Dementia: Cancer scanner ‘could help early diagnoses’

BBC News | 22 February 2020 | Dementia: Cancer scanner ‘could help early diagnoses’

A cancer scanner could be used to identify some of the earliest and most difficult to diagnose forms of dementia, scientists have said.

Doctors at University Hospital of Wales (UHW) in Cardiff said its PET scanner could show signs of the condition in people who are not showing symptoms.

About 47% of people in Wales living with dementia do not have a diagnosis.

The Welsh Government said it is investing £10m a year in its dementia action plan (Source: BBC News).

The full story is available from BBC News 

 

 

Number of people with dementia in Europe set to almost double by 2050

Alzheimer Europe | February 2020 |Dementia in Europe Yearbooks 

A new report from Alzheimer Europe predicts that the number of people with Alzheimer’s disease-based on current trends- will increase twofold by 2050. The report emphasises that this is despite a reduction in the prevalence of dementia. 

The 2018 Alzheimer Europe Yearbook focuses on the current status and development of national dementia strategies in Europe, detailing the content of the existing strategies, thereby providing a comparison between countries. There are currently 21 countries and regions with a dementia strategy, 2 countries whose governments have formally committed to the development of a strategy, two neurodegenerative strategies published and further work underway in other countries (Source: Alzheimer Europe)

The full publication is available to purchase from Alzheimer Europe

In the news:

OnMedica Number of people with dementia in Europe to almost double by 2050

National Audit of Dementia – Spotlight report on psychotropic medication

Hospital initiated prescription of psychotropic medication for behavioural and  psychological symptoms of dementia – Spotlight audit 2019 | Healthcare Quality Improvement Partnership

HQip
Image source: https://www.hqip.org.uk/

This report is for a spotlight audit carried out using data gathered from the casenotes of people with dementia who had been prescribed psychotropic medications at some point in their hospital admission. It reports on the types of medications used to treat behavioural and psychological symptoms of dementia (BPSD) in hospital and what symptoms are most frequently targeted.

For this audit, hospitals provided information from the casenotes of people with dementia admitted to hospital who had been prescribed any psychotropic medications that may have been given to combat BPSD. The audit collected information on:

  • Whether medications were present on admission or were new prescriptions
  • If prescriptions made in hospitals had reasons for the prescription recorded and what they were
  • Whether prescriptions were reviewed on discharge

Full report: Hospital initiated prescription of psychotropic medication for behavioural and  psychological symptoms of dementia – Spotlight audit 2019

NICEimpact dementia

NICE | February 2020 | NICEimpact dementia

Around 460,000 people in England are diagnosed with dementia. And it’s estimated that an additional 200,000 people are undiagnosed. The latest report from NICE  highlights progress made by the health and care system in implementing NICE guidance. We recognise that change can sometimes be challenging and may require pathway reconfiguration. Additional resources such as training and new equipment may also be required.

We work with partners including NHS England and NHS Improvement, Local Government Association, the Association of Directors of Adult Social Services, the Care Providers Alliance and Public Health England to support these changes, and we also look for opportunities to make savings by reducing ineffective practice (Source: NICE).

Read it online 

 

Empowering Better End‐of‐Life Dementia Care (EMBED‐Care): A mixed methods protocol to achieve integrated person‐centred care across settings

Sampson, E. L. |2020|Empowering Better End-of-Life Dementia Care (EMBED-Care):
A mixed methods protocol to achieve integrated personcentred care across settings | International Journal of Geriatric Psychiatry |P. 1-13|DOI: 10.1002/gps.5251

Researchers will use a mixed methods approach to examine the Empowering Better End-ofLife Dementia Care (EMBED-Care) Programme, which aims to deliver a step change in care through a large sequential study, spanning multiple work streams.

According to the research team looking at better end of life care can help us understand current and future need, develop novel cost-effective care innovations, build research capacity, and promote international collaborations in research and practice to ensure people live and die well with dementia.

The entire research protocol which outlines this research project  is available from International Journal of Geriatric Psychiatry 

Abstract
Objectives: Globally, the number of people with dementia who have palliative care
needs will increase fourfold over the next 40 years. The Empowering Better End-ofLife Dementia Care (EMBED-Care) Programme aims to deliver a step change in care
through a large sequential study, spanning multiple work streams.
Methods: We will use mixed methods across settings where people with dementia live
and die: their own homes, care homes, and hospitals. Beginning with policy syntheses
and reviews of interventions, we will develop a conceptual framework and underpinning theory of change. We will use linked data sets to explore current service use, care transitions, and inequalities and predict future need for end-of-life dementia care. Longitudinal cohort studies of people with dementia (including young onset and prion dementias) and their carers will describe care transitions, quality of life, symptoms, formal and informal care provision, and costs. Data will be synthesised, underpinned by the Knowledge-toAction Implementation Framework, to design a novel complex intervention to support assessment, decision making, and communication between patients, carers, and interprofessional teams. This will be feasibility and pilot tested in UK settings. Patient and public involvement and engagement, innovative work with artists, policymakers, and third sector organisations are embedded to drive impact. We will build research capacity and develop an international network for excellence in dementia palliative care.
Conclusions: EMBED-Care will help us understand current and future need, develop
novel cost-effective care innovations, build research capacity, and promote international collaborations in research and practice to ensure people live and die well with
dementia.

Supporting adult carers

Supporting adult carers | NICE guideline [NG150] | Published January 2020

This guideline covers support for adults (aged 18 and over) who provide unpaid care for anyone aged 16 or over with health or social care needs. It aims to improve the lives of carers by helping health and social care practitioners identify people who are caring for someone and give them the right information and support. It covers carers’ assessments, practical, emotional and social support and training, and support for carers providing end of life care.

This guideline covers general principles that apply to all adult carers. Recommendations about supporting carers of people with specific health needs can be found in NICE guidance on those conditions.

This guideline includes recommendations on:

See also:  NICE interactive flowchart – Supporting adult carers

Dementia, spirituality and palliative care

Palmer, J. et al. | Research literature on the intersection of dementia, spirituality, and palliative care: A scoping review | Journal of Pain and Symptom Management | published online | January 2020

Abstract

Context

Dementia marks an increasingly prevalent terminal illness for which palliative care, including spiritual care, could improve quality of life. Research gaps exist in understanding the intersection of dementia, spirituality, and palliative care.

Objectives

We conducted the first scoping review examining the nature and breadth of peer-reviewed studies across these three topics to guide future research.

Methods

The scoping review followed methods from The Joanna Briggs Institute Reviewers’ Manual (2015). We developed a priori a scoping review protocol outlining the Population, Concept and Context for study, data sources, search strategy, inclusion/exclusion criteria, and procedure for screening, extracting, and analyzing data.

Results

The final sample consisted of 19 studies with the following themes: Characterizing Spiritual Needs, Preferences, and Resources; Characterizing Palliative or Spiritual Care; Predicting Provision of Spiritual Care; and Assessing Spiritual Care Interventions. Eighteen studies were published in the past decade, and eleven were based in Europe. The majority of studies focused on long-term care settings, grouped stages of dementia or did not specify dementia stage, and investigated interventions indirectly related to spiritual care. Many studies were limited in sample size and in generalizability/ transferability and used less sophisticated research designs.

Conclusions

Research across dementia, spirituality, and palliative care needs to examine distinct stages of dementia, settings beyond long-term care, and formal spiritual care interventions plus utilize rigorous study designs (e.g., randomized clinical trials). Such research could advance practice and policy that enhance quality of life for tens of millions of persons with dementia and their family members worldwide.