Retired old age psychiatrist Daphne Wallace (pictured) is determined to play her part in improving dementia care – particularly as she has the condition herself. Vern Pitt reports
After a fulfilling career as a consultant clinical psychiatrist Dr Daphne Wallace in 2005 found herself needing support after being diagnosed with vascular dementia.
“I didn’t have any specialist follow-up,” she says. “Over the next three and a half years I had an increasing sense of abandonment,” she says. “Some people felt that I knew about it because I had been dealing with it while I was working. There is a sense of bereavement and loss and a total change in how you look at your life ahead of you.”
Wallace retired from practice in 2000 and has been a prominent campaigner in the dementia sector for several years. Bringing both her professional and personal experience to bear she has a unique perspective on where dementia services are now and how they need to improve.
Poor care is root of fear
She says poor care is the root of people’s fear of the disease. “When people in the past have come across someone with Alzheimer’s disease the person has been sitting dozing the day away in a rather grotty home with no contact,” she says. Wallace says this fear leads to people being scared to report they are having problems, potentially delaying diagnosis of the disease.
However, she says the public’s perception of the disease is improving with more people reporting to their doctor earlier. She says the education and understanding of primary care professionals is still lacking and this can lead to patients being turned away.
She points to hospitals as an ongoing area of concern. Dementia patients entering hospital are likely to stay longer than others going in for the same procedure and the longer they spend there the worse it is for their symptoms of dementia, according to the Alzheimer’s Society’s Counting the Cost report last year. Wallace has experienced this first hand, 10 years ago: “I’ve had patients on my books who have terrible problems when they fall ill and go into hospital,” she says, “a higher proportion end up in care homes of some sort.”
One area Wallace is optimistic about is the government’s target for reducing the use of antipsychotic drugs for dementia patients by two-thirds in three years. She affirms that delivering more understanding care will bring other benefits on top of drug reduction. “Better care is better care. People’s whole quality of life improves,” she says.
In order to bring progress she feels not only do politicians and those in the sector have to improve standards but the public has to become confident in challenging poor services where they find them. “The public should not accept bad care. It’s still not easy to persuade people to complain and yet if people don’t then the regulators can’t respond,” she says. Wallace says that the Care Quality Commission cannot investigate all complaints but where there are many concerns it should take action.
Making the links
Wallace says policymakers need to make links with other initiatives. She says that overlaps with other conditions such as stroke can help to push dementia care up the agenda.
One of those areas of overlap is help for carers which Wallace says will become more crucial in future. “There aren’t going to be as many people around to do it. Informal carers save the country huge amounts of money,” she says. More needs to be done to make it possible for people to care for family members, Wallace believes.
She applies a similar theory to dementia research, which receives less funding than several other major health challenges such as cancer. “We need more research into the cause, how we treat it – and possibly a cure – but we also need research into the ways we manage it and alleviate the symptoms of it,” she says.
By the time the next election comes around, probably in 2014 or 2015, Wallace says we will need to see real results in the improvement of dementia care. She says there is good momentum behind the dementia strategy to drive the improvement of care but that the next government, whatever its colour, needs to capitalise on it.
Having qualified in 1965 Wallace worked as the first old age psychiatric consultant in Leeds from 1979 to 2000. She was a trustee for the Alzheimer’s Society for 11 years and was on the external reference group for the national dementia strategy. She remains involved in steering a number of dementia research projects.