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Hi. I'm Doctor Andrew Rochford.
I want to ask you a question: have you ever met someone whose life has been affected by dementia?
The odds are, you have.
There are more than two hundred new cases of dementia diagnosed in Australia every single day.
Right now it's actually the largest cause of disability in people over the age of sixty-five.
These days we're all living longer - which is great news - but an ageing population means we're more and more likely to meet someone with dementia in our daily lives.
Just because the risk of dementia increases with age, it's not a normal part of ageing.
It's a disease.
In fact, younger onset dementia can affect people in their fifties, forties, or even in their thirties.
And this can make it hard to recognise.
When you or I meet someone with an illness or a disability that makes life a challenge for them, we tend to adapt the way we work to try and help them out.
But if it's not obvious that a person has dementia, how are you going to know?
When we talk about dementia we're actually talking about a range of diseases that can affect the brain in different ways.
Some can make it hard for a person to make new memories. Others can make it hard to communicate, and can make even simple situations become confusing and aggravating.
The information in this resource will help you to recognise the signs of dementia. It'll also help you think about how you can minimise the impact of dementia in your own day-to-day life.
Listen to the audio version of the transcript (right click & save target as to download)
A bright and spacious bank, sunlight streaming in the windows. The air conditioning hums. Customers wait in a queue. The teller, in her forties, calls "Next please," from behind her computer monitor.
A customer, an Italian woman in her forties, glances around from the front of the queue, before approaching the counter with a piece of paper. Smiling, putting her handbag on the counter, she says "Hello, I need a bank cheque for this amount." The teller responds "OK, let's have a look." Then, in surprise, she says, "Oh, you were in last week, right?" The customer ignores this, repeating "I need a bank cheque." The teller tries again, saying, "You were in last week for a bank cheque for a gift, right?"
The customer raises her eyebrows and shakes her head, saying "No." The teller says, sheepishly, "Oh, sorry." The customer continues, "It's for my daughter, it's her birthday. Sophia." The teller stares at the woman, about to respond, but changes her mind, saying, "OK." She taps on her keyboard, asking, "I'll just need her full name." No response. She looks up from the monitor to the customer, repeating, "Full name." The customer smiles, saying, "Oh, Maria Angelato." The teller is confused, asking, "Oh, your daughter's full name?" The customer's smile fades and she hesitates, before saying "Gianni." The teller shakes her head, asking, "Sorry, didn't your say ‘Sophia' before?"
The customer blinks slowly, frustrated, saying slowly, "Gianni Angelato, my daughter." She smiles again, hopefully. The teller nods, saying, "OK." She types on the keyboard, and asks brightly, "Now have you got your card on you or some identification on you?" The customer responds with a confused frown, saying, "I don't have a card." The teller persists, asking, "Do you have some ID on you?" Now the customer frowns, asking, "Why?" The teller responds, "I just need some ID to access the account details." The customer looks upset, saying, "I just need a bank cheque." The teller replies sympathetically, but firmly, "I understand, I just need to see some ID though." The customer opens her handbag with frustration, saying, "This is crazy. At Regional they didn't need ID I just got to sign a form."
The teller blinks, concerned, asking, "Where?" Impatiently, the customer repeats, "Regional Credit Union." A young man and woman in the queue behind her laugh and shake their heads. The customer turns, annoyed, then looks back to the teller, who says "Um, Regional Credit Union haven't been around for a while. Listen, let's just go down here where it's a bit quieter, OK?" She gestures to her right and walks down the counter.
The customer follows, past another customer and teller, to the far end of the counter. The teller taps on the keyboard of another computer as the customer meets her, frowning, confused. The teller reaches for a paper and slides it across the counter to the customer, saying "OK, I just need a signature here?" The customer stares at the page, upset, saying "No, no, no, not Gianni. Sophia." The teller watches her shake her head, saying, "Sorry?" The customer shuts her eyes, clearly upset, saying, "You put Gianni. That's my sister. It's for my daughter." The stares at her, repeating "Sophia?" The customer replies, impatiently, "Yes, Sophia. You put Gianni." She glances back at the queue, muttering, as the teller taps on her keyboard, saying "Sorry, Maria..." Cutting her off, the customer mutters "I should just go back to Regional."
She turns to ask the customers in the queue "Are you with Regional? Is anyone here with Regional?" The other customers glance at each other, bemused. The teller says gently "Maria? Maria, I just need a signature here." She slides the paper back to the customer, who frowns, very upset, as she signs it and passes it back. The teller checks it and hands the cheque back to Maria, who looks at her desperately. The teller smiles, saying "For Sophia."
The teller watches her shake her head as she walks away, her smile fading to a look of concern.
Listen to the audio version of the transcript (right click & save target as to download)
A female presenter walks towards camera in a brightly lit bank, filled with customers moving to and from the counters.
She says, "Our banks are changing. But as we respond to new technology and evolving business models, our customers are changing too. More and more people in our society are living with dementia. And it's not just something that affects the elderly. Younger onset dementia can affect people as early as their forties or fifties, and its effects aren't always obvious. So, it's important that people with dementia are supported in their independence, wherever possible..."
