Dementia Care

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This issue of the AJDC is very special for me. Many of the articles in it
have been written by colleagues who I worked with in the Dementia
Training Study Centres’ (DTSCs) program. A program that, as you will read in
Margaret Winbolt’s reflective piece, occupied us for very nearly 10 years. The program
that made it possible to launch the AJDC.
But those articles are not about the past, they are about the new incarnation of the
DTSCs – Dementia Training Australia. This is the consortium that will deliver training
and education to the workforce providing care to people with dementia across
Australia. There are also articles written by new colleagues from the University of
Tasmania and Alzheimer’s Australia who complete the DTA consortium, and by
HammondCare staff who are delivering the new national DBMAS and SBRT services
via Dementia Support Australia. Combined, these new programs represent a concerted
effort by the Department of Health to cover the spectrum of training and support needs
of aged and health care organisations wishing to provide high-quality care to people
with dementia. There is a sense of a new direction emerging.
Perhaps another sign of this new direction is to be found in Catherine Barrett’s article
on love, personhood and dementia. It describes Australia’s first symposium on
dementia and love, being held next year in Victoria. It has been many years since I have
heard the words love and dementia used in connection with the delivery of care by
professionals. I do remember the phrase ‘tender loving care’ (TLC) being used in
psychiatric hospitals in the early 1980s, but it seemed to me it was always used to
indicate that nothing could really be done for the patients and we should resign
ourselves to falling back on this platitude.
Looking back on those days, and most of the time since, I think we were all pretty well
trapped by the pathogenic model. We saw the person with dementia as a combination of
problems and our task was to solve each of those problems. Tom Kitwood tried to
rescue us from this and if we had found a way to actually consistently practice person-
centred care then we, including people with dementia, would be a lot better off. But,
with some shining exceptions, we haven’t found a way and, in the majority of places,
the term person-centred care has become another platitude.
Perhaps we need to shift our position a little and try to put things into a slightly
different perspective; use some new words that might help us see things afresh.
If we have been trapped by the pathogenic model, then we might find a new
perspective by experimenting with the salutogenic model. Salutogenesis is a term
coined by Aaron Antonovsky, a professor of medical sociology who used it to describe
an approach focusing on factors that support health and well-being, rather than on
factors that cause disease (pathogenesis). An excellent example of its application is to be
found in the design of the Royal Children’s Hospital in Melbourne, a building that
expresses joy, love and engagement with life. One way of shifting our perspective
would be to stand in that hospital, looking at the sharks in the aquarium, the three-
storey monkey, the children playing the interactive games on the walls or using the
specially designed seats as shops and castles, not to mention the meerkats, and ask
ourselves the questions: ‘Why do kids have all the fun?’, ‘Why are we so focused on the
problems, particularly the behavioural problems, when we can see that supporting a
full life has better results?’
Australia’s new dementia training and support services, along with the first
symposium on love and dementia, described in this issue, may be signs that times are
changing. Perhaps it is time to experiment with words that have proven their use in
other fields to see if they can help us to gather new energy for the next phase in the
development of services for people with dementia. I recommend that we look into the
salutogenic approach to see what it can do for us and the people we care for.
Executive Editor Professor Richard Fleming
(02) 4221 3422,
Managing Editor Kerry Schelks
UK Editor Mark Ivory
Production Editor Andrew Chapman,
Website Manager James Baldwin
Publisher Dr Richard Hawkins
The Australian Journal of Dementia Care is
published six times a year by Hawker
Publications Australia Pty Ltd, 7 Conrad
Place, Wishart, QLD 4122.
Printed by Spotpress, Sydney.
© Hawker Publications Australia Pty Ltd 2016
ISSN 2049-6893
Advertising Kerry Schelks
Address Building 233 (ITAMS), G13,
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Subscriptions $95 per annum (see
page 40 for details) from DCA,
Australian Journal of Dementia Care
Advisory Board
Professor Elizabeth Beattie, Director,
Dementia Training Australia, Queensland
University of Technology
Professor Henry Brodaty AO, Director,
Academic Department for Old Age
Psychiatry, Prince of Wales Hospital and
Dementia Collaborative Research Centre,
UNSW
Marily Cintra, Executive Officer, Health and
Arts Research Centre, Inc, Canberra
Dr Penny Flett AO, Medical Lead,
Brightwater Care Group Oats Street
Rehabilitation Service
Emeritus Professor Rhonda Nay,
La Trobe University
Kathryn Quintel, CEO, Alzheimer’s
Australia SA
Tara Quirke, Dementia consultant and
educator
Margaret Ryan, Head of Dementia
Services Group Development, Bupa Care
Services, Australia
Dr Andrew Stafford, Director, Dementia
Training Australia, University of WA
Dr Margaret Winbolt, Director, Dementia
Training Australia, La Trobe University
Disclaimer
The opinions expressed in the Australian Journal of Dementia
Care are those of the authors and are not necessarily those of
the publisher. Furthermore the publisher and authors do not
assume and hereby disclaim any liability to any party for any
loss, damage, or disruption caused by errors or omissions,
whether such errors or omissions result from negligence,
accident, or any other cause.
Writing for AJDC: Do you have a project or survey to
report, or a change in practice organisation or structure
which has worked well (or not), and would you like to
share this experience with others? We welcome
contributions of this kind, as well as bright ideas for
improving the environment or well-being of people with
dementia, and letters to the editor responding to
articles in AJDC. Contact Richard Fleming at
TheAustralian Journal of Dementia Care is a multidisciplinary
journal for all professional staff working with people with dementia,
in hospitals, nursing and aged care homes, day units and the
community. The journal is committed to improving the quality of
care provided for people with dementia, by keeping readers
abreast of news and views, research, developments, practice and
training issues. The Australian Journal of Dementia Care is
grounded firmly in practice and provides a lively forum for ideas
and opinions.
A new direction emerging?
C O M M E N T
2 Australian Journal of Dementia Care December 2016/January 2017 Vol 5 No 6
By Professor Richard Fleming , Executive
Editor, Australian Journal of Dementia Care