Alzheimer’s Society | July 2018 | Ten minutes of social interaction improves wellbeing in dementia care
Spending ten minutes interacting with people with dementia in care homes can benefit their wellbeing. The Wellbeing and Health for people with Dementia (WHELD) programme trained care home staff to increase social interaction from two minutes a day to ten, combined with a programme of personalised care. Carers were encouraged to discuss the patient’s interests and involve them in decisions about their care. The Improving Staff Attitudes and Care for People with Dementia e-Learning (tEACH) study, conducted by the University of Exeter Medical School and King’s College London in partnership with the Social Care Institute for Excellence (SCIE), was presented at the recent Alzheimer’s Association International Conference 2018. The study involved 280 residents and care staff in 24 care homes over a nine- month period.
Carers participated in an e-learning programme, carers who participated via Skype continued to deliver improved resident wellbeing four months after the trial was completed. Although boh treatment arms improving resident wellbeing and staff attitudes to person-centred care.
Dr Doug Brown, Chief Policy and Research Officer at Alzheimer’s Society, said:
‘It’s unacceptable that people in care homes only get ten minutes of social interaction each day. What we need is a person-centred approach to care, that takes into account each individual’s unique qualities, abilities, interests, preferences and needs.
‘This study supports what we know from our own research – training is crucial in order to provide this type of individualised care, activities and social interactions, which can have a significant impact of the well-being of people living with dementia in care homes (Source: The Alzheimer’s Society).
NHS England | July 2018 | Improving dementia care through care navigation and social prescribing
A new case study from NHS England looks at an innovative approach to improving care for patients with dementia through navigation and social prescribing at a medical group in Gateshead. As more people receiving a dementia diagnosis, senior nurses and GPs began to seek an alternative approach to the conventional ten-minute appointments. Many of these patients’ needs related to social care and wellbeing rather than acute clinical issues. Carers weren’t being identified and appropriate support wasn’t being received. Most case finding was undertaken by GPs and senior nurses. Some patients and carers were becoming frustrated, and the quality of care was at risk of being compromised.
This approach involved a new way of working in which healthcare assistants (HCAs) are leading changes in practice to deliver a range of positive outcomes for both patients and carers, including increased access to health and social care services, improved dementia screening, individualised care plans and social prescribing.
Existing health care assistant (HCA) and receptionist roles were redesigned to undertake this function. Staff were trained to prepare them for the change.
The purpose of the Primary Care navigator role is to:
Communicate with patients and carers, asking questions and actively listening
Guide people to sources of help and support, from the most local to national
Support case-finding through clinical referrals and opportunistic screening
Develop a directory of services of third sector and other community support available for people with dementia and their carers
The practice has now extended the navigator role to support all social prescribing for patients with complex needs. It will be the foundation for implementing a ‘House of Care’ approach to long term conditions, to support self-care and self-management. Gateshead CCG has included the initiative in its primary care strategy.
Berk, L., Warmenhoven, F., van Os, J., & van Boxtel, M| 2018| Mindfulness Training for People with Dementia and their Caregivers: Rationale, Current Research, and Future Directions| Frontiers in Psychology| 9| 982.
Frontiers in Psychology has published a new article that provides an overview of studies for people with dementia and/ or their caregivers, the review also gives recommendations and suggests areas that require further research.
The world population is aging and the prevalence of dementia is increasing. By 2050, those aged 60 years and older are expected to make up a quarter of the population. With that, the number of people with dementia is increasing. Unfortunately, there is no cure for dementia. The progression of symptoms with no hope of improvement is difficult to cope with, both for patients and their caregivers. New and evidence-based strategies are needed to support the well-being of both caregiver and patient. Mindfulness training is a body-mind intervention that has shown to improve psychological well-being in a variety of mental health conditions. Mindfulness, a non-judgmental attention to one’s experience in the present moment, is a skill that can be developed with a standard 8-week training. Research has shown preliminary but promising results for mindfulness-based interventions to benefit people with dementia and caregivers. The aim of this review is (a) to provide a rationale for the application of mindfulness in the context of dementia care by giving an overview of studies on mindfulness for people with dementia and/or their caregivers and (b) to provide suggestions for future projects on mindfulness in the context of dementia and to give recommendations for future research.
National Collaborating Centre for Mental Health (NCCMH) | July 2018 | The Dementia Care Pathway:
The National Collaborating Centre for Mental Health (NCCMH) have released The Dementia Care Pathway, this full implementation guidance outlines the dementia care pathway and associated benchmarks to support improvements in the delivery and quality of care and support, for people living with dementia and their families and carers.
It accompanies and builds on a shorter guide published by NHS England Implementation guide and resource pack for dementia care (see below) and contains key commissioning and service development considerations (Source: RCPSYCH).
Leading philanthropist Bill Gates has announced that he is to invest in a new fund designed to bring about improved diagnosis of Alzheimer’s disease.
Mr Gates made his first investment into dementia research in November 2017 when he put $50m into the Dementia Discovery Fund (DDF), which provides backing for early-stage drug discovery projects around the globe. The DDF was formed through a collaboration of the UK Department of Health, Alzheimer’s Research UK and several leading pharmaceutical companies.
This latest announcement sees Mr Gates make a further investment into a new fund, Diagnostics Accelerator, run by the Alzheimer’s Drug Discovery Foundation in the US. The fund will back research aimed at accelerating earlier and better diagnosis of Alzheimer’s disease in the clinic.
