smile (or cry) at some of the comments of family life in a home community. That aside may not seem pertinent, but it should not diminish the important messages for adult readers about the implicit (mis)behaviour towards those who come to live with dementia by friends. At thde same time their are heartwrming stories of help in naturally dementia friendly communities.

Finally, the natural acceptance of their grandparents life with dementia, although expressed at times with a sense of loss and sorrow, is an example to all.

The book ends with a useful 'directory' about dementias and sources of information about them and the support services available, particularly in Kent but also nationally.

[Please note that if you want to read The Dementia Diaries it is available in all Kent CC's public libraries and has been distributed to Kent County County's schools. Otherwise, it is available from KCC SILK office for £5.99 including packaging and postage. It is likely that special arrangements will be made for bulk purchases. Also see Post 15.]

Publisher:     SILK Publishing, Social Innovation Lab Kent, Kent County Council, 3rd Floor, Invicta House, County Hall, Maidstone, Kent ME14 1XQ.
ISBN:  978-0-9576600-0-7  

9 Preventing or Mitigating a Propensity to Wander with Assistive Technology [Update 2 - 25.13.13]

In the book The Dementia Diaries (TDD) one grandchild recounts how grandpa took to wandering very frequently about his home community. In earlier times he had become a local celebrity such that when he did wander many residents would tell his family of his whereabouts - the community was dementia friendly.

'Wandering' is a term used to describe a memory concern where a person, perhaps with a memory problem or in early onset dementia, cannot remember how to get home or to their destination, is lost, and may appear confused.

A seemingly a-technological, anti-wandering device is a simple mock-up "bus stop". The idea is that when a person with dementia mentions wanting to collect the grandchildren or to go shopping etc, they may start to go, ie wander. A "honeypot" for many, if not most seniors in life is the bus as a means of transport. We all wait for buses. If a care home garden has a bus stop two possible functions arise: 

1. the place becomes a meeting place
2. the bus stop is then honeypot for social interaction
3. it is a place where a wanderer may be found.

This post attempts to flag up findings in the literature on the need to give  attention to more technological ways of preventing or mitigation a propensity a person with dementia may have to wander.  Not all living with dementia will wander and if a person does, it may be a passing phase. Nevertheless it may become a concern for all including carers and families.

The practical steps and assistive technology at home or in a care setting  that might be taken are numerous, and some are not without opposing views. They include:

1. A life record and a recent head and shoulders photograph (taken within the last six months
2. a card giving personal details - name, address etc - and contact details of the person's carer or family member 
3.  'assistive' care technology involving which surveys movement within the home or care setting, eg care home
4. exit doors and gates with devices clocks, lights or other means of informing the wanderer or warning alarms to warn a carer or nurse
5. Signage which shows the individual, for example, that the route being taken leads to a particular location, eg the garden
6. A GPS device carried by the person with dementia which shows where he or she is if wandering.  

For Swanley and the county, the charity, Kent Search and Rescue (KSAR) (coordinating with Kent Fire and Rescue Service and the Kent Police) will conduct a search for a missing person. KSAR recommends the writing the life history or record to include:

• places which the wanderer particularly likes or dislikes
• a colour photograph taken on the days on which the clocks are changed [For the benefit of readers who are overseas - our clocks are changed by one hour twice a year  for daylighting purposes.]
• Any other information which may assist in any search.  

A note of the clothing a person is wearing or may be thought to be wearing might also be useful to the searchers.

Other assistive technology allows a carer to have a record of or to monitor the movement of a resident within their home, or when they leave it. However, devices at the exit doorway may be in place to set off an alarm in the supervisor's office or to gently warn the wanderer of the time of day by say, "It is night time." or by showing an illuminated clock. Another device might be a mat with an embedded warning signal. [It is of course important not to distress the person.]

The Sussex Police have a scheme based on a GPS device for persons living with dementia. It shows where the wearer is located. More detail of the adoption of the device is given by copying/pasting the link:

 http://www.theguardian.com/commentisfree/2013/may/01/dementia-police-tracking-device

Finally, in South Korea Dr Young Mi Lim is conducting research into links between wandering and wayfinding by those with dementia. 

8 Dementia and a Community's Businesses [Update 4 - 14/12/13]

 If you are the owner or employee of a business, you are likely to have someone in the family or a friend or customer who is living with dementia. About 40 million of our population in England know at least one of the 600,000 or so who have one or more of the dementias.

Businesses are being or will encouraged in dementia friendly communities, eg Swanley, to build on good practice in developing ways of being more supportive of those with dementia, and their carers and families.

Just a short information and awareness session will be enough to create insights into the challenges you, your spouse, partner or another may face as a carer of someone just beginning to live with dementia.

Listed below are some of the matters which have or are being addressed by private, public and third sector businesses. It cannot be exhaustive and merely records findings from focused and casual searches; in some instances a note of changes have been given.

