For David Harries, breaking the difficult news that someone has dementia is a harder job than telling someone they have cancer.

Nonetheless, an important service for an ageing community just got easier. Dr Harries’s practice, which allows seniors and their families to meet him in their homes, is now covered by government insurance.

The former chief of geriatrics for the Bermuda Hospitals Board estimates there are around 2,000 residents with some degree of dementia.

“There’s an unmet need out there,” Dr Harries told The Royal Gazette. “My practice has been very well received; people don’t often get the chance for home visits.”

Calling on peoples’ homes on weekends or holidays makes it easier for family members to take part.

It also helps Dr Harries to observe a patient’s surroundings, thus obtaining a better idea of their condition.

The causes of dementia are not yet understood by science. “The biggest risk factor is just getting older,” he said.

“People are living longer. So it’s becoming more common.”

His service enables those who feel they might be developing the condition to get assessed.

Patients and their families can also learn about managing symptoms or, on a practical level, Dr Harries can advise them on taking care of a will or power of attorney. Such details are often overlooked until dementia gets so advanced that the courts are necessary.

During his ten years as head of geriatrics, Dr Harries ran the hospital’s mood and memory clinic, which was key to differentiating between dementia and depression.

“Depression can mimic dementia. It can cause people to lose concentration, and forget things, and their social circle contracts,” he explained.

“A lot of people who have dementia are also depressed and might benefit from antidepressants.”

After leaving BHB last year, Dr Harries started his practice as a means of taking the same clinical resources into people’s homes.

It has been by far the most popular choice. Only three have felt the need to avail themselves of his office in Hamilton.

Since October, he had been meeting clients after they or their relatives obtain a referral from their doctor. The assessments take roughly an hour, with no co-pay — many seniors already have enough trouble meeting their insurance payments, he said.

With Bermuda’s senior population growing, care homes are feeling the strain and while Dr Harries called care at home “the gold standard”, advanced dementia requires full-time care, and the island has no such dedicated facility.

“That is another unmet need. But things have improved over the years. The charity Action on Alzheimer’s & Dementia has done a fantastic job, and now benefits from FutureCare can go to part-time caregivers at home.”

With Dr Harries’s business now also covered by FutureCare and government health insurance, the service network continues to catch up.

“We are all talking to each other, which is important,” he said. “It’s moving in the right direction.”

•To reach Dr Harries, call 707-3168 or e-mail djh@ihs.bm.