A recent poll shows UK adults believe dementia is in the top three health areas the NHS should focus on in the next 10 years | Alzheimer’s Research UK
The survey commissioned by Alzheimer’s Research UK shows starkly different public priorities to those outlined today in an interview with NHS England’s Chief Executive Simon Stevens, which failed to acknowledge the harm dementia presents to the UK’s economy, health services, and lives of people living with condition and carers.
The survey asked people to consider how they would like resources, innovation and funding to be prioritised in the next 10 years. The top disease areas identified in an open-ended question were dementia and Alzheimer’s, cancer and mental health.
The survey also showed one in four UK adults say they believe dementia is the biggest health challenge facing the NHS in the next 70 years in terms of the cost to the NHS and the number of people affected in each of eight disease areas, including cancer, heart disease and mental health conditions. A quarter of adults selected dementia, the highest percentage for any disease area.
Alzheimer’s Research UK, the UK’s leading dementia research charity, is calling on the government and NHS England to make dementia a major priority in the forthcoming 10-year plan. This includes fostering innovation through increased funding for dementia research, working to detect the diseases that cause dementia 10-15 years sooner, increasing awareness of dementia risk reduction, and preparing today for future dementia treatments so they can reach people without unnecessary delay.
Figures released by the Office for National Statistics (ONS) show there has been a 7.4% increase in deaths from all forms of dementia – with a 5.3% increase in deaths from vascular and unspecified dementia, and a 13.9% increase in deaths from Alzheimer‘s disease
The Office for National Statistics latest figures reveal there were 533,253 deaths registered in England and Wales in 2017, a 1.6% increase from 2016. Data for 2017 shows that in total, there were 67,641 deaths attributed to Alzheimer’s disease or other forms of dementia – 13% of the total deaths recorded that year. This is a rise from 2016, when there were 62,948 deaths from dementia (12% of all those recorded).
Alzheimer’s Research UK is calling for urgent investment in dementia research, following the release of these new statistics. Dr Matthew Norton, Director of Policy and Strategy at Alzheimer’s Research UK, said:
“These figures yet again underline the overwhelming impact of dementia for the UK, and for hundreds of thousands of families who are hit by the condition. With one in four hospital beds occupied by someone with dementia and deaths from the condition rising, we must take urgent action. As well as support for dementia research, the condition must become a priority for the NHS 10-year plan”.
A new machine-learning model that scans routinely collected NHS data has shown promising signs of being able to predict undiagnosed dementia in primary care. The results from the feasibility study suggest that the model could significantly reduce the number of those living with undiagnosed dementia | BJGP Open | via ScienceDaily
Improving dementia care through increased and timely diagnosis is a priority for the NHS, yet around half of those living with dementia are unaware they live with the condition. Now a new machine-learning model that scans routinely collected NHS data has shown promising signs of being able to predict undiagnosed dementia in primary care.
Led by the University of Plymouth, the study collected Read-encoded data from 18 consenting GP surgeries across Devon, UK, for 26,483 patients aged over 65. The Read codes — a thesaurus of clinical terms used to summarise clinical and administrative data for UK GPs — were assessed on whether they may contribute to dementia risk, with factors included such as weight and blood pressure. These codes were used to train a machine-learning classification model to identify patients that may have underlying dementia.
The results showed that 84% of people who had dementia were detected as having the condition (sensitivity value) while 87% of people without dementia had been correctly acknowledged as not having the condition (specificity value), according to the data.
These results indicate that the model can detect those with underlying dementia with an accuracy of 84%. This suggests that the machine-learning model could, in future, significantly reduce the number of those living with undiagnosed dementia — from around 50% (current estimated figure) to 8%.
Study shows a relation between neighbourhood green space and mental capacity after following 6,500 people in the UK for 10 years | Environmental Health Perspectives | via ScienceDaily
Contact with greenspace is known to have beneficial effects for mental health. A new study by the Barcelona Institute for Global Health suggests that it may also play a positive role against cognitive decline in elderly. In particular, this research published in Environmental Health Perspectives shows that the loss in cognitive functions expected as part of the ageing process is slightly slower in people who live in greener neighbourhoods.
Researchers performed a 10 years follow-up of 6,500 people aged 45 to 68 from the Whitehall II cohort in the UK. At three different timepoints during the course of the study, participants completed a battery of cognitive tests that assessed their verbal and mathematical reasoning, verbal fluency and short-term memory, as well as the decline in these functions. Neighbourhood greenspace for each participant was estimated using satellite images.
The data revealed that the decline in the cognitive score after the 10-years follow up was 4.6% smaller in participants living in greener neighbourhoods.
There is evidence that the risk for dementia and cognitive decline can be affected by exposure to urban-related environmental hazards (such as air pollution and noise) and lifestyle (such as stress and sedentary behavior). In contrast, living near green spaces has been proposed to increase physical activity and social support, reduce stress, and mitigate exposure to air pollution and noise.
NHS England| July 2018 | The Atlas of Shared Learning
NHS England have released a case study highlighting the work of mental health nurses in Somerset, who have established a new community-based Intensive Dementia Support Service (IDSS). It has had a significant positive impact on patients, carers and colleagues – providing interventions at point of crisis in the person’s usual place of residency, with the aim of reducing admissions to an older person’s mental health ward.