1. Employees who care for a person with dementia is likely to need flexi-time to accommodate the needs of the person living with dementia.
2. Employees who regularly meet members of the public are likely to meet in increasing numbers those with memory problems or a with one of the dementia. Many employees will need to be able to recognise the symptoms of a dementia, and learn to behave in an appropriate manner. In a dementia friendly community opportunities for in-house training are likely to become available. Much will be common sense but some behaviour can be challenging.
3. An employee who develops memory problems may not have dementia but it is pertinent to encourage him or her to seek the advice of their GP. The National Health Service has, under the national Dementia Challange, developed health and care pathways for assessment, diagnosis and the appropriate treatment of those with memory problems.   
4. It is posssible for an employee over say, 30 years of age to develop dementia: although the chance is that the onset will be at a much later age. If diagnosed the capability to continue working in their current position would need to be kept under review. At the same time concerns about about being able to work and so continue to support any family will need to be addressed. 
5. Many organisations are encouraging managers and other staff to become Dementia Friends in the workplace. Early in the formation of a dementia friendly community volunteers are likely to become Dementia Friends or Dementia Friends Champions (DFC). The latter will be able to offer in-house awareness and information sessions for potential Dementia Friends within a local organisation (see Post No 6). 
6. After such an awareness and information as is offered by a DFC a more targetted training might be required for those in certain kinds of business is likely to be more focussed, eg for a retail business, a bank or a public library, than would normally be offered by a Dementia Friend Champion (see Post No 6).
7. Nationally, some of the nations professions, particularly in the health sector, are adopting a strategy on dementia for their members, eg the Chief Fire Officers Association.
8. Similarly, many of the nation's large businesses and organisations have joined the National Dementia Action Alliance which is developing ways in which its members progress the policies and action progammes arising under the 18 objectives of the Dementia Declaration. 
9. At a more local level trends may or are emerging, namely:

• Local branches of the national orgaisations may be expected to adopt practices obtained from their national parent bodies - this is beginning to happen in Swanley
• Local Dementia Action Alliances are developing among county city or town dementia friendly communities
• Where a local Dementia Action Alliance exists it is likely that busineses will take onthe likes of a) staff training to become aware of dementia, b) take up specified training, c) premises are adapted to be more dementia friendly,  etc, then retail and other premises will post a distinctive dementia logo, eg a purple angel, in view of the street etc. 

Post 8A [30.10.13] gives details of the the initiative for the nation's financial institutions to become more dementia friendly.  Profiles 1 to 5 show how businesses and services in Kent around Swanley are meeting the challenges of dementia.

6 Dementia Friends and Dementia Friends Champions

A Dementia Friend is a person who undertakes to make small changes which might help an individual who has dementia or might make life easier in a community for those with dementia. The 'Dementia Friends' initiative comes with support from the Cabinet Office and with the backing and of a National Lottery Fund grant to the Alzheimer's Society (see Post 5).  

The aim is to recruit 1,000,000 individuals who have each attended an information session on dementia and have then registered as a Dementia Friends with the Alzheimer's Society. At present there are about 30,000 Dementia Friends.

 The information sessions are delivered by Dementia Friends Champions - individuals who have progressed from being a Dementia Friend by further practical session on the delivery of information sessions. About 2,000 Dementia Friends Champions are registered. Dates for training days for Champions can usually be found at:

http://www.dementiafriends.org.uk/

Each Dementia Friend Champion undertakes to prepare and deliver of information sessions to various groups - such as:

• relatives and friends 
• a local community group
• the staff and pupils of a local school 
• small parties of employees of local businesses
• meetings open to the public.  

The Alzheimer's Society offers considerable support - handouts, materials, 'games' etc - for a DFC's information session. The Society keeps a register of proposed meetings and provides a support and a communications network for those who become Dementia Friends.

5B National Vision, Strategies, Policies and Actions for Dementia in England [Update 5 - 16.12.13]

Viewers in Indonesia, South Korea, Ukraine, USA and other places overseas might like to note that these Posts are about a small town in Kent (a county in England). This series of rolling Posts is, therefore, about dementia 'governance' in England* only, but with particular reference to changes coming about in Swanley over the coming months and years. This is a result of an initiative to encourage the town to become a more dementia friendly community (see Post 1).

Although France's national dementia strategy was about eight years earlier than England's, over the last four years England's national vision, strategies and policies for dementia have been formulated and their implementation has begun.  Just a few are included in the list below:

• "A National Dementia Strategy - Living well with dementia" (3 February 2009)
• the National Dementia Declaration (October 2010)
• the National Dementia Action Alliance (2010)
• A policy of upgrading of care settings for those with dementia is funded by £50m - for hospitals, and care and homes (see Profile No 1)
• the Dementia Friends initiative and the Dementia Friends Champions initiative (see Post 6)
• the Dementia Friendly Communities initiative (see Post 4)
• the Dementia Friendly Pledge for businesses and other organisations 
• 'Making a Difference in Dementia Nursing Vision and Strategy'
• The G8 Summit (Decemeber 2013) agreed cooperation and the enhancement of funds for research into dementia.   

Each of these will be described briefly in later Posts together with a rolling account of their local impact in Swanley. 

At the moment there are a growing number of dementia friendly communities in Kent, eg Northfleet, Dartford, Eastry, West Malling, and Westgate. In due course KCC aims to have 12 such settlements - but it is likely that as a result of the three 'pilot' communities many others will be initiated.

