A report on dementia and stigma raises important issues, but shows how medical and social services still fail (or refuse) to communicate with each other

I approached this booklet published by a variety of dementia and ageing charities with enthusiasm, because my experience as a social worker is that stigma is a really difficult issue for people who are diagnosed with dementia and their carers. This is shown by a number of interesting and thoughtful essays on service users' and carers' experiences.

I was a bit less enthusiastic about the whole thing, since the papers see dementia and stigma almost entirely from a medical perspective, and the dinner in the House of Lords (funded by the drug company Pfizer) where the report originated contained a lot of neuroscientists and not a lot of people with any kind of social care experience. I know Pfizer has to sell its drugs, and dinners at the House of Lords are very nice and might encourage important people to consider an issue. But most of the attenders were professionals, campaigners and parliamentarians already interested, so it was largely preaching to the converted.

Most of the papers are not worth reading, although there is a useful paper from people in the Bradford dementia group on how different cultural backgrounds may create stigmatising views of dementia. But most of the papers are too brief either to provide thoughtful analysis or document research findings; these are largely opinion pieces, albeit opinion based in some cases on strong professional and academic experience. But it reflects a lack of awareness of the extensive policy and sociological literature on stigma. And a poor appreciation of the complex understanding of culture in our social relations that has been arrived at in the social sciences. Most of this material is extremely naive about culture. Medical and social sciences are still talking past each other on these issues.

And as an example of telling you the obvious derived from high-flown scientific research, a paper on the neurology of stigma tells us that some 'ancient' bits of the brain wiggle (or whatever - this is my word) when faced with things that people are prejudiced about, while bits that are more recent in our evolution have to wiggle harder if they are going to overcome the ingrained prejudice of the older bits with rational thought.You mean you didn't know that ingrained prejudice is hard to overcome using education and rational reflection? And the research he's talking about is about racial prejudice and not dementia, so we don't know if it really applies to the issues the report is about. This is science for the sake of it.

Reacting to how stigma affects people suffering from dementia is a really important issue for social and health care, which needs more than brief reports from a dinner at the House of Lords to tackle.

Link to the site for downloading the report