Amour

There is something universal about the language of love. Across the world we may have many different words for it but the meaning remains the same, and most importantly of all the endless ways of demonstrating it transcend barriers. There isn't a word that can truly convey the beauty or perfection of love.

Towards the end of 2013 I did a radio interview where the presenter repeatedly quizzed me about why I chose to care for my father instead of going to university and doing all the 'normal' things that people in their teens and twenties do. My very repetitive reply was that he was my dad and I loved him.

It was a simple sentiment, and I honestly felt no need to be more expressive. Yet clearly my thought processes, emotions and feelings were somewhat lost on the presenter, who seemed utterly baffled by what I was trying to convey, so much so that he rephrased his question on several occasions.

Is it really so difficult to understand that you would care for a loved one because they are just that, a loved one? The materialism of life, and the desire to climb the greasy pole to facilitate that materialism that is educated into our children at ever younger ages, didn't pass me by, it just never interested me. 

Why? Because some things are more important. A person is more precious than any 'thing' you could buy or have, and the feelings a person can elicit in those who know them are more powerful than any 'thing' could hope to emulate. I never weighted up the option of a university education and the potential for a high-flying career against my dad's needs. Maybe that makes me very odd, but I know I'm not the only person who would have acted in this way.

Millions of family carers do what I did, some do much more, others less, but I would suggest most do what they do because of love. For some it will be duty and they will feel burden not love. For others it may be a situation of convenience or dictated by a financial motivation. But for the vast majority it will be unconditional, selfless love.

Wordsmiths far more illustrious than I have tried to explain what love is, but as I said earlier, my personal view is that it goes beyond words. It's actionable rather than explainable. You may think the greatest manifestations of it come from major life-changing moments like meeting your partner, marriage or the birth of a child, but as many a carer could tell you, it can be far more subtle everyday moments.

Dementia taught me to tell my dad I loved him every time I saw him. I say dementia taught me because a diagnosis of a terminal disease makes it imperative that you make the most of every moment. There isn't time to be bashful - you will have a long time to regret what you didn't have the courage to say or do.

Saying those three little words was a verbal expression of my feelings to a man who often never responded. But during the moments when he did respond, and jumbled words along the lines of “Love you too” came out of his mouth, it was like magic. Most days we settled for much more subtle expression - a squeeze of the hand, singing a line in a song, our eyes meeting or a reciprocated smile.

Really simple everyday gestures that ooze love are amazing, and people with advanced dementia can have a real advantage over people without dementia in those situations, since they rely so much less on words and much more on action, however subtle it might be. If you as the recipient aren't alert to those moments they may well pass you by. If anything should motivate you to be more observant then that is it - believe me, it’s worth it.

All the things you do as a carer, from the simple to the complex, from the advocacy to the laundry, the shopping to supporting eating and drinking, all of those contain subtle moments that show your love. Moreover, during those difficult moments, the sadness, the emptiness, the emotional rollercoaster of being a carer, it's the love you feel that gets you through. Perhaps that is why the theme of love, of being loved and feeling love, feature so prominently at most funerals - in the toughest times, love can pull you though when you feel you cannot give any more or go on being.

After that radio interview, I thought about what might have prompted the presenter’s line of questioning, and the persistence he showed in trying to elicit a different response out of me. Perhaps university was the best time of his life and he felt I'd missed out. Perhaps he thought the lack of a career and the financial security that could have come from that had deprived me of opportunities to see and do things that have now passed me by.

Or maybe he had just never been a carer. Or lost a parent he loved. For anyone who has, I think my motivation for doing what I did would be very clear. Of course the great beauty of life lies in the fact that we all take our own path, for better or worse, and what was right for me wouldn't be right for everyone.

Finding love, expressing love and appreciating the many different ways in which love can manifest itself is the greatest joy life can give you. Caring for my father was a privilege and a blessing that I wished had never ended. It was borne though love, sustained though love and lives on though my work, which incidentally I also love! The joy of amour is truly a wonderful thing.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook 

Reaching for the stars

It seems very appropriate that today, on World Alzheimer’s Day and Dementia Awareness Day (DAD), I’m doing a Memory Walk for Alzheimer’s Society, hoping that memories of my dad will give me lots of inspiration and strength for the 10km. Sometimes the symmetry of life is simple and yet so very clever.

