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A visit to the doctor (Dementia-friendly?)

Updated: Aug 31, 2023

We did not go often – It required a walk and a short bus journey to a part of town where the houses were bigger – an impression magnified by their being on a hill, with drives sloping upwards.


We were mother and me and my brother. We huddles along with others into the waiting room, which was the front room of the large, high house. Bent wood chairs, wooden cladding to the walls and an array of old photographs which showed the doctor as a younger man, in military uniform and as one of a triumphant hockey team.


As the clinic time arrives, Dr S would come into the waiting room to welcome us all. Mum shot to an erect sitting position and breathed: ‘Good morning doctor’, almost reverently. We waited our turn and inhaled the strange medicinal scents which drifted about the room; wondered at the ailments of others.


When we were really ill, Dr S would visit us at home. He had delivered me in the back bedroom of grandma’s house just down the road from our house.


Providing better specialist services for older people with mental health problems, some with dementia, from the mid-1970s, we learned that home visits were a preferred and most effective mode of first contact and follow up. But in the 2000s we began to work with Ian Greaves and his team at Gnosall to provide integrated services within Primary Care. It was a magical formula – seeing people in a setting they know and trust – a setting which knows about them and their families – now and from earlier days. The waiting area is open and modern – purpose built – but there was a welcome for everyone by name from the receptionists, a toilet nearby if needed, and another welcome in the privacy of the consultation room. Every dimension of the patient’s story was available there and then, helped by computerised records


If people were not able to come to the clinic – a home visit was always possible


Our local surgery has moved into a Medical Centre shared with another Practice. White wall, silent adverts and information on screens. The waiting area is large, open. People come and go to disappear along corridors lined by numbered grey doors


Patients are not greeted by the receptionists but walk humbly by toward the electronic check in where we are recognised, in silence, by number: day born, month born, year born. Are you Dr David Jolley? Etc


All in silence and secret. So we sit – mostly in silence and on seats which are comfortable but fixed to determine which way we face. People come and people go. The receptions from the two surgeries are spread along the airport-style desk and conduct quite loud and intense conversations with other patients by telephone – occasionally interrupted by a queue of living patients within the clinic. You can’t help but make up stories from the fragments innocently and carelessly shared by the receptionists – cross cultural – cross Practices!


Secrets are blown as the screen displays your name and actually says it out loud – and you stand to be recognised before scuttling along the corridor of numbered rooms. Poor doctor – so far away from the action – conducting a warm and helpful consultation – informed by computer and feeding back to the computer – But thankfully knowing us – and promising follow up and a home visit as needed




 


Each week we post a blog from David Jolley where he shares his personal views on relevant subjects.

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