27 January 2011

S3M-7793 Dementia Strategy

The Deputy Presiding Officer (Alasdair Morgan): The next item of business is a debate on motion S3M-7793, in the name of Shona Robison, on the dementia strategy.

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Stewart Stevenson (Banff and Buchan) (SNP):

Irene Oldfather described Alzheimer’s as a terminal illness. That reminded me of what Clive James said in his autobiography:

“Don’t take life seriously; you won’t get out of it alive anyway.”

In other words, we are all going to die; something will kill us. Laughter has a place in every care home.

We must ensure that we have environments in which quality of life includes the whole range of human emotions that people suffering from dementia are capable of enjoying. It will be different for each person, so care must be tailored to each person. If we are to do that, the focus must be on diagnosis—and early diagnosis.

Jamie Stone covered some of the range of difficulties that people with dementia and their families can experience. I suggest strongly that, while mental capacity exists, people should get the kind of advice that will enable them to deal with future mental incapacity. Like some other members, I guess, I have already made arrangements for my future mental incapacity—to which my wife refers from time to time—by putting in place a power of attorney, so that arrangements are in place if I get into a position of mental incapacity in the legal sense. Early diagnosis and good advice to carers and families helps them to do that and removes one of a wide range of burdens that they will experience during the progression of the condition that is dementia.

Ian McKee talked about the changing nomenclature and descriptions that have been attached to the condition. As someone who for at least 50 years has taken an interest in genealogy, I have probably read thousands of death certificates, because they contain a lot of information. The modern system of certification was introduced in Scotland in 1855. On certificates from that date onwards—including certificates for members of my family—you see the term “senile decay” or “senile dementia”, with an indication of the period of time over which the person concerned suffered it. The diagnosis is relatively imprecise and imperfect, but it is clear that dementia is not a new condition but has been with the human race for a long time.

We must also focus on the fact that the burden that we place on carers—the expectations that we may have of close family members—can create illness, especially psychological illness, in those carers. It is important that they get the right kind of support. The gamut of emotions that many carers experience is not dissimilar to bereavement, but without the opportunity to move to the final phase of bereavement—accommodation, which involves putting in place happy memories of the person who has been lost and coming to terms with that loss—because the loss of the person from their carer’s life is postponed by their condition, even though their mental capacity to interact with the carer may already have departed.

I have a dear friend whose wife is suffering from dementia. She distresses him so much that he has not seen her for four years; she has been unable to communicate with or to recognise him for well nigh 10 years. The condition of that very elderly gentleman tugs at my heartstrings whenever I talk to him about his wife.

My sister-in-law has just retired—at the age of 73—as a mental health nurse, working in a care home for the elderly mentally infirm, and my mother used to chair the local mental health services committee in Cupar in Fife, so I have had a lifelong interest in this issue. There are absolutely no easy answers to it, but the document that the Government has produced and the good heart that has been seen in all participants in the debate should give us great encouragement that we are on the right track.


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