The walk will have a two-fold benefit in A) getting me a bit fitter (exercise being good to prevent dementia and a host of other diseases), and B) raising money that I hope will go into funding vitally needed local services to support people to live well with dementia in their communities. It will, of course, also help to raise awareness of dementia, but for me that is where Dementia Awareness Day really comes into its own.

The blog I wrote for last year’s Dementia Awareness Day – ‘So how much do you know about dementia’ – remains to date one of the most popular blogs I’ve ever written. It explodes myths, busts stigma and re-enforces the messages that are most likely to help people to live well with dementia, and indeed create more dementia friendly communities for them to live in.

All of the work I do is about using my personal experiences to inform and educate, support and empower. Looking over my blog, I honestly wish I’d had this resource when my dad was first diagnosed (and indeed before that point), so I hope it helps to fill that gap for families who are living with dementia today.

Being an ‘Expert by Experience’ is an honour. However hard my dad’s dementia was at times, it was a privilege to be entrusted with caring and loving him when he was at his most vulnerable. To be that close to someone who had given me so much (life no less!) is special in a way that words really cannot accurately do justice to. You really had to have been there.

If there is one thing I wish I could give every person, it’s the uniquely special nature of those moments without the pain that dementia causes. I wouldn’t wish dementia on anyone, but I would wish for everyone to be able to learn the life-lessons that I did. If I could bottle that, I’m sure the world would be a better place.

In many ways I’m an idealist, a person who sees good before bad, hope before despair, and who tries to make the best of every situation. I care so passionately about looking after humanity, and making the lives of our most vulnerable people the best that they can possibly be. I want to inspire everyone to love our older generations, and to make living with dementia – at any age – about living and not just dying.

Sometimes I want to reach for the stars, then I remember that I’m only 4’6”! But days like today are a reminder that we can always push ourselves harder (my 10km), that raising awareness of dementia with just one more person is an achievable aim for everyone (DAD), and that the love of those who are such a focal point in our lives never dies. Somewhere up in the stars my dad’s watching, and with his help who knows what is possible.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

Sense and simplicity

One of the many positive things to come out of the increase in dementia awareness is the focus on how we provide the best possible care for people living with dementia. The importance of training for everyone involved in dementia care has never been higher on the agenda, and there is a huge desire to equip people from all backgrounds with the skills and knowledge needed to enhance quality of life for everyone with dementia, but what does good dementia care training really involve?

So many people ask my advice on dementia care, not just from a personal standpoint but also from a professional and business point of view. My answer is always the same – keep it simple. I am not a fan of complex theories, extravagant ideas or novel concepts – everything I have ever seen work best for my father and numerous others living with dementia is simple, down-to-earth, logical care that focuses on the individual, their personality, passions and interests, keeping their past constantly in mind, living in their present, and giving them the best possible future.

Underpin that with strong bonds between the carer and the person with dementia, deliver that care with compassion, empathy, dignity and respect, and voilà – you have good dementia care. Nothing fancy, nothing ground-breaking, just the implementation of the obvious, or maybe it is only obvious to me because my father had dementia for so many years and during that time I saw some of the very best, and worst, dementia care.

Those who are living, or have lived, through a loved one’s dementia journey are often the best educators. We notice what others ignore, and having felt the whole range of emotions - and in my case seen dementia from the very beginning, through numerous stages and symptoms over many years to those final days of end-of-life care - you develop an acute sense of how to nurture someone through their dementia journey.

That feeling for dementia is what really needs to be communicated through modern-day dementia training – teaching the mechanical nuts and bolts of care is no longer enough. What does not need to happen, however, is for it to be packaged up in jargon. Carers do not need to be bombarded with new-fangled language to identify a simple aspect of good care. For example, at a recent event I spent the best part of half an hour listening to a very animated presentation on what amounted to continuity in care, where the people presenting the session managed to make the idea of having the same carer regularly looking after a resident that they had formed a bond with sound ground-breaking. Yet over 8 years ago, as my father was settling into his first nursing home, he developed a friendship with a particular carer who was then made his keyworker and remained as such until that carer left, just a few weeks before dad passed away. Not so much revolutionary as the simple application of observation and sense.

