1. Dementia Alistair Burns

2. Dementia What is it? Can we diagnose it? Can we treat it? How do we view it? Can we prevent it?

3. What is the difference between dementia and Alzheimer’s disease? Liver Heart Brain SymptomJaundice Breathless Memory loss SyndromeLiver failure Heart failure Dementia CauseHepatitis Atherosclerosis Alzheimer’s disease

5. Courtesy of Professor George Grossberg Changes in the brain characteristic of Alzheimer’s disease NormalAD APNFT AP = amyloid plaques NFT = neurofibrillary tangles

9. Dementia What is it? Can we diagnose it? Can we treat it? How do we view it? Can we prevent it?

10. Dementia: treatment goals Time Slowing of disease progression Treatment Symptomatic benefit Maintenance of function Cure Natural Progression Cognitive and functional decline Diagnosis

11. Dementia What is it? Can we diagnose it? Can we treat it? How do we view it? Can we prevent it?

12. Dementia Where have we come from? Where are we now? Where are we going?

16.  I have personal choice and control over the decisions that affect me.  I know that services are designed around me, my needs and my carer’s needs.  I have support that helps me live my life.  I have the knowledge to get what I need.  I live in an enabling and supportive environment where I feel valued and understood.  I have a sense of belonging and of being a valued part of family, community and civic life.  I am confident my end of life wishes will be respected. I can expect a good death.  I know that there is research going on which will deliver a better life for people with dementia, and I know how I can contribute to it. http://www.dementiaaction.org.uk/ i statements

17. Dementia Where have we come from? Where are we now? Where are we going?

18. Prime Minister’s challenge on Dementia (2012) Improvements in health and care Raising awareness Better research

19. 66.1% 31-Aug 31-Oct 66.5%

20. designcouncil.org.uk

21. Private Eye, November 2011

22. Dementia Friends www.dementiafriends.org.uk

23. 1. Dementia is not a natural part of ageing. 2. Dementia is caused by brain diseases. 3. It’s not just about losing your memory. 4. It’s possible to live well with dementia. 5. There’s more to the person than the dementia. Five key things about dementia www.dementiafriends.org.uk

24. Describe the steps in making a cup of tea

29. Dementia Friends www.dementiafriends.org.uk

30. Dementia Where have we come from? Where are we now? Where are we going?

31. Prevention and public health Patients having far greater control Break down barriers between primary/secondary care Multispecialty Community providers Primary and Acute care systems New deal for GPs Parity of esteem Local leadership

32. Awareness Key role of GPs Post diagnostic support Information, advice, carers Access to diagnosis Staff training Dementia Institute Dementia Friends/ businesses Research I million dementia friends Highest diagnosis rate

33. Dementia Wellbeing: Crosswalks Teaching Well Integrating Well Researching Well Commissioning Well Monitoring Well (1) Training - common to all areas. (2) Includes wellbeing and choice evaluation (3) BPSD – Behavioural and Psychological Symptoms of dementia (4) Organisation for Economic Co- operation and Development (5) 2012, 2015

35. ICHOM Draft Standard Set for Dementia: Outcomes © 2015 ICHOM. All rights reserved. When using this set of outcomes, or quoting therefrom, in any way, we solely require that you always make a reference to ICHOM a s the source so that this organization can continue its work to define more standard outcome sets.

36. Dementia What is it? Can we diagnose it? Can we treat it? How do we view it? Can we prevent it?

42. Alistair.burns@nhs.net 07900 715549 @ABurns1907