“Clinical Iceberg” is a term used to describe the large amount of illnesses that go unreported. For example, medical statistics are created based on information from the doctors, these statistics go on to make government policies on healthcare. According to Last (1963) as much as 94% of illness is not reported to doctors. It is the vast amount of unreported illnesses that are known as the ‘Clinical Iceberg’. Almost a million people in England will have dementia within a generation and the bill for dealing with the disease will rise to £35bn a year.

[Picture from the US: Acute Care Geriatric Nurse Network: link here.The Acute Care Geriatric Nurse Network (ACGNN) was established in British Columbia in 2003 by a collaborative of Clinical Nurse Specialists in gerontology, geriatric medicine, geriatric psychiatry and geriatric rehabilitation and orthopaedics. The purpose of the collaborative and the ACGNN is to enhance nurses’ ability to provide evidence based care to acutely ill older adults.]

Almost two-thirds of people living with dementia have Alzheimer’s disease. Andrew Ketteringham, head of external affairs at the Alzheimer’s Society, said: ‘The projected growth in people with dementia is huge. Our own research has shown that by 2025 more than a million people in the UK will have the disease, so it will touch the lives of every one of us because every family in the country will have someone with dementia. The society predicted last year that 1,735,087 people in the UK would have dementia by 2051. Numbers are increasing sharply, mainly because of the UK’s ageing population. But mounting evidence also suggests that lifestyle-related conditions, such as obesity and physical inactivity, increase someone’s chances of developing dementia. Martin Knapp, a professor of social policy at the London School of Economics, and Dr Paul McCrone, a health economist at King’s College London. Sir Derek Wanless, chaired its steering group for a paper on this from the King’s Fund.

Now the King’s Fund have reported that people with dementia in general (including to Alzheimer’s disease) are having NHS-funded care withdrawn in the later stages of their illness. It says relatives have to pick up the bill for additional nursing support. Barbara Pointon, from Dementia UK and the Alzheimer’s Society, today described: “What’s happening with NHS continuing health care is it’s getting more and more difficult to get in the first place, and when people with dementia move into the advanced stage and need more care, it’s being taken away from them.” This finding is important because the King’s Fund is calling for a shake-up of the system that differentiates between health care, which the NHS pays for, and social care, which local authorities and individuals have to fund.