The statistics for dementia are frightening. According to the Alzheimer’s Society, while just 1 in 50 people between the ages of 65 and 70 have some type of dementia, 1 in 5 people older than 80 do. If you take into account an ageing population, the stark future facing us is a tripling of dementia patients over the next 35 years, reaching 135.5million by 2050.
In the previous section, we highlighted several examples of robots in healthcare. Robots have also been used to alleviate some symptoms of dementia but these robots are distinctly more cuddly. A couple of years ago, we were introduced to Paro the baby seal. Its Japanese creator deliberately chose an animal that people were unlikely to have “unhelpful memories” of. The vast majority of the 3,000 Paro seals around the world are in Japan. There are 10 in the UK. Paro is about companionship – encouraging social interaction and therefore calming anxious patients.
A similar device has also been launched recently by a Swedish team of academics. This time it is a cat. Whilst Paro was designed deliberately because people were unlikely to have memories of a seal, JustoCat was designed precisely because it assumes that many people have memories of cats and can use this to access memories from the past. Experts call this the “reminiscence method.” The robot cat is about the same size and weight of a real cat and purrs and meows. As with Paro the seal, the cat can provide some respite to nurses and carers who have found that the cat seems to soothe and calm dementia patients. One big advantage is that the cat’s fur is removable and washable which means that it can be used in a hygienic way
We have already highlighted Japan’s ageing population in the previous section and so it is probably no surprise that it is working on developing what it calls a “dementia-friendly” culture. One city in Japan, Uji, assigns care teams of doctors and welfare specialists to those in the early stages of dementia, including home visits and medical appointments. In addition, 5.4 million people have volunteered to become “dementia friends.” Japan is also home to “Katari-no-ie” – public dementia day centres which are located in the relatively friendly and welcoming environment of an ordinary house. The ritual of food – both preparing and eating – is a key part of Japan’s support initiatives. One of the particular benefits of an environment like this is that their carers are able to take some well-earned respite.
We have seen that the ritual of food provides the focal point for many of the activities for dementia centres in Japan. Eating is a real concern when it comes to dementia patients. Sometimes those with the condition not only lose their ability to eat healthily but sometimes find it hard to remember to eat at all. This is where a device called Ode comes in. Ode is an alarm clock with a difference. It has been proven that the sense of smell is directly connected to both emotion and memory and so Ode emits delicious smells three times a day to stimulate the appetite of dementia sufferers. Currently there are three smell “menus” which include items such as orange juice, beef casserole and cherry Bakewell tart but more fragrances are hopefully being planned so the smells that are emitted can be based on dishes that are known to be favourites of the patients. Initial tests have proven to be very encouraging. Over half of the patients gained 2kg or more during the 11-week trial.
Eatwell is another innovation trying to solve a similar issue from a different angle. Eatwell was developed by Sha Yao – a San Francisco student. Her Eatwell tableware set was designed to encourage eating both through their eye-catching colours but also their practical designs. The insides of her bowls and cups are blue with the choice of yellow or red for exterior. These colours have been found to increase appetite as well as an overall sense of well-being. The bowls have an anti-slip base and the spoons are curved to make them easier to hold. Sha Yao has recently secured funding and has started to ship products around the world.
Sometimes, improvement in a patient experience can be achieved with some simple planning upfront which is why special mention goes to Oxford Terrace and Rawling Road Medical Group – a GP practice in Gateshead in the UK. The population is predominantly deprived with high numbers of refugees and asylum seekers. They have a very high prevalence of patients with dementia and found that it was becoming increasingly challenging to manage their needs through a standard 10 minute GP appointment – largely because often these needs relate to social care rather than acute clinical needs. This put real pressure on the on-call doctor. The practice therefore developed a Primary Care Navigator role which was designed specifically to navigate and signpost patients, their families and carers through the health and social care system. This included regular fortnightly contact by telephone or drop in and setting up self-help groups around the practice as needed. Through this role, the practice have found that they have been able to avoid unnecessary admissions, increase the carers register and improve communication between the practice and other complementary organisations. The team deservedly won the CCG Innovation within Primary Care award at the recent Bright Ideas in Health Awards.
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