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Dementia

My Lords, I congratulate the noble Baroness, Lady Murphy, on securing this debate. It is a matter that should be aired. I disagree slightly with the noble Baroness, Lady Warnock. Her distinction between taboo and stigma is interesting, but ordinary people still think that a stigma attaches to dementia. Many have adopted the word "Alzheimer’s" for all forms of dementia, because they feel that it is more acceptable to society than "dementia", which is a much older word. However, in some ways the noble Baroness is right—I agree absolutely that for most people the dread of dementia is very worrying. Dementia is no respecter of persons. My mother was a very early graduate from Sydney University—one of only 100 women at the time. She was a bright young woman. When I went to see her in Australia in 1958, she had had a stroke, mini-strokes and was suffering from early dementia, from which she never recovered. She went on to become quite childlike and lived for a number of years. Fortunately, I was one of nine children and the other members of the family were able to look after her, but she was in residential care. She lived to quite an age. Another interesting case is that of Iris Murdoch—many of us have seen the film. Years ago, I was asked to meet Iris Murdoch when she was signing books. Her latest book was The Sea, the Sea. I met her in Marylebone library, where the reading and book signing was held. She was such a clever woman—I was very impressed, and the book was very complicated, too. A few years later, when I moved to the country, I found that my house was immediately opposite hers. I had no idea that she lived there, but we met again in the village street. She was still quite well, but not very well. She remembered clearly having met me before, and welcomed me to the village—she was charming. We all know that she deteriorated very badly. I used to see her when her husband took her for walks in the village. They moved out of the village altogether when they needed to be closer to medical care. Again, she was a very clever woman in whom we saw a lot of changes. I pay tribute to my noble friend Lady Perry. George was a most brilliant man and I know how much she did to look after him in his last years. When I was chairman of the Royal Free Hospital, we had a special section of the hospital that had been the home of Sir Thomas Lipton, the famous man from the days of the America’s Cup who was going to win it back for Britain. This home was converted into a special place for the care of dementia cases. It was a huge Victorian home, on to which the hospital had built a lot more. Every year we had a garden party for everyone, including the relatives, and I went every year while I was chairman of the hospital. Many relatives told me that the problem with dementia is that it is a living bereavement and I agree with that. Early onset dementia is uncommon, but it happens, and can occur in people as young as 30. One man came every day to see his wife who had been in a bad state from the age of 40. It is hard when people are old, but it is more anticipated. It is rare in young people, but it is very upsetting. I was given a marvellous book, Alzheimer’s at your Fingertips, which was written by Dr Nori Graham, a consultant at the Royal Free Hospital, Harry Cayton and Dr James Warner. It was published in 1997. It is so good because it answers the practical problems of the people who have so much to do with caring for people, particularly in the early stages of Alzheimer’s. It answers questions, such as who will get Alzheimer’s disease. It says that it is uncommon in younger people, but it can affect them, and that it occurs more in some groups. Alzheimer’s is the most usual occurrence of dementia. After that comes vascular dementia, the type that my mother had, which is due to a stroke. We all know many people who have had a series of mini-strokes. Often they make a partial recovery between the strokes, then they have another one and they go a further step downhill. I rushed to read this book when my wonderful godson was diagnosed with Pick’s disease. Unfortunately, that is not good. The book sets out the details of the forms of dementia, which people do not understand, and explains that the causes are not fully understood. It refers to the importance of seeking a diagnosis, which so many speakers have emphasised today, and I could not agree more. The book covers practical care, general questions and the different situations in which people find themselves. Non-recognition is very distressing for loved ones who find that they are not known. The book is written in the form of questions and answers, for example: ""My wife often says to me ‘When are you going to take me home’. Then she packs some things into a bag—pictures, ornaments, etc. How can I explain that this is her home?"." Another example is: ""Sometimes, in the evenings, my husband looks at me and asks me when am I leaving. He then hands me the telephone and says ‘Tell my wife to come home, so that you can go back to your home’. What can I do?"." People find themselves in these types of situation all the time. The answers are reassuring and it is comforting for people to know that others suffer the same situation. The book then gives answers to the questions. Another interesting question is: ""My husband, who has Alzheimer’s disease, often gets angry, and sometimes hits me. He never used to do this. What can I do to calm things down"." I have met many people who find themselves very distressed by a husband who has always been a calm and loving person suddenly becoming quite violent. Restlessness, agitation, wandering, anger, aggression and bitterness are all problems that people face. Knowing that others face the same problems consoles them and helps understanding. However, there is a need for a greater public awareness. People often know nothing about it until they find themselves in that position. Public awareness changes attitudes and means that people are more supportive in general. I support the view that diagnosis is undoubtedly the key. I was rather pleased to meet a young German doctor at an Alzheimer’s function here. He told me that he had come to England to do research into this because he believes that our research is probably further ahead than that of most other countries. What we all want to see is not research into either prevention or cure, but research into both. The strategy is excellent, but we should deal with this matter in such a way that we do not have this distressing number of cases.