Footnotes:

 1  For  the record, Swanley is administered by a 'town council', within the administration of Sevenoaks District Council, which in turn is within the administration of Kent County Council.

2   However, Swanley is in the area of Dartford, Gravesham and Swanley Clinical Commissioning Groups.  

*[ Northern Ireland, Scotland and Wales are likely to have similar and different policies, etc but the institutional bodies formulating and implementing are probably different in each country.]

4 Some Ways to Understand a Dementia Friendly Community [Update 5 - 05.12.13]

The concept of community is various! In many posts on this blog it is a settlement - village, town or city. In other posts the term community means an organisation or even an industry. Could I suggest that a family might be a "community" which is or is capable of becoming dementia friendly?

A dementia friendly community is one where all are pulling together for those living with dementia in their midst. Any initiative for a dementia friendly community (DFC) is likely to be underpinned by the following vision:

1. Those living, working or visiting a village or town will have awareness of dementia or will be able to readily obtain information and guidance about dementia - so gradually developing for themselves a good knowledge of the needs of those living with dementia - and so be able help them, particularly in shops, offices and service facilities.
2. Those living in the community who have memory problems are encouraged to visit their doctor or a local memory clinic for assessment, diagnosis and treatment, if necessary.
3. Those living with dementia in the community will have in time the support of a local team of health and social care professionals offering easily accessed, well-defined and integrated services for early assessment, diagnosis and treatment which is GP-lead and supported by specialists. 
4. Where appropriate, the physical environment gradually changes by adaptation, improvement or development so that homes, shops and other buildings enable those with dementia experience good accessibility, and safety, and so enables them to live in their own homes for as long as possible.   
5. Finally, those with dementia, their carers, and their families will feel that they can live well in a supportive community which meets their concerns and needs for information and help at appropriate times.  [For KCC Library Services and dementia see Post 15.]    

In Post 8 (21.10.13) a more detailed vision of the way in which the community's businesses may respond to a DCF initiative are explored. An approach which is often adopted is to join a local Dementia Action Alliance (DAA)- it is commonly a community- or county-based group or county. A local DAA is registered with the National Dementia Action Alliance. 

3 Dementia Health Event - The Oaks Surgery and Patient Voice [Update 1 - 29/11/13]

It is likely that most organisations could carryout their independent actions of support and service provision without recourse to a "dementia friendly community" group. However, in any town or village one aim of the DFC group is to promote awareness and information. It may be able to offer support where needed. 

The Dementia Health Event in Swanley's Clocktower Pavilion on Tuesday October 15th 2013 comprised two sessions of similar presentations of talks (and stalls) about dementia. The hall was packed for the first session when the  three speakers gave the following:

• an account of dementias in terms of their forms, symptoms, assessment, diagnosis,and treatment
• an account of the work of the Alzheimer's and Dementia Support Services (ADSS)
• an account of a care organisation's approach to their work. 

A packed hall of residents and others listened and asked pertinent questions of the speakers. The talks touched many concerns and issues and the questions were answered fully.

The Oaks Surgery and Patient Voice (Patient Participation Group) are appreciatively congratulated on their efforts in organising and presenting the event.  

2 Local Resources Development - for Swanley DFC [Update - 31.10.13]

Several kinds of help will be needed for those living with dementia, families and carers. The resources given below will also interest other residents, professional in health and care, students, and local administrators.

Preparations are in hand for:

• a short series of Dementia Information Sheets about the life with dementia 
• a "Dementia Directory" in hardcopy and virtual forms. It will show information on local services and resources together with contact details
• a regular updating of "Dementia Diary" in virtual form. It shows dates of a few local, national, and international events
• a Panel of Speakers on relevant topics about dementia health, care and services
• a series of posts on this Blog - particularly on policies for dementia and profiles of local organisations
• a number of Dementia Friends
• a Kent-wide website (being constructed by SILK).    

1 Lift-off for Swanley as a Dementia Friendly Community [Update 2 - 28/11/13]

Lift off was on August 9th 2013 when residents, councillors, and representatives of about 20 organisations met to learn how Swanley (Kent) might become a more dementia friendly community (DFC). (For DCFs see Post 4.)

Following this lift-off a booster and .Second Community Meeting is planned for Thursday November 28th 2013.

At the heart of all this is the thoughts and needs of those living with dementia, their families and carers.

The Novemember meeting will focus on:

• the analysis of the survey responses
• future plans individual organisations have made
• ways of helping one another 
• potential partnerships
• any need for co-ordinating activities.

The First Community Meeting was conducted by Kent County Council SILK project manager who led several interactive sessions when concerns, resources and other features of a DFC were  identified and noted. Existing resources are substantial but not much is known about them. (For SILK see Post 7.)

The meeting agreed the need to carry out a series of surveys. When the responses to these are analysed a clearer knowledge of what needs to be achieved will be known.

Swanley is the third DCF in Knet after Northfleet and Westgate. (For Kent's DCFs see www.kentfriendlycommunities.co.uk