Editorial Comment: Alzheimer’s morass

Judging by two new reports, this is no country for old men or women. You begin to hear the Who’s anthem to the generation gap – “hope I die before I get old” – not as the fierce slogan of youthful rebellion it was meant to be, but as dread of neglect in later life. According to one report, from the Alzheimer’s Society, more than 680,000 people in the UK have dementia and the figure is set to rise by about half by 2021 and to double by 2051. It springs from a trend which ought to be entirely welcome – we are living longer, a growing proportion of us to be older than 85. Figures published elsewhere suggest that one quarter of the increasing population of over-85s will develop dementia, a third of them needing constant care. It is this care that is the problem because, says the report, “the UK’s current health and social care system is characterised by a widespread failure to support people with dementia and their families.”

Despite the £17bn spent annually on formal and informal care for people with dementia, the system is in a mess. Those with the condition cannot get the treatment they need – the National Institute for Health and Clinical Excellence’s restrictions on prescribing Aricept are ill-judged – and carers are left to flounder. In this context the £25m set aside by the government to provide respite care for carers is a pittance, amounting to a measly £5 per carer.

One of the major challenges facing health and social care commissioners struggling to work together will be to make more sensible use of existing funding. All too often dementia is simply allowed to take its course when there are cost-effective social care and medical interventions available that could have slowed it down and improved the quality of life of both client and carer. Another report, from Age Concern, throws the postcode lottery for continuing care into stark relief, showing that in some areas people are 40 times more likely to be eligible for free continuing care on the NHS than in others. Dementia sufferers are among this lottery’s victims. There are many claims for more money from the Treasury’s comprehensive spending review later this year, but this ought to be a high priority.

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