PATIENT STORY: Stephen is a retired engineer in his mid 70s from south Co Dublin. About two years ago his wife noticed he was getting progressively more forgetful. He began to forget the names of his grandchildren and could not remember where he had put the car keys. His symptoms became progressively worse and his family brought him to see his GP.
The family doctor referred Stephen to the local geriatric services where he was investigated thoroughly for any reversible cause of dementia. Those tests were normal and he was discharged home with a presumptive diagnosis of Alzheimer's disease.
He managed at home for a further 18 months. It was a difficult time for his wife as Stephen took to following her around asking repeatedly "take me out" or "you said you'd take me home". When he did go out on his own for a newspaper, he had difficulty remembering his way home from the local shops. On several occasions he was brought home by neighbours which the family found very embarrassing.
Eventually it got to the stage where Stephen's wife was afraid to leave home. She effectively became bound to the house, except when she took her husband for drives to break the cycle of repetitive questioning. The stress on her as his main carer became almost unbearable and the family realised that it was no longer sustainable for Stephen to remain at home.
They discussed the options with the family doctor; one of those was the dementia unit (Iona Ward) in the Royal Hospital, Donnybrook, Dublin. After a visit there, it was decided to make a formal application for admission.
It took six months for a bed to become vacant; during this time support in the form of a day-care centre and a home-care worker was provided by the Alzheimer's Society.
Stephen was assessed by the medical director of the Royal Hospital, Dr Mary Deane, and admitted there. The main criterium for admission is that the patient is mobile, as the dementia unit is designed to maximise mobility and independence. A sitting and activity area is adjacent to the eight-bedded sleeping area which allows Stephen and others to move freely from one area to the other, even at night.
Stephen benefits from occupational therapy and physiotherapy as well as expert nursing care. His family members visit him regularly and have created an album of old photographs and memories which Stephen relates to on visits.