The Big Big D

2nd September 2025 Going Postal Health, Science 0

From HMS Pinafore:

Captain:

Bad language or abuse, I never, never use,
Whatever the emergency;
Though “bother it” I may occasionally say,
I never use a big, big D —

Chorus: What, never?
Captain: No, never!
Chorus: What, never?
Captain: Hardly ever!

When William Schwenck Gilbert wrote those words it was considered too risky to say the word ‘damn’ on stage, hence his allusion to it rather than having the captain actually say the word.

Today we have no such qualms and much worse passes the lips of actors on stage and screen. But there is still one word that ‘dare not speak its name’ – dementia. That’s today’s big big D.

In the coronavirus episode, about 200,000 people in the UK died within 28 days of a positive test. Today we have a million people with dementia. It’s sobering to think that we have five times as many people with dementia as with the lurgy, but the country was turned upside down for that bug while for dementia – not so much.

There are over 200 types of dementia, with the most popular being Alzheimer’s (if that’s the right way to describe a disease!). About 90% of sufferers have Alzheimer’s, but there are also young onset dementia, vascular dementia, dementia with lewy bodies, frontotemporal dementia, primary progressive aphasia, just to name a few.

We all get a tad forgetful as we age, that’s normal. Now where did I put my keys? Take a moment to see if any of the following apply to you or a loved one:

Difficulty with everyday tasks such as paying monthly bills, following recipe when cooking, instructions on flat packs.
Repetition – when writing letters, doing things twice.
Communications. Forgetting words, completely losing the conversation.
When out on your own, forgetting your way home. Being unable to remember where you are going or what for.
Personality changes, very rapid, a person can sometimes become aggressive. Stops reading books, active person becomes lazy.
Easily becomes confused as to times and places.
Regularly misplacing things, eg keys in fridge, watch in sewing basket. Ah, that’s where my keys are!
Troubling behaviour, such as having trouble dressing, putting other people’s clothes on.
Difficulty with abstract thinking, finding it difficult to absorb information from things you read or you are told.

So what causes it, and what should you do?

Alzheimer’s is caused by a build-up of amyloid and tau proteins which form plaques and tangles in the brain. Connections between nerve cells are lost and there are less chemicals to send messages around the brain. Maybe that should be fewer chemicals… Over time, this causes cells to die and brain tissue is lost.

You would think that there would be a blood test that can identify the build-up of these proteins, but there isn’t (yet) so we only get diagnosed when we are a long way down the path and symptoms such as forgetfulness start to appear. If you are lucky enough to get an early diagnosis, there are drugs that arrest the development of the disease, and in my view this is almost as good as a cure as it prolongs the time when you can be active and independent.

So if you think several of the warning signs apply, what should you do?

First, book an appointment with your GP to ask for a dementia review. Your GP might carry this out, or you might get a referral to a specialist unit. You might get the all-clear, or you might get a diagnosis. If you’ve got it, your diagnosis is the first step on the path to living well with dementia.
Discuss your diagnosis with family. You can use the time now to do some planning. There are things like an Advance Care Plan you can draw up, to make it clear how you would like to be looked after. And if you have a trusted relative, consider drawing up a Lasting Power of Attorney, so your attorney can make decisions for you, either financial or medical or both.
Do you drive? You must let DVLA know about your diagnosis. They don’t automatically take your licence away, but do check with family if they notice any safety issues.
Look for a support group and join it, with your partner if possible. Local support groups can be a source of much information about the benefits and help you are entitled to, as well as a valuable source of encouragement from people in the same boat as you. Get a copy of the helpful booklet ‘Knowledge is Power’. Much good advice can be found on self-help websites, and I recommend: Dementia Guidance
Look out for dementia-friendly activities in your area. These groups – memory cafes, walks, and the like – are often attended by people from the Alzheimer’s Society or Admiral Nurses. They will offer free booklets with all sorts of useful information, from applying for Attendance Allowance to reductions in Council Tax, to getting a Blue Badge.
And finally – know that a diagnosis is not the end, it’s more like the beginning of a new chapter. Many people live well with dementia, and there is a lot of support out there. You are definitely not on your own. So reach out and you will be pleasantly surprised at the help that’s available.