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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.
The prison population is getting older, and it's increasingly likely you'll encounter an inmate with dementia in the course of your work.
You wouldn't make a prisoner lift with a broken arm. But if an inmate has dementia, there won't be a bandage or a sling to show you. The warning signs of dementia are subtle, and they're different for everyone.
An inmate with dementia may experience memory loss, confusion, or even physical difficulties. Their behaviour might change - you could catch them on a good day, or a bad one.
No matter how a person experiences dementia, its effect on their behaviour is unintentional. When that's not obvious, life can be confusing - for everyone.
That's why understanding dementia can help to make your work easier. Keep your eyes open. Talk to your workmates. And ask yourself the question: could this be dementia?
Listen to the audio version of the transcript (right click & save target as to download)
A maximum security prison, surrounded by gum trees, on a cloudy day. A white van passes a small garden and enters through a gate surrounded by barbed wire. A pair of feet in white sneakers step out, and walk forward: an older inmate in a tracksuit is ushered by a prison officer by a small flower bed. The inmate stops and stares at a green succulent flower in a patch of dirt, before the officer ushers him onward.
Inside an examination room, the inmate flicks a pen in his fingers – his hands are cuffed. The officer takes the pen from him as a female social worker opens a file as he says, "Nigel Stewart, transferred from remand, sentence plan includes employment and education options. Show your ID." Nigel slides his ID across the table to the social worker and says, "Yeah, I know the drill. Nigel Stewart. You've got a reservation for me." The social worker takes his ID and glares at him, saying, "Watch it." Nigel glances at the officer, saying, "I've got a request." He leans in towards the social worker, saying, "A pot. About this big." He makes a circle with his cuffed hands. The social work smiles, and the officer says gruffly, "We'll see. You behave yourself first." Nigel sits back.
The prison officer walks down a corridor, attempting to flick the pen in his fingers. In his cell, Nigel makes his bed, seeing the officer as he walks past. He nods to him, saying, "No, do it on the thumb and forefinger." The officer tries, saying, "Yeah, right." Nigel makes his bed, asking, "Hey when's my next review coming up again?" The officer replies, "Not till the end of August." Nigel nods, saying, "Right." As he bends down, the officer's eye is caught by something behind Nigel – an empty green pot, on the windowsill. The officer smirks, and walks on down the corridor.
High fences surround the prison.
The officer marches around the garden path, pausing as his eye catches something on the ground: the patch of dirt where the succulent was is now a shallow hole in the ground.
In his cell, Nigel waters the succulent, now in a green pot. The officer passes his open cell door and pauses, saying, "Nigel, why aren't you in the paint shop?" Nigel looks up at him and says dryly, "Early retirement." The officer smirks and nods, walking on.
In the corridor, the officer approaches a younger officer and asks, "Richard, why's Nigel Stewart off painting?" Richard answers, "He got fired, didn't he?" Richard marches on, leaving the officer thinking for a moment, before turning and walking the other way.
In the paint shop, inmates work as the foreman puts down a drill, talking to the officer behind him, "He wouldn't do as he's told." The officer asks, "What, he wouldn't work?" The foreman replies, "Nah, I'd show him how to use the new gear but within two minutes he's back on the old machine. He'd just never finish his work."
In the corridor, the officer locks a cell door, moving on to the next, checking it, then stops as he passes Nigel's cell. Nigel is writing as his desk, the succulent in its pot in front of him. The officer asks, "You right?" Nigel turns, twirling the pen, and asks, "Yeah, when's my next review?" The officer replies, "Still the end of August." Nigel looks blank, saying, "Is it?" He drops the pen. The officer says, bemused, "Yeah." Nigel stares, saying, "Right." As the officer locks the cell, Nigel looks annoyed, saying, "Oy, my door!" The officer calls through to him, "You're in max now, once a day, remember?" Nigel stares blankly, replying, "Oh. Yeah." As the officer walks away, Nigel stares, confused.
As they walk up a corridor, Richard asks the officer, "Did you have problems with Nigel Stewart again this morning?" The officer replies, "You notice anything up with him? Has he been down the last week or two?" Richard replies, "Him, down? He gets a bit agro on and off, but if anything he's been a bit too friendly for my liking." The officer remarks, "Mmm, he got fired from work duty." Richard asks, "Too much lip?" The officer responds, "No, he wasn't finishing." Richard says, "Oh, that's a surprise, he told me he's done paint shop work before." The officer thinks.
Outside, the clouds hang overhead.
The officer walks up a prison corridor, twirling the pen on his fingers, to find Nigel sitting on his bed, staring at the wall of his cell. He sees the officer, and they nod to each other, before the officer walks on. On the desk, the succulent hangs, dying, in its pot.
