Richard Comber

It could be you

Richard Comber on how the crisis in nursing care is adding to the horrors of senile dementia

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Do you suspect you soon may be going to lose your marbles? And are you over 65? Or do you suspect your elderly parents may be going to lose theirs? Is this loss of faculties likely to be a serious one? Then do not inquire in New Labour's New Britain for whom the bell of despair tolls. It tolls for thee.

The care of the elderly mentally ill is in meltdown in much of the country and can only get far worse. It is a national disaster, made worse by the old and infirm who lack the energy and means to defend themselves. It is callous and shameful.

I was a community psychiatric nurse until I retired earlier this year with exhausted relief. Every day I came across tragedies which make the admirable Dr Theodore Dalrymple sound like an optimist. No wonder all who work in the field of dementia in the elderly are scared stiff they are going to 'catch it' from patients. Statistically, 15 per cent of the population will suffer from dementia eventually, usually either Alzheimer's or stroke dementia, and nearly half of that percentage will suffer very seriously. Demographically, the 'dementia bomb' is about to explode.

What is likely to happen? It all depends on the severity. Cases vary in degree and type. Many milder forms can be cared for at home if help is available. The worse the symptoms, the bleaker the prospects of any decent care. One of my carers, aged 80, has just had her grossly confused old husband placed in a specialist home 40 miles away. She cannot drive, has no children, few friends nearby and is severely arthritic. The old man cries for her at night and she for him. But she is relatively fortunate. She found a first-class private home with devoted staff, who admitted him ahead of a long queue. True, it costs her £550 a week, but her modest capital will pay for that until it is so reduced that social services will reluctantly begin to make a contribution. She is now utterly burnt out mentally and physically.

And why is this establishment so far from her home? Because I and my hard-working social-worker colleagues have, over the past year, filled every decent specialist nursing home in this area for miles around. We have to cast our nets further and further afield.

The number of old people is growing alarmingly. Guiltily, I must admit that now officially includes me; being 65, I am one of the 'young old'. (The 'middle old' are those aged 75