Editorial

Citation

Klee, D. (2013), "Editorial", Working with Older People, Vol. 17 No. 4. https://doi.org/10.1108/WWOP-08-2013-0022

Editorial

Article Type: Editorial From: Working with Older People, Volume 17, Issue 4.

There are millions of people living with dementia in the world – 35.6 million to be precise. By 2020 there will be 70 million and 60 per cent of these will be living in developing countries, according to the BBC news (BBC). It was the last part of this statement that got me thinking. We are just starting to understand the challenges of an increasing population of people living with dementia in the UK, but I certainly had not thought through the increased challenges for a person living in a developing country.

An early diagnosis of dementia can result in better access to treatment, information and care (Alzheimers Disease International, 2010). However, in high-income countries only 20-50 per cent of dementia cases are recognised and documented. In third world countries dementia is often undiagnosed and there is little available in terms of treatment or professional care. A study in India found that 90 per cent of cases of dementia remained unidentified (Alzheimers Disease International, 2010). Spending on dementia is lower than that of high-income countries, despite a greater prevalence (Alzheimers Disease International, 2010).

As I did some background reading and spoke to friends and colleagues with experience of living in low-income countries I began to get a picture of what it might be like for people with dementia and their families. In rural India, for example, it is likely that three or four generations would live together with the daughter or daughter-in-law caring for a parent with dementia as well as raising a young family. The World Alzheimers Disease International (2010) Report found that 58 per cent of all costs for dementia care in low-income countries was on informal care. In a study covering India, China, South East Asia, Latin America, Caribbean and Africa (Prince, 2004), 704 people with dementia and their care givers were interviewed. The study found that most care givers were women, living with the person with dementia in extended family households. One quarter to one half of these households included a child.

There will be additional problems in rural China, where the one child policy has resulted in an imbalance of male to female children. It is the duty of children, particularly boys to provide financial support to their parents – they often have to live and work in the city away from their parents to achieve this. So, older people with dementia may not have children living nearby that are able to provide care and support. This interesting topic was discussed in a paper by Guojun Wang et al. (2012) in Working with Older People.

On 11 December 2013 the UK will host the first G8 Dementia Summit. The meeting will be held in London and attended by the Prime Minister David Cameron and Health Secretary Jeremy Hunt. The need for more research, new treatments and interventions to delay onset and manage the progression of the disease will be the focus of this international summit. Apart from the huge cost to all countries of dementia – if dementia were a country it would rank as the 18th highest economy (Alzheimers Disease International, 2010), it is resulting in high levels of family strain, particularly in third world countries (Prince, 2004) and poor quality of life for people living with dementia.

Over the past three years there have been some excellent articles on dementia published in this journal. Minghella and Schneider (2012a, b) wrote two papers on Rethinking a framework for dementia parts one and two were published in Volume 16, Nos 3 and 4 of the journal. They offer a very helpful framework with person centred outcomes for each stage of the journey.

Argyle (2012) addressed person centred dementia care, with observations on the positive impact of activities which offered a person centred approach.

Dementia friendly communities and an example of what has been achieved in York was described by Crampton and Eley (2013).

Hearing the voice of the person living with dementia was explored in two articles, one on advocacy by Brown et al. (2013) and another on the engagement, involvement and empowerment of people with dementia (Litherland and Williamson, 2013).

Neil Mapes from Dementia Adventure looked at the benefits of green exercise and open space for people with dementia (Mapes, 2010) and in another paper the benefits of activity in woodland (Mapes, 2012).

In this issue there is a paper by Manthorpe, Iliffe et al. on the Evidem Programme – a five year programme of research in dementia care and practice in England. It sets out the lessons learnt by the core research team in newly basing research in the NHS with multi disciplinary working across academic disciplines.

Working with Older People will continue to publish articles that help our understanding of the diagnosis, treatment, care and support of dementia. Hopefully the G8 summit will help lead the way to more investment in research, diagnosis and treatment for people with dementia in all countries.

This issue of Working with Older People covers an interesting and diverse range of topics. In addition to the paper on the Evidem Programme there is one from the Campaign to End Loneliness, giving an update on their progress as well as information on how commissioners of health and social care can be influenced to address loneliness. Readers may remember an earlier article by the Campaign to End Loneliness in Vol. 15, No. 2 (Ferguson, 2011).

There is a fascinating paper by Toby Williamson on the Baby Boomer generation, following some in depth research commissioned by the Mental Health Foundation, Baby Boomers – Growing old but getting on with life.

We have contributions from Northern Ireland on the need for services for deaf/blind older people and Wales on falls and fractures with risk factors, useful interventions and a case study of the situation in Wales.

This excellent line up is complemented by a book review on the ILC-UK publication Has the Sisterhood Forgotten Older Women? I was intrigued by this title and so managed to get a copy of the book and to persuade Carolyn Bernard from the National Development Team for Inclusion to write the review. Both the review and the book are an interesting read.

Look out for a special themed edition of Working with Older People in the new year on Older People Creativity and the Arts. This issue will be about how creative activities such as art, music, dance, drama and writing are helping to reach older people who might otherwise feel excluded from society and to improve their quality of life.

Deborah Klee

References

Alzheimers Disease International (2010), The World Alzheimer's Report 2010 The Benefits of Early Diagnosis in Intervention, Alzheimers Disease International, London
Argyle, E. (2012), “Person-centred dementia care: problems and possibilities”, Working with Older People, Vol. 16 No. 2, pp. 69-77
BBC (2013), UKs G8 Summit to Tackle Dementia, 19 August, available at: http://bbc.co.uk/news/health (accessed 25 August 2013)
Brown, G., Standen, N. and Khilji, K. (2013), “Dementia advocacy in a time of austerity”, Working with Older People, Vol. 17 No. 2, pp. 58-64
Crampton, J. and Eley, R. (2013), “Dementia friendly communities: what the project ‘Creating a dementia friendly York’ can tell us”, Working with Older People, Vol. 17 No. 2, pp. 49-57
Ferguson, L. (2011), “The campaign to end loneliness”, Working with Older People, Vol. 15 No. 2, pp. 66-70
Litherland, R. and Williamson, T. (2013), “DEEP: the engagement, involvement and empowerment of people with dementia in collective influencing”, Working with Older People, Vol. 17 No. 2, pp. 65-73
Mapes, N. (2010), “It's a walk in the park: exploring the benefits of green exercise and open space for people living with dementia”, Working with Older People, Vol. 14 No. 4, pp. 25-31
Mapes, N. (2012), “Have you been down to the woods today”, Working with Older People, Vol. 16 No. 1, pp. 7-16
Minghella, E. and Schneider, K. (2012a), “Rethinking a framework for dementia 1: a journey”, Working with Older People, Vol. 16 No. 3, pp. 122-31
Minghella, E. and Schneider, K. (2012b), “Rethinking a framework for dementia 2: a new model of care”, Working with Older People, Vol. 16 No. 4, pp. 180-9
Prince, M. (2004), “Care arrangements for people with dementia in developing countries”, International Journal of Geriatric Psychiatry, Vol. 19 No. 2, pp. 170-7
Wang, G., Su, Y. and Hatton-Yeo, A. (2012), “The security for Chinese older people in urban-rural one-child families”, Working with Older People, Vol. 16 No. 2, pp. 86-96