Useful tips on the COVID-19 vaccine for people with dementia #covid19rftlks

Dementia Partnerships | January 2021 | Useful tips on the COVID-19 vaccine for people with dementia

The Royal College of Psychiatrists in conjunction with Dementia UK, have produced a briefing that includes useful tips for giving the COVID-19 vaccine without causing distress and how to explain the vaccination to someone who is living with dementia.

Image source: rcpsych.ac.uk

The breifing includes useful tips for giving someone the vaccination without causing undue distress; how to explain to someone with dementia and/or their families about the COVID 19 vaccination and what happens if someone with dementia is unable to consent to their vaccine via Dementia Partnerships.

Read the full article at Dementia Partnerships

Access and download the Useful tips on the Covid-19 vaccine for people with dementia

NIHR: Informal dementia carers had to make difficult decisions about paid care during COVID-19

NIHR | January 2021 | Informal dementia carers had to make difficult decisions about paid care during COVID-19

Often people in the community living with dementia rely on informal, unpaid carers such as family and friends. Researchers wanted to find out how the first nationwide COVID-19 lockdown affected unpaid carers, and how they made decisions about accessing paid care. They conducted telephone interviews with 15 unpaid carers during the first wave of the pandemic (April and May 2020 ). From this sample almost three quarters (73.3%) of the carers lived with the person they were caring for. A little over half (53.3%) of carers were caring for their spouse.

Now this, the first study to report on the impact of COVID-19 on paid home care for people living with dementia, highlights how unpaid carers had to increase their care hours, but also areas of concern and difficult decisions carers had to make.

The researchers drew three themes from the interviews:

  • Carers felt concerned by the risk of paid carers bringing coronavirus into the home. Lack of personal protective equipment (PPE) and feeling unprepared to provide additional care heightened these fears: “I didn’t know how to use all the equipment and I didn’t feel safe and also didn’t know how to protect myself from injury and well and being of risk to Mum”.
  • Carers had difficult choices to make. Many avoided hospitals and other health providers. They struggled to weigh up the options of cancelling or continuing paid care and some described real fears of re-obtaining paid care post-COVID if they cancelled during lockdown.: “..a family friend of ours who’s already been told by their social worker that because they’ve managed without the [paid] care then they’re not likely to get it back after the coronavirus”.
  • Implications for unpaid carers included increased workload and difficulty in accessing food deliveries: “At the moment I can’t get an online shopping slot. Trying to get through to the helpline to get us put on the vulnerable list has proved an impossibility, I’ve spent hours and hours and hours on the phone which gives you a layer of angst that on top of everything else you don’t need”.

Lead author Clarissa Giebel, Research Fellow, Department of Primary Care & Mental Health, University of Liverpool & NIHR ARC NWC

When we did these interviews in April, most family carers were so afraid of the virus that they cancelled paid care, even though they desperately needed it. As a result, they got overburdened. I’ve spoken to people as part of a new study who said they got so burnt out during COVID that they had to send their loved one to a care home. We need to remember those carers are people in their own right and they need psychological support and care support too.

Clarissa Giebel, Research Fellow, Department of Primary Care & Mental Health, University of Liverpool

Read the full NIHR Evidence update Informal dementia carers had to make difficult decisions about paid care during COVID-19

Primary paper available from BMC Geriatrics

SCIE: Safeguarding adults with dementia during the COVID-19 pandemic

Social Care Institute for Excellence| updated 5 January 2021| Safeguarding adults with dementia during the COVID-19 pandemic

Social Care Institute for Excellence in partnership with the Alzheimer’s Society has published a quick guide to support care providers and staff to safeguard people with dementia during the pandemic. There are increased concerns that, during this time, people may be more vulnerable to abuse or neglect.

This may be a result of:

The guide is available online from SCIE

Age UK report: The impact of COVID-19 to date on older people’s mental and physical health

Age UK | October 2020 | The impact of COVID-19 to date on older people’s
mental and physical health

Carers, families, and friends of people living with dementia have told Age UK that they have seen rapid deterioration in their loved one’s cognitive function, which has affected memory, sleep, mood, and behaviour. They explained how hard it has been to help someone with dementia to understand why they cannot do the things they enjoy or see the people they love

Full details are available in Age UK’s report The impact of COVID-19 to date on older people’s mental and physical health

See also:

Age UK Age UK research lays bare the drastic impact of the pandemic on our older population’s health and morale

Worst hit: dementia during coronavirus #covid19rftlks

Alzheimer’s Society| September 2020| Worst hit: dementia during coronavirus

A new report from the Alzheimer’s Society spotlights the impact of the pandemic on family and friends caring for a loved one with dementia. Worst hit: dementia during coronavirus reveals that 92 million extra hours of care have been given in response to what the report terms, the ‘double whammy of lockdown making dementia symptoms worse, and the chronically underfunded social care system leaving them nowhere else to turn.’

Almost half (45%) of those caregivers surveyed by the charity, felt the level of care their loved one with dementia needed was more than they could give. Half of carers have spent more than 100 hours a week looking after or helping the person they care for since 23 March.