I sometimes wonder if that long-standing joke about common sense – that sense is in fact no longer common – actually has a lot of truth in its jest. I suspect that in this drive to be technological and futuristic many people feel that you can only successfully convey a message if you package it up to such an extent that you ask your audience to play a never ending game of pass the parcel. Where care is concerned, however, front-line staff simply do not have the time to unravel ideas – you need what you are being asked to do to be logical, natural and above all else, effective.

Caring for people with dementia can be a very rewarding job. When you understand how dementia can affect a person, why they do what they do and how you can make every interaction with them meaningful for both of you - whether you are passing their room, feeding them a meal, giving them a bath or playing a card game - work becomes pleasurable, the giving and receiving of care happens in an atmosphere of friendship and mutual trust, and a care home becomes a loving community of like-minded people all working towards common goals.

My advice to carers? I cannot stress enough the need to personalise everything that you do for a person with dementia, make it compassionate, and be dedicated in your application. Do this and you will not only serve the people who depend on you well, you will also have the satisfaction of knowing that you have wrapped up the life of someone vulnerable in a bespoke security blanket that brings with it warmth, protection and love.

It is not a one-way street, however. The best, most committed and caring staff can be worn down in hospitals, care homes or by care companies that do not appreciate the need to allow their staff to have the time to work effectively. Good care is never rushed care. Teamwork should involve everyone in looking after a person with dementia, from the person themselves and their family to every staff member. An inclusive care home, where everyone feels valued, whether they are a staff member, a person with dementia or a visitor, is a happy home. Finally, for any employer looking to give their staff the most effective training in dementia, remember those guiding principles of sense and simplicity. When both are commonplace everyone is nurtured and flourishes.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

So how much do you know about dementia?

Awareness is something that is talked about extensively in healthcare. In fact it is fair to say that those of us working in this field are pretty much obsessed by it. Days or weeks designed to highlight particular conditions are important for those wanting to get their message across, but for me every day is an awareness day, offering an opportunity to educate someone who doesn't know about dementia, inform professionals who work within dementia treatment, care or policy making, and most importantly of all, help and support those who are going through their own experiences of dementia.

By far the most challenging aspect of my work comes from getting the message about dementia across to people who do not have any experience, understanding or concept of dementia. They may have some outdated ideas about 'senility', some ‘facts’ they believe that are quickly proven to be fiction, or some very dismissive ideas about how someone with dementia is not worth bothering with, but nothing that represents real life for people living with dementia or their loved ones.

For some people dementia, or as many refer to it by its most common form Alzheimer’s, is actually something to joke about. A quick search on twitter under #alzheimers will soon uncover many people, especially young people, who use this hashtag on tweets about things that they have forgotten, or done that they should not have, to indicate humour. This perhaps sums up many of the wider perceptions that are still out there about dementia, so let me bust a few myths:

• Dementia is not a normal part of ageing (types of dementia are caused by diseases of the brain). 
• There is so much more to dementia than just forgetting things (dementia symptoms are multi-faceted, vary hugely and are individual to each person).
• Dementia doesn't just happen when people get older (young onset dementia, defined as dementia in someone under 65, is increasing and dementia can even occur in children, although this is rare).
• People with dementia are still people, not a disease. 
• Dementia is not contagious. 
• Those living with dementia still want to lead active and full lives and not be locked away and forgotten about (most people want to be cared for at home not in communal establishments).
• People with dementia can make a positive contribution to society if supported to do so.
• You can live well, or live as well as possible, with dementia.

What is important in the long-term care and support of people with dementia is primarily personalisation, compassion and dedication. Personalisation because everyone is an individual and should always be recognised as such in every aspect of their life and care. Compassion because care without it is not care at all, and dedication because dementia is long-term, progressive and terminal, requiring specialised understanding, continuity and commitment to excellence in caring for someone with it.

In the case of myself and my family, we never saw my father as a victim, or considered ourselves to be such. Dementia, whilst cruel in the way it strips back a person’s abilities, can never take their spirit or soul, and with the right therapies glimpses of this are possible until the very end of their life. I have written previously about how we never sought sympathy; what we have always wanted is understanding, acceptance and a will within society to confront dementia and defeat it, and I believe this is true for many people in the same position.

