Mention the word dementia, even to a group of health-care professionals, and you are likely to see shoulders sag and eyelids drop. The condition still carries with it a sense of hopelessness despite recent scientific advances made in the dementia field. In many ways, it reminds me of the reaction to terminal cancer which prevailed in pre-hospice days.
Dementia is a progressive degenerative disorder of the nervous system which affects memory and other "higher" brain functions such as behaviour, language, judgment and the ability to orientate. It is commonest in people over 65, with a prevalence of 20 per cent in the over-80s. As the Republic's demographics change, the current estimate of 30,000 sufferers is expected to rise by 7,000 in the next 10 years.
While Alzheimer's disease accounts for 70 per cent of dementia cases, some people have what is termed vascular dementia. This is the result of a series of mini strokes, which in themselves may bring about no perceptible symptoms, but which lead to dementia over time. A mixed picture of Alzheimer's and vascular dementia is frequently found at autopsy.
The Dementia Services Information and Development Centre (DSIDC), based at St James's Hospital in Dublin, was launched by Micheal Martin, the Minister for Health and Children, in June. Aimed at demystifying some of the misconceptions about dementia, the centre hopes to generate increased public awareness of the disease. In practical terms, according to its director, Dr Suzanne Cahill, it hopes to develop models of environmental adaptation which will help individuals with dementia to maximise their ability to function.
When I visited the centre recently, news had just come through that the DSIDC had been awarded EU funding to study how "enabling" technologies might improve the quality of life of people with dementia. A three-year project will be conducted in collaboration with researchers in Norway, Finland and the UK. The "Enable" study will investigate the extent to which it is possible to facilitate independent living for people with dementia.
As the memory of sufferers fails and their judgment falters, scientists have looked to advancing technology to create devices which will enable patients to retain their independence. A typical gadget is the PICTO phone which has pictures of friends, relatives and tradespeople instead of numbers on the keypad. Simply pressing the appropriate photograph puts the user straight through to the number.
Other devices to promote autonomy include a Norwegian invention (pictured) of an electronically powered calendar, which changes day and date automatically. It has space for pictures, which can be changed by carers to reflect the seasons, or to depict a birthday or wedding anniversary. Instead of having light switches in a house, it is possible to trigger light by body heat sensor. So if you need to go to the toilet at night, crossing a sensor will immediately switch on the light in both bedroom and bathroom. This device has been shown to reduce stress and panic among dementia sufferers.
A "locator box" is a shoulder-high, wall-mounted device which depicts commonly mislaid items such as keys, glasses, pension book or purse. When the button beside the key picture is pressed, a device on the mislaid item emits a warbling sound which continues until the keys are picked up.
The useful application of modern technology is endless; other gadgets being tested include an alarm to prevent misuse of microwave ovens, an automatic bath water volume and temperature control and even a device which will sense gas from a cooker and will automatically open a window.
Prof Brian Lawlor, chairman of DSIDC's management committee and professor of old age psychiatry in Trinity College Dublin says: "Assistive technologies are becoming part and parcel of modern-day living, and there is no reason why they should not become part of everyday living for persons with dementia."
One of DSIDC's principal aims is to provide information for professionals. Judy Oxley, the centre's information officer, has assembled a large database on dementia services as well as a well-resourced library. Education and training is the responsibility of Mary Drury, education officer, and she has already run a series of training courses both at the centre and in various health boards. I was especially impressed to see that care attendants and house-keeping personnel are included in the multidisciplinary workshops.
Early diagnosis and destigmatisation are important issues in the management of dementia. DSIDC is set to play a key role in bringing about real change for sufferers and carers alike.
For further information contact DSIDC (phone: 01-4162035, email: dsidc@stjames.ie). The Alzheimer Society national helpline (1800-341341) runs Mon- Fri, 10 a.m.-4 p.m.
Contact Dr Houston at mhouston@irish- times.ie or leave messages on tel 01-6707711, ext 8511