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Many helping hands can ease the burden

Wellbeing

Many helping hands can ease the burden

KAILAS ROBERTS illustrates how a team approach to dementia management is needed to cover all bases for patients’ health and wellbeing.

In my clinic, I have colleagues who are passionate and skilled when it comes to working with people with dementia, as well as their families and carers.

They are predominantly allied health practitioners. And I often think that the support they provide is more valuable than what I, as a medical practitioner,  can offer.

You see, dementia is a condition that affects multiple aspects of your wellbeing and health.

The stereotype of forgetfulness does a woeful job of capturing the complexity of the condition.

Sometimes the forgetfulness is only a minor issue (not all types of dementia have this as a key component). And even if it is pronounced, the day-to-day effect of it may be eclipsed by other more-problematic symptoms.

I want to highlight the roles of the allied health specialists when it comes to managing dementia.

Firstly, physiotherapists: whenever anyone asks me what the best thing is you can do for your brain, I have a reflexive answer – be physically active.

There is some evidence that regular physical exercise may influence the trajectory of early dementia, with the improvement in blood supply to the brain as well as the promotion of growth factors such as BDNF (brain-derived neurotrophic factor) – crucial for nerve cell health.

As most people with dementia tend to be in the elder years, this comes with physical challenges that may impede the ability to keep active. Physiotherapists are skilled at creating tailored routines that allow people to safely keep active.

They also play a vital element in preventing falls – the outcomes of which can be catastrophic, of course.

Next, we have clinical psychologists.

The psychological repercussions of dementia can be profound – both for the person with the condition and their family members and carers. There are themes of loss and grief for many and there is the real impact of carer stress which can wreak havoc on a person’s mental and physical health and wellbeing. A psychologist is skilled at providing strategies to manage the situation and is also someone outside of the family to talk to. I have often found that family members do not want to let each other know about their problems, lest they burden them further at an already stressful time.

Third, we have neuropsychologists who undergo similar training initially to clinical psychologists but then become skilled at cognitive assessment.

They can provide invaluable information about what parts of a person’s brain is working well and not.

This can help with diagnosis but also allows the neuropsychologist to work with the person and teach them ways to best navigate day-to-day life in spite of their cognitive deficits.

Occupational therapists (OTs) are also very helpful. One of their main roles is to ensure that the physical environment – the home of the person with dementia – is optimised. Simple things such as hand rails and extra supports in the bathroom can make all the difference to independence and allow people to stay in their own home for longer.

It can also be beneficial to engage a speech therapist to facilitate communication (which can falter with dementia) and to evaluate the person’s ability to swallow, reducing the risk  of choking.

Finally, although not an official allied health stream, we have an aged care navigator at our clinic (who is an OT by trade). Their job involves helping others navigate the complexity of funding and supports and the behemoth that is MyAgedCare. This is a daunting task and help is often greatly appreciated.

The best approach to dementia is one that involves a team approach, and the importance of allied health practitioners should not be underestimated.

Kailas Roberts is a psychogeriatrician and author of Mind Your Brain: The Essential Australian Guide to Dementia, now available at all good bookstores  and online. Visit yourbraininmind.com  or uqp.com.au

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