Question: What is the hardest thing you have had done?

Sheffield Psychiatry Ward Team answered on 29 Jan 2019:

Hi, Emma here.

Sometimes it can be very difficult breaking bad news to people. For example, there are lots of types of dementia and they are all progressive, which mean they get worse with time.

One type of dementia is called fronto-temporal dementia, because it affects the frontal and temporal lobes of the brain. The frontal lobe is what controls our inhibitions, for example stops us saying things in public we wouldn’t want to say out loud (commenting on someone’s appearance for example), and also our empathy and our motivation. This form of dementia can lead to people becoming quite impulsive, and saying mean things and seeming quite selfish to their friends. It can also lead to people not having motivation to do much more than lay on the sofa all.

I once had to break the news that a young gentleman (in his 40s) had this form of dementia and I found that very difficult, because it involved telling him that this would get worse with time until he dies. He had a young family and a busy job and it was one of the hardest things I’ve had to do. We all keep a professional distance from our patients but I would be lying if I said you don’t get upset at times.

This is however part of the job, and you have to take the hard bits with the good bits. At least giving him that diagnosis meant his family understood that his personality was changing because of the dementia, so they can try and see the change as a symptom of the illness rather than the person choosing to be mean or unkind. It also meant that we could support him as best we could to make decisions about what he wanted to do in the future.