A report from several voluntary sector organisations calls for an improvement in the way that the needs of people with learning disabilities and dementia are addressed | VODG
This paper explores how best to develop support, services and treatments for the growing number of people with a learning disability and dementia. It builds on earlier work, across the voluntary sector strategic partnership which focuses on dementia support within the context of the protected characteristics defined under the Equality Act 2010.
NHS RightCare has published new data packs for a range of mental health and dementia services for each CCG.
NHS RightCare has published new Commissioning for Value mental health and dementia packs for each CCG. The packs contain data across a range of mental health and dementia services, and include a number of new indicators not included in previous packs. The information is intended to support discussions about mental health care in local health economies to improve the value and utilisation of resources.
Dementia-friendly wards are recent developments to improve care for patients with dementia in acute hospitals. This qualitative study used focus groups to understand the impact of dementia friendly ward environments on nurses experiences of caring for acutely unwell patients with dementia.
Qualified nurses and health care assistants working in an acute NHS Trust in England discussed their perceptions and experiences of working in a dementia-friendly ward environment. Four themes developed from the thematic analysis:
(1) ‘It doesn’t look like a hospital’: A changed environment,
(2) ‘More options to provide person-centred care’: No one size fits all,
(3) ‘Before you could not see the patients’: A constant nurse presence and
(4) ‘The ward remains the same’: Resistance to change.
Recommendations and implementations for practice are discussed.
The qualitative research on young onset dementia is providing insights about the ‘lived experience’ of patients and caregivers. However, findings from these studies have seldom been integrated into descriptive overviews. Our aim was to search the qualitative research, to integrate the qualitative findings, and offer an account of the lived experience for patients and caregivers.
The search of the qualitative research formed part of a broader comprehensive literature search investigating salient measurement issues in the young onset dementia psychosocial research. Five electronic databases were searched (Medline, CINAHL, PsycINFO, Embase, the Cochrane Library) plus supplementary searching of reference sections and use of online search engines. We identified 23 qualitative articles.
In the pre-diagnostic period, patients experience changes in cognition and functioning but may be uncertain about changes and their significance. Caregivers may observe changes, think of explanations, and are important in instigating medical intervention. Obtaining a diagnosis may be a demanding process and the possibility of dementia may not be anticipated. In the post-diagnostic period, patients and caregivers use several strategies to cope and adjust. Patients can withdraw from established responsibilities while caregivers assume compensatory roles/duties. Patients perceive changes in their identity while caregivers perceive changes in the caregiver–patient relationship. Both can experience grief, isolation, and stigma.
The diagnosis of dementia elicits significant changes in thinking, emotion, and lifestyle that patients and caregivers are unlikely to be ready for. Both receive insufficient support or guidance in particular of a psychological nature on how to cope and adjust.
NHS England’s National Clinical Director for Dementia and a Devon-based consultant psychiatrist review impressive changes to dementia diagnosis and care in the West Country | NHS England
A pan-Devon partnership project group was established in October 2012 with a number of local partners of whom Devon Partnership NHS Trust was the lead.
Following a review, including patient and carer experiences, four objectives were formed. First, there should be a fully integrated person-centred care pathway. Second, that early diagnosis should be made by a specialist memory clinic, with a clear referral pathway and a person-centred, ‘One Stop’ approach. Third, all GPs should be made able to make a diagnosis in the moderate to later stages of the illness. Fourth, that all patients should have consistent access to evidenced-based interventions wherever they were diagnosed
The redesign process was at all times in consultation with patients and carers, GPs, the voluntary sector and with reference to best practice. Project groups of clinicians from each organisation and locality were set up to design and deliver the new integrated service which was implemented across Devon nine months later.
This briefing summarises findings from fourteen reports on dementia and numerous visits to care homes by local Healthwatch. It finds that people want to see improvements in: information for improving dementia awareness; making sure people with dementia and their carers have the support they need; and making the environment more dementia-friendly.
Bunn, F. et al. BMJ Open. Published online 18 January 2017
Objectives: People living with dementia (PLWD) have a high prevalence of comorbidty. The aim of this study was to explore the impact of dementia on access to non-dementia services and identify ways of improving service delivery for this population.
Conclusions: This study suggests that, in order to improve access and continuity for PLWD and comorbidity, a significant change in the organisation of care is required which involves: coproduction of care where professionals, PLWD and family carers work in partnership; recognition of the way a patient’s diagnosis of dementia affects the management of other long-term conditions; flexibility in services to ensure they are sensitive to the changing needs of PLWD and their family carers over time; and improved collaboration across specialities and organisations. Research is needed to develop interventions that support partnership working and tailoring of care for PLWD and comorbidity.
A shift in focus from symptoms and disability towards the capacity and potential of the person with dementia is urgently needed to create a more balanced view of dementia and a more dementia-friendly society, which enables people and their families to adapt to the changes dementia brings in their lives.
The new concept of social health suggested by Huber and colleagues seems helpful to make such a shift. In this dedicated special issue, a consensus-based operationalization of the concept of social health in dementia is proposed and several aspects of social health and related dementia care are addressed within the framework of European collaborative projects of the INTERDEM network.
When hospitalized, people can become acutely confused and disorientated. This condition, known as delirium, affects a quarter of older patients and new research shows it may have long-lasting consequences, including accelerating the dementia process. | via ScienceDaily
New research by UCL and the University of Cambridge shows delirium may have long-lasting consequences, including accelerating the dementia process. Episodes of delirium in people who are not known to have dementia, might also reveal dementia at its earliest stages, the research found.
Scientists looked at three European populations — in Finland, Cambridge and UK-wide — and examined brain specimens in 987 people aged 65 and older. Each person’s memory, thinking and experience of delirium had been recorded over 10 years towards the end of their life.
When these were linked with pathology abnormalities due to Alzheimer’s and other dementias, those with both delirium and dementia-changes had the most severe change in memory.
Harrisson, J.K. et al. (2016) Age Ageing. 45(6). pp. 740-746
The optimal management of hypertension in people with dementia is uncertain. This review explores if people with dementia experience greater adverse effects from antihypertensive medications, if cognitive function is protected or worsened by controlling blood pressure (BP) and if there are subgroups of people with dementia for whom antihypertensive therapy is more likely to be harmful.