Some thoughts from my desk

Dr Allan Shell sits down to pen his thoughts on dementia in general practice, and how you can help promote quality of life, rather than just longevity of life, in your older patients.

  When we as GPs consider health prevention, we perceive ourselves as being the experts in consultation or people skills because we do a lot of person to person healthcare. I believe that, for too many of us right now, this is in stark contrast to the way we deal with our patients living with their dementia.

  I have now been a general medical practitioner for over 40 years. And, like many of you, I have benefited from the many quality medicines that my GP has prescribed, and personally witnessed some of the fantastic life-saving procedures that are being done in Australia.  

However, it sometimes seems that we have also created a ‘longevity of life’ rather than a true ‘quality of life’ for some of our older patients. As one of the lucky “baby-boomer” generation, getting older for me is an enjoyable experience - surrounded by healthy adult children and delightful grandchildren – but it’s not always lucky for some.  

Dr John Crimmins recently stated that “as GPs we always appear to define ourselves by the particular knowledge that is applicable to our discipline or a particular set of skills”. I have been one of those GPs fortunate enough to redefine my particular knowledge and to impart that new knowledge and skill to others; and, to redefine myself as a GP expert on the topic of Dementia, as an Academic GP and Adjunct Lecturer (UNSW).  

In interviewing medical colleagues on the topic of Dementia, on a number of occasions and in a number of regions, they most often complain about having “not enough time” to manage the patient living with dementia. And, sometimes, not enough time for the person(s) caring for that person living with their dementia.  

It’s time to stop and consider having more time for all your patients living with their dementia, and to also consider spending your valued time with ‘the people living with the people living with their dementia’.  

“Ah, there’s nothing you can do about that (Dementia)”, you’ll say. Well, “I beg to differ”, I will say .  

GPs are the first contact for the majority of older patients in this great country of ours, and we need to coordinate their care for a more enjoyable ‘quality of life’, not just a ‘quantity of life’. Making the effort to update your skills (by participating in ThinkGP’s online ALM for example) to actually “co-ordinate a patient’s care”, when he or she is living with their dementia, will ensure that you are a prime component in the health care management of that person living with dementia and their carer(s). To learn more about the assessment, diagnosis and management of dementia click here.


Breonny RobsonAllan Shell, MBBS, Grad Dip PH
Allan has an extensive background in general practice & has been involved with the Primary Dementia Collaborative Research Centre (DCRC) as an Academic GP, & as a Visiting Fellow within the School of Psychiatry at UNSW since 2009. He has co-authored a number of peer-reviewed papers on dementia & is involved in a national project to promote "a more timely diagnosis and better management of dementia in general practice”.