A customer, an Italian woman in her forties, enters the bank, looking around, confused.
The presenter continues, "And helped to understand their financial management."
She speaks to the camera again, in the bank foyer, saying "It's important to remember that an early diagnosis of dementia does not necessarily mean that a person can no longer make decisions for themselves, but it can become progressively more difficult for them to understand or remember their financial decisions over time."
The customer approaches the counter and smiles at the teller, who smiles back. The Italian woman hesitates, confused, as she searches in her handbag, then shakes her head and laughs as she finds her card. The teller inspects it, looks confused, and hands it back with a question, to which the customer frowns and looks unsure. She glances around at her surroundings, uncertain.
The presenter continues, "Sometimes a person with dementia may just take longer than usual to fill in a form, organise their cash or answer a query. They might experience difficulties with their memory such as forgetting to pay a bill, or paying the same bill more than once. As dementia progresses, complicated tasks that require memory, reasoning and risk assessment become more challenging."
In the manager's office, the customer sits down with the manager, a man in a shirt and tie, in his forties. He hands her a business card, which she takes with a smile, and they shake hands. He gestures as he asks her a query, and she searches in her handbag for a letter which she unfolds, handing it to the manager. Another woman, in her thirties, enters and greets the customer with a kiss on the cheek as she sits next to her. She shakes hands with the manager, and he hands her a business card too, which she reads carefully before smiling at the customer. She nods at the customer, who nods back, and the manager explains something to them both.
The presenter says, "As a result, there is a heavier reliance on family, friends and carers. Eventually, a person may reach a point where they are legally considered to not have the capacity to make decisions, or appoint an enduring power of attorney. Legal conditions can vary from state to state, so it is worth seeking legal advice before granting or accepting an enduring power of attorney."
In the bank, the customer stands at the counter with a young man standing close behind her. She pulls her purse from her handbag and talks, confused, to the teller – also a young man – glancing over her shoulder to the young man behind her, who leans over her shoulder and talks over her. She holds up a hand to quiet him.
The presenter continues, "People with dementia are more at risk of financial exploitation, due to their increased reliance on others. It is important to be aware that the level of involvement by carers or family members may vary between people in different situations, or at different times. Communication should be clear, and direct."
Another teller – a young woman smiling pleasantly – now talks to the customer, who smiles at first, then frowns, confused, as she places her purse bank in her handbag. Distracted, she smiles again to the teller, who listens patiently, before taking her handbag and walking away, disturbed.
The presenter walks towards camera again. She says, "Dementia is confusing, and can make every day transactions seem stressful. A slow, reassuring tone is helpful, and patience is important if a person's behaviour is repetitive. Everyone experiences dementia differently, but there are plenty of ways we can help to make the banking experience an easier and more rewarding one."
She continues walking.
By the time I finish this sentence, someone else in the world will have been diagnosed with dementia.
That's one every seven seconds.
This means within thirty years there will be more than one hundred million people living on the planet with dementia - more than four times the population of Australia.
So if you don't know someone with dementia yet, you will soon.
Remember: not all forms of dementia are the same.
Some might make it hard for a person to remember something that just happened, even though they can remember things that happened years ago.
But in other forms of dementia, memory loss might be less noticeable than sudden changes in mood, dizziness and unsteadiness, or even hallucinations.
Think about it this way: have you ever had one of those dreams where no one could understand what you were saying, no matter how hard you tried? You wake up, confused, and realise that none of it made any sense - but it felt real to you at the time.
Sometimes that's how a person with dementia feels. Remember, what they're feeling makes sense to them, even if it doesn't to you.
Sounds confusing, doesn't it?
Now consider this person surrounded by noise and distraction: in a shopping centre, for instance, or a busy workplace. That's what I'd call a challenge.
But it's the challenge that a person with dementia faces every day.
So what can you do to make life a little bit more fulfilling?
When you find yourself faced with unusual behaviour - it might be confusion at simple instructions, or repetitive questions - ask yourself the question: could this be dementia?
A person with dementia will find it much easier to understand you if you speak calmly and in short sentences. It helps to maintain a friendly attitude, in your body language and your eye contact.
If possible, you could even help by moving the conversation away from any distractions or loud noises. If a person with dementia is older, maybe you could take them somewhere they can sit down: it can all help to make communication easier - for both you and them.
The main thing is to be patient. We all lead busy lives, and it's not always easy to consider the reasons behind someone's behaviour.
For more about communication, you can go to the "Additional Information" section on this resource.
No matter how independent a person with dementia is, they rely on the care of their friends, families and their communities. Everyone deserves the chance to get the most out of their lives, and with a little effort you can be a big contribution to that.
As the population ages, you're more and more likely to come face to face with dementia. It could be in your work, but it might also be in your everyday life. It might even be a friend or a family member.
If you feel the impact of dementia, how do you want your community to respond?
Understanding dementia won't just help you deal with situations in the workplace - it helps reduce the impact for everyone.
So next time you find yourself faced with unusual behaviour, why not ask yourself: could this be dementia?