Sunday, December 7, 2008

Are Personal Physicians missing the signs of Dementia and Alzheimer's?


This must be "pet peeves" week at the Alzheimer's Reading Room. I just finished an article that discusses how hundreds of thousands of dementia sufferers remain undiagnosed in the U.K. My personal experience is confined to Palm Beach County Florida but, I believe this also applies to the U.S. The reason this is happening? It occurs because the majority of personal physicians lack the proper training; and also, because a typical visit to the doctors office lasts around ten minutes (once you are in to see the doctor).  Additionally, persons in the early stages of dementia or Alzheimer's are able to function. My mother was still driving and shopping long after it was apparent she suffered from dementia. When she was diagnosed a physicians assistant told me an interesting story. He said, he remembered an episode a year or more before she was diagnosied where my mother showed up for an appointment and insisted she was there at the correct time. When they tried to explain to her that she had been in the doctor's office that morning she became so agitated that they had to put her in a room and calm her down.  You might be thinking, well, why didn't somebody do something. Here is the incredible explanation.  The doctor never informed anyone of the episode, and later when I learned about the episode my mother maintained that it never happened.
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This is off track but I will include another story that pertains to this issue. When the doctor finally agreed that my mother was suffering from dementia she wrote us a prescription for Aricept and that was it. I said to her, that's it. She said, yes. I said, what about a neurological consult. She said, No.  If you have been following along with me in previous posts you know I fired that doctor. Subsequently, I fired another personal physician. Finally, we arrived into the hands of our current personal physician who is well versed in dementia and Alzheimer's.  I often wonder how he maintains his very busy practice and keeps up to date on the latest developments, medications, and research. He does. If you live near Delray Beach, Florida I would be happy to give you his name.

I want to ask you this? Do you have a personal physician that is well versed in Alzheimer's, treatments, and alternatives? Do you have the very best personal physician in your area? If you don't you are making a mistake. I know now from five years of experience you need to get the best personal physician and specialists. I hope you will take the time to do this. You might also want to share this article with children and loved one's of the elderly. Don't forget. One out of every two persons over the age of 85 suffers from Alzheimer's. Many of them are going undiagosed. 

How untrained GPs are missing two-thirds of dementia victims

By Daniel Martin

Hundreds of thousands of dementia sufferers remain undiagnosed - largely because of a lack of GP training, it can be revealed.
Research shows two-thirds of victims have not been identified by the NHS - meaning they get no drugs, home help or other vital assistance.

And a separate survey of family doctors found that their inadequate training, and a shortage of support services for sufferers, is mostly to blame for the health service's failings.

There are at least 700,000 people living with Alzheimer's or a related condition in Britain, with 575,000 of those in England, according to Government-recognised research.

GPs are expected to compile lists of all those diagnosed. But according to an analysis of those lists in England by the Liberal Democrats and the Alzheimer's Society, only 220,000 are registered.

It means around 355,000 - 62 per cent - of dementia sufferers live without any support from the NHS.

Meanwhile, in the survey of GPs by the Daily Mail, 29 per cent admit they have not had enough training to diagnose and manage dementia.

Some 60 per cent said there was a reluctance to diagnose because of a lack of support services, while 40 per cent felt hesitant to make a diagnosis because of the dearth of drug treatments.

Worryingly, 10 per cent feel nothing can be done for victims, so do not bother to diagnose at all.

Overall, more than two-thirds said funding shortages were to blame for care failures.

Neil Hunt, chief executive of the Alzheimer's Society, said: 'Without a diagnosis, people can't understand frightening symptoms and can't make plans for the future or access support.

'GPs get very little time and we hear cases of people being told they are stupid and sent away.

'Others have a five minute session and are basically told, "good luck, I don't envy you but there's nothing we can do".

'It's no wonder people give in to depression and give up. But the evidence is many can have a reasonable quality of life if the disease is diagnosed early enough.'



The LibDem research into undiagnosed sufferers found 95 per cent of PCTs have fewer than half the registered dementia patients expected.

It also unveils a postcode lottery, with some health trusts having far fewer registered patients than others.

The worst is Heart of Birmingham PCT, which covers the centre of the city. An estimated 82 per cent of sufferers there are undiagnosed.

The best is Islington in North London. But even there, some 32 per cent go undiagnosed.

LibDem health spokesman Norman Lamb said: 'These findings beg the question - why are so many going without the help their GP can offer?

'Too often people assume nothing can be done and it is a part of ageing.

'We must challenge this view, because a great deal can be done to delay the onset and progression of the condition.

'The NHS must do more to ensure people are encouraged to seek early help and that they have access to care from their GP, specialist assessment and accurate diagnosis.

'But the problems go wider with a social care sector under massive pressure.

'The Government has been slow to acknowledge these problems and there's a risk that urgently-required reform will be knocked in the long grass as economic problems grab attention.'

But Care Services Minister Phil Hope promised investment into dementia research will 'continue to grow'.

He added: 'We recognise that the key to improving the diagnosis rates is firstly to increase public and professional awareness.

'Secondly, we must ensure professionals involved in diagnosis have the skills and knowledge to do so effectively.'

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