What does dementia teach you? 

• To appreciate the smallest things in life, since they become extremely precious (a simple hello from my dad in his final few months brought a massive smile to my face). 
• To make the most of every day (good days and bad days become an ever-present feature with dementia, and when the good ones come along you want to make the most of them). 
• To never give up (yes there isn’t a cure yet, but there is a lot you can do to make someone’s life with dementia a more positive experience than it would have been ten, twenty or thirty years ago). 
• Finally, in my case, to share our experiences with the world (everything my dad went through is there to inform, educate and influence others. He would have wanted to make a real and lasting difference, and hopefully through me that will be his legacy).

This World Alzheimer's Month, play your part in raising awareness, familiarise yourself with what I've said above, and if your life has never been touched by dementia to date but is in the future, remember the guiding principles in this blog post. Guidance never stands still, it grows as we learn and develop ideas, but the fundamental need for care, dignity, respect, and to be valued and loved never change.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

What makes a dementia friendly community?

When I last wrote about the UK’s dementia challenge I said that we needed to make our country a place where people who are living with dementia can lead the lives they deserve to, rather than the ones foisted upon them by prejudice and ignorance. In practice, this means every community becoming dementia friendly, embracing this most cruel of diseases, and seeing the people who have developed it as an asset, rather than a problem.

It requires a change in attitudes, approaches and opinions that will not happen overnight, and realistically some people will never be convinced by the argument that everyone with dementia deserves to live well with it, rather than simply die from it. However, given the current numbers of people with dementia, and the predicted number of cases for the future, many more lives are going to be touched by this disease than a lot of people may even want to contemplate at the moment, making this the time for the UK to become both more aware of dementia and more friendly towards it.

At every stage of dementia, from pre-diagnosis to end-of-life care, every service accessed by people with dementia and their carers needs to have an intrinsic appreciation of what dementia means, how it affects everyday life, and what can be done practically to make using services easier. For the wider community, it is about adopting the key principles of compassion, dedication and personalisation to ultimately become more dementia friendly.

None of this is achievable without widespread awareness and education of dementia across all generations, from education in schools to campaigns targeting people in their 20’s, 30’s and 40’s whose parents or grandparents may be showing signs of dementia, and finally to supporting people in their 50’s, 60’s, 70’s and 80’s who may have dementia themselves, be trying to look after a partner with dementia, or are concerned about the impact dementia could have on their life if they develop it.

To do this community healthcare services, community groups, social and charitable groups, local and national media, and technology like social media, apps etc need to pull together as one to reach as wide and diverse an audience as possible. Realistic but also positive coverage of dementia that informs people, rather than terrifying them, will prove that this disease is not a black hole of nothing, and that living well with it is an attainable desire for everyone with dementia and their families and friends.

At the heart of all awareness campaigning must be people with first-hand experience of dementia, whether they are currently living with it, caring for someone with it, or have done in the past. I have written previously about harnessing the power of people’s first-hand dementia experiences to appeal to the hearts and minds of the wider population, and that will never be more important than in the quest to make dementia friendly communities. These people are the pioneers who can lead the way in helping the whole country feel as passionately about dementia care as they do. Small seeds of change do already exist within social media, with the Twitter hashtag #dementiachallengers uniting people, like me, in this common goal.

As I have often touched on, whilst I wish my father had never had dementia, his years with it gave us as a family many memories and experiences that changed our lives in a positive way, finding hidden depths to our feelings and resources, and giving us the privilege of supporting a wonderful man in his life with dementia that, whilst he would have hated it, also gave him the opportunity to show great courage, dignity, good humour and warmth in living with it.

Although much has changed since my dad’s life with dementia began, there are still significant barriers for people living with dementia today. Access to services is still very much a postcode lottery, people are often not informed or supported regarding what they are entitled to, there is not enough emphasis on providing therapeutic dementia care (through the arts for example), not enough access to some of the great design and technological advances that can improve the lives of people with dementia and those who look after them, and there are many day-to-day obstacles to overcome. Even a simple trip to the shops, or going out for a coffee, can turn into people staring at you, whispering, being unhelpful, or refusing to make allowances for the needs of someone with dementia, and that is assuming you have the resources to even get out of the house or care home to begin with.

