What we’ve learned about Covid and Dementia
It is the fourth of June and this is number four in a series for Scotland’s dementia awareness week. It’s all about the phrase, “It should have been done by June!”, which for obvious reasons makes me jump.
Dementia and Covid-19
What was I supposed to say? I’ll start with three things about Covid.
First; we’ve learned a lot about Covid in the last few months. We know about how the disease spreads, how to prevent it and lots more about treatment. It looks like we’ve flattened the curve because the NHS has not collapsed. But the disease is still there.
Second; we’ve learned that the disease is NOT as deadly as Ebola, or Rabies, where 25-90% of infected people die. Generally, fewer than 1.5% of people die. If you’re over 80 years old, it’s a different story. It’s more like 13-17% who die. You catch it the same way, but you die more easily.
Third; you get it from others if you fail to use social distancing, fail to wash your hands enough, touch your face with dirty hands. You can also get it from breathing in other people’s droplets. If you’ve ever had to walk through someone else’s smoke from vaping or smoking in the street, it demonstrates how stuff goes from their lungs to yours. Simple really. You might even have felt spit on your face when someone else coughed or sneezed. Sometimes, you don’t even feel it.
Three things about Dementia
First; the NHS cleared a lot people out of the hospitals into care homes to get capacity for treating cases. Not blaming anyone, but with hindsight, that “saved the NHS” at the expense of the social care system. And the NHS maybe didn’t need “saving” right then because the cases didn’t come quite as predicted at that time.
Second; a lot of those people, who were rapidly designated as ready for discharge, were in the age group at significant risk of death if they got Covid. And they got Covid. Sometimes they probably already had Covid before the move. With hindsight, that could have been checked.
Third; social distancing (think physical isolation) is bad for dementia. Getting people not to touch their face is impossible in dementia. Every action that is good for suppressing Covid makes dementia worse. You’d need to sedate the person to make them Covid compliant in their behaviour and we all know sedation can cause early death itself. The person with dementia being isolated for suspected Covid becomes more, rather than less, likely to be infected. With hindsight, some of the advice about caring for Covid in care homes was laughable.
Covid and Care Home Complexity
In summary, it is complex. Many people in care homes died faster than they would have if this had not happened. Spraying responsibility and blame around doesn’t help. I'd volunteer to be on the inevitable National Enquiry team but they are unlikely to pick me because a) I know a lot about dementia and care homes, b) I volunteered during the earliest phases in the NHS and I saw what went on and c) I think that is a hopeless way to justify change we already knew was needed.
Be a good citizen
Use common sense
Avoid unnecessary contact
But, for goodness sake don’t start to blame the care homes. What happened, happened TO them and was not created BY them. I know it’s tempting, but just don’t.
If you would like more information, you can buy my book Dementia, the One Stop Guide or Care Homes: When, Why and How to Choose a Care Home. I am available for consultancy for families or organisations. And if you have any further queries or questions, or suggestions for something you’d like to see me write on, please contact me via the Contact Page
See my new course on Dementia the One Stop Guide on Policy Hub here
