Dr Jacinta Guthridge, from Taree Aged Care Services, servicing the Lower Mid North Coast Sector has some practical and positive advice.

‘Some things to reduce your chances of being diagnosed with dementia include; a good healthy diet, not smoking, not drinking too much, being social, being physically active and doing cognitively stimulating activities. If a person already suffers dementia, modifying these risk factors might not alter the course of the illness but might reduce the rate of decline.

These lifestyle recommendations are important in reducing the risk and delaying the onset of dementia.

‘Socialisation is important, especially if it involves physical activity and brain stimulation; good examples include tennis, bowls and dancing, but there are many other engaging options. It’s important to do brain activities that are more challenging than just familiar activities, for example if you have always done crosswords, it might be best to try different and novel puzzles instead. Other enjoyable activities that are likely to be of benefit in stimulating the brain include learning a language or a musical instrument.

Dr Guthridge stresses the importance of a healthy diet.

Good Eating

Diet is important for good brain health. A Mediterranean type diet is a good example of a healthy diet, it includes a high consumption of fruit and vegetables, legumes, olive oil, and unrefined cereals, as well as a moderate amount of fish and dairy products. We are fortunate to have these foods readily available in our area, but unfortunately many of the younger generation of kids don’t eat enough fruit and vegetables if at all, preferring packet and processed food, which is often high fat, high salt, sugar loaded, and with artificial colours and flavours, not recommended for good brain health! A good diet is very important for brain health for all ages, starting from a young age.

Capacity

Dr Guthridge offers practical advice to patients and carers.

If the family of a person with dementia is worried about their decision making capacity, especially if they are concerned about their welfare, then it is important to seek professional help. People with a dementia may still be able to make some decisions regarding their health, care needs and finances, but as their disease progresses they may no longer have capacity to make their own decisions. In this situation a substitute decision maker will be needed. Sometimes family may be concerned that their relative is being exploited financially or is at risk of abuse or neglect, in this situation getting a referral for an assessment from the Aged Care team would be recommended. It may be necessary to have the persons’ capacity formally assessed. People with dementia often don’t have the insight to recognise they are no longer managing to care for themselves, they may not manage household tasks, such as cleaning, and selfcare tasks, such as bathing and eating properly. This lack of awareness is part of their illness, they don’t recognize that they need help. The Aged Care team can do an Assessment, reviewing the person’s individual situation, and make recommendations such as care packages and respite to support the person with dementia and their carers.

Sometimes a person with dementia may not have family, or a Guardian and/or Power of Attorney to make decisions in their best interests, in this situation an application to have the Public Guardian and/or Public Trustee act on their behalf may be needed.

‘There may come a time when a person can’t manage even with the support of family and a care package and it is necessary for them to go into a Residential Aged Care facility.  It may be difficult to know the best time for a person with dementia to move into an Aged Care facility, sometimes allowing a certain level of risk at home before making the decision to go into care permanently.  A period of respite care is sometimes of benefit.

‘We are lucky in that we have a lot very good Residential Aged Care facilities in this area, but it’s always a hard decision to place a loved one into care.  Choosing a place that feels “right” ahead of time is a good idea.’

  The Hunter New England Health District based at Taree Aged Care Services,  provides services to the Lower Mid North Coast Sector (South to Hawks Nest, North to Moorland/Harrington, West to Gloucester and beyond). They have a Dementia Support Worker, an Aged Care Social Worker and an Geriatric Nurse Practitioner, and a Psycho-Geriatric Clinical Nurse Consultant; in addition to Dr Jacinta Guthridge (Senior Staff Specialist Geriatrician) and Dr Lana Kossoff (Consultant Old Age Psychiatrist; or Visiting Medical Officer Psycho-Geriatrician).

Their Dementia Support Worker provides a lot of education including free, weekly Carer Group sessions.

When people go into care they are usually supported by the team at the Aged Care Facility, with the help of GPs and Specialists. In the hospital setting there are ASET Nurses (Aged Care Services in the Emergency Team) to coordinate responses for admissions who fit the criteria, and Aged Care Discharge Planners who ensure that the client is being discharged to an appropriate, safe environment with suitable supports.

Other information for client or carers  is available at “My Aged Care” for new referrals or requests for services.  1 800 200 422 or www.myagedcare.gov.au.