Listen to the audio version of the transcript (right click & save target as to download)
A bright, sunny day. High metal fences, topped with barbed wire, surround an exercise yard at a minimum security prison.
A female prison officer asks her male colleague, "You watch the footy last night?" He sighs, saying, "I was working." They are both watching as two inmates argue, the largest with his back to the officers. The female officer marches towards them, ordering, "Hey! Cut it out! What's going on?" The fight gets heated. The male officer spies a lawn mower, sitting unattended in the middle of the yard. He calls out to a bearded inmate sitting against a fence by a pair of brooms, "Harry!" Harry looks up at him, as the officer continues, "What do you think you're doing?" Harry replies, "Waiting." The officer barks, "Well you're done waiting, get back to work!" Harry blinks and stands, saying, "Alright." He walks away from the direction of the lawn mower. The officer calls out, "Where are you going? You're on mowing!" Harry pauses, looking at him. The officer motions with his head. "This way." Harry glances over, then says "Yeah I know. I know." He walks towards the mower, as the female officer returns to the male officer, saying, "Yeah, watch him. He's pushing it." She walks away, as the male officer watches Harry.
An accommodation block, single storey, surrounded by gum trees. In a small cell Harry sits on a bed, looking upset, as another inmate talks in the hall outside, "I've got to get in, I've got to get in!" The female officer replies, "Calm down, just settle down." The male officer marches down a corridor towards the female officer and the inmate, who insists, "It's not his room anymore." The female officer responds, "I don't care, you don't touch him." She looks up at the male officer, who glances into the room to say to Harry, "Harry, back in your own room." Harry replies, "This is my room!" The female officer argues with the inmate as the officer says, "You moved, remember? Come on, get out of there!" Harry looks confused, then stands and walks out, saying, "What does he want my room for?" As he passes, the officer says, "Enough!" The officer watches the inmate enter his cell, before following Harry up the corridor.
Night, and a prison officer looks down over the lamp-lit yard. The officer exits a gate labelled "No Prisoner Access", followed by a younger officer who greets him, "Heya Bill", before speaking into his radio, "Sorry Trace, go again?" Bill asks him, "How was it today?" as Tracey responds on the radio over their conversation. The younger officer replies "Ah, same as usual. Catch the footy last night?" Bill replies, "Nah, taped it. Hey, has Harry been acting up for you lately?" The officer shakes his head as they walk down a path beside a block of offices, saying, "Not that I've noticed. Actually he's been pretty good. Although Tracey says he keeps not picking up his diabetes meds, so they have to keep sending for him?" The officer walks off to respond to his radio, but Bill pauses, asking, "Chris, he's not bothering, or he's forgetting?" The officer shrugs, saying, "How should I know? Tracey's given him a warning though." They walk away in opposite directions.
The next afternoon, the prison carpark is full as the young officer and Tracey walk side by side. A car pulls alongside them, and they wave to it, saying "See you tomorrow!" Driving it, Bill opens his window and asks, "Hey Tracey, Harry on three, has been acting up-" The young officer interrupts, swinging his keys, saying, "Day's over mate!" He talks to Tracey as she talks on her phone, stopping to ask Bill, "Has he been acting up again?" Bill replies, "I don't think he's acting up, Chris said health services keep having to send for him to pick up his diabetes pills." Tracey replies, "Yeah, for about the fourth time now," then returns to her phone. Harry persists, "Well what does he say when you ask him?" Tracey replies, "Oh, he always says he's done it already but he never has." Bill thinks, then says, "So he's forgotten." Tracey reaches her car and turns, saying, "I don't know." Bill asks, "Did you report it?" She is distracted by her phone, so he asks again, "Did you report it?" She grins at him, saying, "I haven't got time for that! Go an watch the game." He thinks, before driving on.
Barb wire tops a fence by a cell block. Inside, Harry sits on a bed in a cell, staring at the wall. Bill enters and stands in his doorway, asking, "You good Harry?" Harry looks up, smiles, nods, saying, "Thanks." He looks dazed. Bill smiles, nods, and walks on, Harry watching him go, before staring back at the wall.
Prison is a challenging environment for any inmate. But the lifestyle of many inmates prior to prison heightens their risk of dementia.
Ageing, limited education, substance abuse and acquired brain injuries are just some of the factors that increase the likelihood that an inmate develops dementia - and indigenous inmates are in an even higher risk demographic.
Dementia is not the same as mental illness. There are no medications that will reverse the condition, and the behaviour of a person with dementia is not always intentional.
Repetitive questioning, wandering, and difficulty following instructions are all problematic behaviours in an inmate. But if the behaviour is unintentional, punishment may not be the best prevention.
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?