Dementia care: linear links and networks.

The consequences of dementia, for both patients and primary caregivers, are formidable. Primary caregivers are often overburdened or are significantly at risk for becoming overburdened. How do we meet this substantial and complex social challenge, which is as yet insufficiently recognized? We must start looking for new forms of care and support, for more goal-oriented care while maintaining humane values. The problem of dementia demands that we follow more leads: new treatments and interventional care, greater use of technology, new divisions of labour among professionals and more empowerment of primary care. At issue is the organization of physical and social environments for patients with dementia that closely meet their needs. The road toward this goal is long and complicated, but a start has been made in the Netherlands.

[Hans Neuffer (1892-1968). Medical moral philosopher and politician of profession in personal union]. / Hans Neuffer (1892-1968) ärztlicher ethiker und standespolitiker in personalunion.

Hans Neuffer had a well established, civil familiary background. He was raised according to Christian values and remained a practising Christian until the end of his life. Before 1945 he was no person in public life. In spite of the fact that he disapproved the Nazi rule, he did not practise open resistance. After World War Two politically guiltless physicians were needed. Neuffer had this quality and on top of that he had a talent for organisation. In the beginning he was medical functionary in his swabian hometown Stuttgart. In 1949 he took over tasks as medical functionary nationwide. Under his leadership the German physicians succeeded in creating the structures of self administration, that still exist today. Big improvements in income were achieved. The German physicians profited from this until the seventy years of the last century. In addition to this the German doctors managed to become fully accepted members of the World Medical Association (WMA). Besides his work as medical functionary, Neuffer was occupied with ethical questions. The premise of Neuffer's medical ethics were the physician's close ties to God. The responsibility to God was more important than responsibility to conscience, science, the people or the government. One of the foundations of Neuffer's ethics lies in the doctor's personality. Like an artist the "true" physician felt an inner calling. He possessed high mental capacity and had special psychological abilities. Such high moral, mental and psychological demands could only be fulfilled in freedom. Freedom required an adequate income and physicians' self administration. This kind of medical ethics fitted well to the political aims of West Germany's General Medical Council. The freedom of the medical profession and independence from society or government were crucial positions. Hans Neuffer was a politically and morally guiltless medical functionary. At the end of his presidency in 1959, West Germany's physicians had achieved all important aims of their political program.