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Can you have ‘half believe’ in dementia friendliness?



handshake

There have been numerous examples of refusal of handshakes over the years. In 2012, Luis Suarez refused a Patrice Evra handshake. On the other hand, a handshake can be extremely symbolic. In 2013, it was reported that there had been a brief, but important handshake, between Obama and Castro.

Indeed, using the “Handshake” app, sales reps can take orders on the company’s tablet application while in a store or at trade shows, with the latest data on inventory and previous sales histories at their fingertips. It is now reported that app developer Handshake has raised $8 million in new funding to grow its business selling a mobile wholesale sales ordering and fulfillment application.

There has been much media coverage about a leaked memorandum from the UK Labour Party about ‘changing the subject’ when immigration comes up on the doorstep in campaigning. But, it turns out on closer inspection, such a tactic is advised if a potential voter shows unwillingness to discuss the topic of immigration in a constructive way.

The handshake is the symbol of bilateral goodwill. In other words, for a handshake to work, it cannot be refused by one party. The concept of ‘dementia friendly communities’ critically depends on rational members of the public wanting to show goodwill to people living with dementia. There may be all sorts of reasons why a member of the public might be unwilling to have that conversation. Possibly, a person might demonstrate prejudice towards, and discrimination, against a person living with dementia out of sheer ignorance; or because of powerful preconceptions from media imagery.

It is inevitable that combating such imagery is only possible if the media play out their side of their bargain. In other words, they avoid words such as ‘battle’, ‘fight’, ‘war’, or ‘robbed of his mind’. But this is not always the case. It is possible that if you know absolutely nothing about what dementia is you might have formed very crystallised opinions. Such views are ‘bigoted’ in the sense that it will be difficult for any amount of campaigning to change one’s perception of dementia.

It is now possible that creativity could be one of the best tools in shifting cultural prejudices. The latest ‘illridewithyou’ trend is a testament to that. Many Australians are still showing their support for Muslims using the hashtag #illridewithyou.

The trend started even as the siege in Sydney was ongoing on Monday. But, perhaps inevitably, a backlash has hit Twitter: #iwontridewithyou has been tweeted more than 3,000 times. On a train, one passenger reportedly spotted a Muslim woman removing her hijab, ostensibly out of fear of being targeted. The passenger told her to put it back on and offered to walk with her in solidarity. And so began #IllRideWithYou. The hashtag went viral and is currently still trending worldwide, days after the end of the hostage crisis.

It is very hard to think you can half believe in ‘dementia friendliness’, however defined, in that you can’t be ‘half pregnant’. One would think you might either sign up to the notion of wanting to learn more about the dementias, inclusivity, or accessibility, in other words making a community welcoming to a person living with dementia – or not. But the unpalatable truth is, possibly, that we all have different degrees to which we should want to prioritise this. I have often heard at meetings ‘what makes people living with dementia so special?, albeit asked politely; a person who asks this might be a commissioner in mental health services who is genuinely asking what makes a person living with dementia a higher commissioning priority than, say, a person with first episode psychosis?

These are difficult questions. The current ‘Dementia Friends’ initiative, implemented by the Alzheimer’s Society, with Public Health England in support, officially runs next year too in 2015. But at the end of this time, whatever the exact number of new ‘Dementia Friends’, serious questions will need to be asked about the wellbeing for a person newly diagnosed with dementia is any better. The annual funding of social care is reported to have dropped in recent years, from official figures, with social care not having been ring fenced since 2010.

There has never been a campaign for dementia friendliness to match the vigour of ‘illridewithyou’. Admittedly, there are key differences between stigma and prejudice against a person living with dementia, and, say, that towards a Muslim lady wearing a burkha. But this relates to another aspect of the ‘dementia friendly communities’ policy strand I have been concerned about for a very long time. Proponents of ‘dementia friendly communities’ have often argued that you might be able to spot someone with dementia in a shopping queue by virtue of the fact he or she is having trouble with monetary change. But this is a difficult path to tread down.

Somebody having difficulty with change could be exhibiting such behaviour as he or she is thinking about his partner having just died. The screening test is not particularly sensitive or selective. More basically, many dementias are ‘invisible’ to the outward observer. It might not be obvious to a stranger that someone is living with a dementia, or he or she never talks about the night terrors, the changes in semantic language, or the change in complex visual perception.

More fundamentally, we might get to the end of 2015, and we find that nothing has particularly changed in public attitudes. People living well with dementia might not find that members of society want to ‘ride with them’, but I feel the ‘Dementia Friends’ initiative has been influential in changing around a culture of indifference. Lazy commissioners will have to find another initiative to hand their anti-stigma credentials upon. My gut instinct that we will get to know whether as a society we know whether it’s possible to ‘half believe’ in dementia friendliness by the actual behaviour of us as a society. This will be very difficult to ascertain, but we will need to look into this. One thing’s for sure, it won’t be easily determined by the abundance of stickers in shop windows promoting ‘awareness’.

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