The doctors in a general practice employ many different staff, especially if they are part of a large busy partnership. Most people will meet one of the receptionists before they meet their doctor. Some receptionists are better than others, but all should take patients’ and relatives’ problems seriously and treat them with consideration however harassed they may themselves be feeling. They should never be allowed to make diagnoses and they should never fob patients off. Anything they are told should be treated as confidential; strictly speaking, there is no reason at all why they should know anything about the problem that has led to the request for a consultation with the doctor.

Of the other medical staff, older people with dementia are most likely to meet the health visitor or the district nurse. The latter is particularly responsible for helping to provide nursing care to sufferers in their own home and this will be more important later on in the course of a dementing illness. In many areas, district nurses are supported by auxiliary nurses who help with jobs like washing and bathing. The district nurse is trained to appreciate the needs, physical and emotional, of patients and their relatives, to provide appropriate care, and to summon up other members of the community health team when required. She will also keep the doctors informed about the physical condition of her patients.

The health visitor is someone who has trained and practised as a nurse and often also as a midwife. She receives additional training, especially in prevention of illnesses. In the past health visitors have tended to concentrate on young people and children but with the increasing numbers of older people they are beginning to play an important role with this age group too. She will be able to give advice and mobilize extra resources if they are needed. Unfortunately health visitors are in short supply.

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