So much can be done to remedy this, however. Organisations can train staff to become dementia aware, not just to assist customers but also as part of the pastoral role good employers should adopt in supporting their staff in their personal lives, recognising that many of their employees will have family, friends or neighbours with dementia who rely on their help. Improving customer advice and liaison roles to encompass helping people with dementia who may be disorientated, confused, aggressive or upset, simplifying signage to help people with dementia to find their way, supporting people with financial transactions, adapting menus to reflect the needs of people who require soft or purred food because of a swallowing problem, and providing toilet facilities that help carers to change incontinence pads in privacy, are just a few simple but important issues businesses can address to become more welcoming for, and understanding towards, people with dementia.

It is not just down to businesses and service providers to make our communities dementia friendly though. If everyone understood dementia, recognised the symptoms in family members, friends and neighbours, and provided a supportive environment where we look out for each other, help with simple tasks, are able and willing to call for professional help when it is needed (and for that help to be forthcoming and appropriate), and took the time to offer kindness, a listening ear, a compassionate touch and a caring outlook, then all vulnerable people, not just those with dementia, would be able to live far more fulfilling lives that offer quality and richness.

Ultimately dementia friendly communities will only exist if there is a shared will between the people, policy makers, media and businesses to make this happen. Creating communities where people with dementia are welcomed, supported and enabled to get the maximum out of life will require flexibility, forward-thinking, huge commitment and above all instilling within our society how valuable people with dementia are.

Recognising the contribution people have made in their lives prior to having dementia, celebrating that, tapping into it and helping them to be as active, healthy and happy as possible during their life with dementia will need the rest of us to show the same courage and determination that my dad, so many before him and so many right now, are showing in battling their own personal dementia challenge.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

Ending the 'chemical cosh'

One of the things I feel most passionately about in dementia care is the inappropriate use of antipsychotic medications.  For many years these have been commonplace when doctors, nurses and care professionals have sought to quell the symptoms of dementia amongst their patients, but the side-effects, turning people into zombies and dramatically increasing the risk of early death, have always made them something I am completely against.

We experienced the use of these medications in my father’s early hospital admissions, firstly when he was diagnosed with dementia, and then when he had to return to hospital because his residential care home could not manage his behaviour. It was on this second admission, before he lost half his body weight from three months in the elderly mentally infirm ward, that we really experienced the ‘chemical cosh’ at first hand.

Dad was a big, imposing man, who walked constantly, displayed agitation, confusion and some aggression, and an all-consuming desire to get out of the secure confines he found himself in. For the staff on that over-stretched, demanding ward, the simplest answer was to put him on medication so that he wasn’t a ‘problem’ to them anymore. Our ‘problem’ with this, however, was considerable. Visiting someone who was suddenly struggling to walk and talk, was sleepy, incoherent and frankly even more confused, was alarming to say the least.

Even with our then fledgling knowledge of dementia, we were convinced there was a better way, and challenged the ward staff. Our success was very limited however; they had their policies, and clearly had been allocated a staffing budget that did not allow for the one-to-one care needed to replace the easy-to-administer ‘chemical cosh’, with the more time-consuming and specialised therapeutic care that we were advocating.

Moving dad to his first nursing home brought a refreshing change in attitudes. The staff were keen to remove the medication, and supported by the GP this was successfully achieved. For us it was exactly what we wanted, we had dad back. No matter what his symptoms, we found ways to manage them, and the care home staff were, for the first time, able to get to know the real man behind the dementia, and what a blessing that was. His sayings, mannerisms and conversation all tumbled out, the staff fell in love with him, and this gave them a connection to him that became vital as the  years passed and his dementia progressed, slowly robbing him of his ability to shine in the way that he had. Now, with their knowledge and love of dad, they could help him, stimulate his memory and trigger those moments that brought light and laughter into his life.