Image is a poster taken from the publication, it states key statistics from the report

Alzheimer’s Society Worst hit: dementia during coronavirus

Alzheimer’s Society press release ‘Exhausted’ family and friends spent 92 million extra hours caring for loved ones with dementia since lockdown

Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption With Risk for Dementia

Kivimäki, M. et al |2020| Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption With Risk for Dementia| JAMA Network Open3|9| e2016084-e2016084

Question  Are alcohol-induced loss of consciousness and heavy weekly alcohol consumption associated with increased risk of future dementia?

Findings  In this multicohort study of 131 415 adults, a 1.2-fold excess risk of dementia was associated with heavy vs moderate alcohol consumption. Those who reported having lost consciousness due to alcohol consumption, regardless of their overall weekly consumption, had a 2-fold increased risk of dementia compared with people who had not lost consciousness and were moderate drinkers.

Meaning  The findings of this study suggest that alcohol-induced loss of consciousness is a long-term risk factor for dementia among both heavy and moderate drinkers.

Importance  Evidence on alcohol consumption as a risk factor for dementia usually relates to overall consumption. The role of alcohol-induced loss of consciousness is uncertain.

Objective  To examine the risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers.

Design, Setting, and Participants  Seven cohort studies from the UK, France, Sweden, and Finland (IPD-Work consortium) including 131 415 participants were examined. At baseline (1986-2012), participants were aged 18 to 77 years, reported alcohol consumption, and were free of diagnosed dementia. Dementia was examined during a mean follow-up of 14.4 years (range, 12.3-30.1). Data analysis was conducted from November 17, 2019, to May 23, 2020.

Exposures  Self-reported overall consumption and loss of consciousness due to alcohol consumption were assessed at baseline. Two thresholds were used to define heavy overall consumption: greater than 14 units (U) (UK definition) and greater than 21 U (US definition) per week.

Main Outcomes and Measures  Dementia and alcohol-related disorders to 2016 were ascertained from linked electronic health records.

Results  Of the 131 415 participants (mean [SD] age, 43.0 [10.4] years; 80 344 [61.1%] women), 1081 individuals (0.8%) developed dementia. After adjustment for potential confounders, the hazard ratio (HR) was 1.16 for consuming greater than 14 vs 1 to 14 U of alcohol per week and 1.22  for greater than 21 vs 1 to 21 U/wk. Of the 96 591 participants with data on loss of consciousness, 10 004 individuals (10.4%) reported having lost consciousness due to alcohol consumption in the past 12 months. The association between loss of consciousness and dementia was observed in men women during the first 10 years of follow-upa fter excluding the first 10 years of follow-up, and for early-onset and late-onset  dementia, Alzheimer disease, and dementia with features of atherosclerotic cardiovascular disease. The association with dementia was not explained by 14 other alcohol-related conditions. With moderate drinkers (1-14 U/wk) who had not lost consciousness as the reference group, the HR for dementia was twice as high in participants who reported having lost consciousness, whether their mean weekly consumption was moderate or heavy.

Conclusions and Relevance  The findings of this study suggest that alcohol-induced loss of consciousness, irrespective of overall alcohol consumption, is associated with a subsequent increase in the risk of dementia.

Full article from JAMA

In the news:

Daily Mail : Passing out drunk could more than DOUBLE your risk of later developing dementia and even one drink per day raises risk by 22%, study warns

Guidance for carers of people with dementia

University College London | September 2020 |Guidance developed for dementia carers when dealing with COVID-19 infection

A team of researchers from University College London (UCL) have developed a decision-making guide for dementia carers, to ensure they can provide the right support and with dignity, should those they care for become infected with coronavirus.

The researchers based at Marie Curie Palliative Care Research Department at UCL, have observed the challenges to carers who can’t be with their loved one or person they support, due to visiting restrictions and having to social distance or shield themselves.

This often means that dementia carers have to make quick healthcare or legal decisions over the phone with a health professional: someone who may have no knowledge of the care and interventions the person with dementia requires.

The new guide, which was developed with families of those with dementia, is funded by an Economic and Social Research Council COVID-19 grant and supported by end of life care charity Marie Curie, Alzheimer’s Society and Dementia UK.

The tool has been designed to support carers work through situations, medical and legal jargon so they can make informed decisions quickly under stressful circumstances.

This includes do not resuscitate orders, legal issues like power of attorney, and ensuring that health and social care professionals understand what is important to the person they are caring for when that patient’s loved ones can’t be by their side.

The research team hopes that the new guide will also ease the emotional burden that families can experience and help resolve any feelings of uncertainty about the decisions they have made for their loved ones (Source: UCL).

Full press release is available from UCL

The decision aid can be downloaded here

COVID-19 and Dementia: Factors affecting patient outcomes and experience along the dementia pathway

Wessex Clinical Senate and Networks | July 2020| COVID-19 and Dementia: Factors affecting patient outcomes and experience along the dementia pathway

The COVID-19 pandemic has impacted significantly on the delivery of NHS services. We have an opportunity to learn from the rapid and necessary service transformation and consider how we recover our services.

Dementia remains a diagnosis with significant impact with a need to balance the timeliness of diagnosis with patient experience and outcomes. Covid may become endemic and our adapted ways of working may become the new normal.

Recent webinars have brought clinicians, service managers and commissioners together to consider factors affecting the dementia pathway in a Covid environment. This document aims to give an overview of factors identified that affect the pathway.

The documents are available to download from the Wessex Senate