Our worst experiences of the ‘chemical cosh’ were approximately eight years ago, and thankfully times are changing. A government initiative, combined with some pioneering work by forward-thinking, innovative medical professionals, has brought about a 52% reduction in prescriptions of antipsychotics in dementia patients between 2008-11. Alarmingly, however, there are some significant regional variations that prove the fight against this culture of pumping vulnerable, elderly people with medications that carry a strong risk of hastening their death, is still sufficiently alive to warrant even tougher action.

One of the most disturbing aspects to the use of antipsychotics is the way in which carers and families of people with dementia are often not consulted about their loved one being treated with these drugs. It must be remembered that as well as patients suffering as a result of being inappropriately prescribed antipsychotics, their relatives do too. Not only is it very upsetting to see the changes in your loved one, it is robbing you of precious time that you will never get back, and should these drugs shorten your relative’s life, you will have to live with that forever.

Antipsychotics should only ever be an absolute last resort, something you give when every other avenue, including all therapeutic and complimentary therapies, have been exhausted. Drugs may be an easy option for healthcare professionals who do not know a patient, and therefore simply want to make their own working lives easier, but it is inhuman and frankly barbaric to subject a person to the life these medications will force upon them and their loved ones.

Clinicians need to listen to carers and relatives and be influenced by them, rather than the propaganda of drug companies or pressures from lazy care homes looking for an easy option to manage challenging behaviour. They also need to be educated in some of the pioneering therapies that are proving how you can care for someone with dementia without the need for antipsychotics. Great work is being done in music, art and reminiscence therapies for example, whilst often the simplest things, like spending time with a person, talking, listening or engaging them in something practical that they enjoy or that was part of a previous routine, can make a huge difference.

These are not complex or difficult tasks for care professionals, they just require dedication, personalisation and compassion – three key aspects of successful dementia care. Using a ‘chemical cosh’ could never be described as representing any of these qualities, and if the UK is truly striving for a gold-standard dementia service, then the challenge to any professional seeking this ‘quick fix’ is to find an alternative way forward.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

Dementia – You can’t catch it!

Stigma is one of the biggest problems currently facing those battling against dementia. Fear of the big D easily rivals fear of the big C, but whilst cancer campaigners have made massive strides in helping society face up to that terrifying disease, thus greatly improving diagnosis and outcomes for those living with it, dementia is still hugely misunderstood.

People with dementia are often isolated and treated with inferiority, consigned by many to no longer being seen as valuable members of society. Yet I have frequently thought, particularly recently as we continue to mourn dad’s passing, just how much dementia simplifies life. This crazy whirl that most of us live in for the majority of our lives is stripped back to the most basic needs and wants when someone is struck by dementia, particularly when they enter the more advanced stages of the disease.

In many ways, therefore, society has much it can learn from those living with dementia, not just about the disease, its diagnosis, treatments and ultimately how it might be prevented or even, hopefully, one day cured, but in the lessons dementia teaches us about what is important in life.

Dementia also brings alive in those who care for a loved one battling it the most overwhelming compassion, love, dedication and humanity; qualities that so many people often overlook in everyday life.

Yet dementia is still a largely hidden disease. Recent government initiatives, and work by organisations such as the Joseph Rowntree Foundation to create dementia friendly communities, are attempting to break down barriers, but it is still people living with dementia, their nearest and dearest, and those charged with guiding them through this minefield that have the most to offer in helping the wider population to acknowledge, confront and defeat this disease.

Over the years I’ve encountered many within my peer group who have no concept of dementia, to the point where some have thought you can catch it, or even that I must have it having spent so long caring for my father! People would avoid visiting dad rather than sit and comfort the man he had become, and sadly there are so many people living out their days in care homes who have ‘no’ family, or at least no one who can face the reality of a relative with dementia.

The notion of feeding, washing and changing an adult like you would a child is something that large parts of society find too horrific to contemplate. That someone could have no concept of where they are, who they are, or who anyone around them is, will equally see most observers recoil in horror. I don’t believe, however, that people living with dementia or their families want sympathy, we didn’t. What we have always wanted is an understanding, an acceptance and a will within society to confront this disease and defeat it.

Dementia is stigmatised, but that doesn’t mean it’s not affecting people from all walks of life every minute of every day. The “Out of sight, out of mind” attitude really won’t work with dementia. The people living with it are real individuals, all with their own unique life story, and the real disgrace is to pretend otherwise.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook