Department of Health and Social Care | May 2018 | After diagnosis of dementia: what to expect from health and social care services
A new report from the Department of Health and Social Care examines the role of advanced care planning and explores the barriers to its implementation as identified by people with incurable cancer and health and social care professionals. It also examines opportunities for change and sets out responsibilities of governments and policy makers.
This document is for anyone diagnosed with dementia and the people who care for them. It has details about what support they should get. It also includes information about:
what is in a care plan
how health care and social care services can help
support available to family and friends who are carers
This publication highlights some notable and innovative practice by councils in supporting people living with dementia after their diagnosis | Local Government Association | Dementia Action Alliance
The guide offers the following Key learning points:
1. Engage with people with dementia. A forum or regular meeting with people with dementia is an excellent way to build self-sustaining networks and help shape services. Local people often don’t have an awareness of all support in the community. Ensure all feedback and actions from the forum are well publicised. By doing this people feel listened to and actions are taken as a consequence.
2. Offer information in a range of ways. Design information in partnership with people with dementia and/or representative organisations.
3. Build a dementia friendly community. Work with local partners in business, health, the voluntary sector and across local authority departments to ensure that your local area is dementia friendly.
4. The ability to work positively in collaboration across partners and establish common goals of practitioners is crucial.
5. It is beneficial to have an awareness of likely demand on service in order to plan effectively.
6. Consistent workforce development is essential for shared understanding and awareness of services across all sectors.
7. People with dementia and their carers are given the opportunity to think about what ‘home’ means and plan for their future housing needs, alongside financial planning.
8. Informal settings are important for delivering information to people who might not naturally identify dementia in themselves or a loved one.
The Faculty of General Dental Practice UK (FGDP(UK)) has made its guidance on the practice of dentistry for patients with dementia available free of charge online.
The guidance covers the epidemiology of dementia and a wide range of implications for dental professionals, including patient identification, competence and referrals, communication, consent and capacity, history taking, treatment planning, care delivery, prescribing and site-specific considerations for dental practices, care homes and domiciliary practice.
Knowing Me! offers practical guidance on person centered care for those living with dementia, depression and delirium. The objectives of Knowing Me! are to raise awareness and understanding of the 3D’s, drive improvements in the standards of care, and improve the outcomes that can be achieved for those affected by the 3D’s.
Knowing Me! is not however a stand alone resource aimed at a particular staff group or a particular care environment but should be seen as a complimentary resource to raise the awareness and understanding of the 3Ds.
Knowing Me! builds on the values and principles of person centered care and support to improve the quality of life and provides useful and practical ways improvements can be made to really make a difference.
London Clinical Networks. Published online: 10 May 2106
Guidance for commissioners and providers to meet the NICE Quality Standard on Dementia (QS1), which states that people with dementia should have an assessment and an ongoing personalised care plan, agreed across health and social care.
This is a guide for »
Service providers, including health, social care, voluntary and charitable organisations
This guide will be of interest to »
People living with dementia
Their families and friends
Practitioners in dementia care
The purpose of this guidance is to »
Describe the key elements of person-centred support planning
Describe how to write a new support plan
A support plan should capture what is important to the person living with dementia.
Once a support plan is put in place it needs to be reviewed regularly, to reflect changes in needs, wishes and circumstances.
The professional who helps putting the support plan together should assume the person with dementia has capacity and use clinical judgement, using the Mental Capacity Act when needed.
Many patients who attend ophthalmology departments also have dementia. This quality standard has been developed to help ophthalmology departments provide high quality care for these patients. It addresses staff training, support to participate in decisions about care, the design of clinical areas, waiting times and appointment durations, provision of information, assessment of vision and referral for support. The breadth of what should be considered in providing care to patients with dementia in an eye clinic requires liaison between all staff, managers, and commissioners of care within the care pathway.
Patients with dementia can benefit from being identified in advance of attending their appointment; staff who have specific training around dementia; and, being provided with support to participate in decisions about care. A pathway for best interest meetings and obtaining informed consent should be identified where patients lose the capability to do so themselves.
The ophthalmology department can be designed and adapted to meet the needs of people with dementia, including lighting, colour schemes, and signage. Shorter waiting times, being offered longer consultation times and receiving accessible information about vision and eye care can be beneficial. If patients cannot use a vision chart then a functional visual assessment is useful to record in their notes. Referral to local support services can be helpful, and issuing a Certificate of Vision Impairment (CVI) (BP1 in Scotland and A655 in Northern Ireland) can facilitate someone being brought to the attention of social care services. The involvement of an Eye Clinic Liaison Officer (ECLO) or Sight Loss Adviser can be helpful.
The living well with dementia workstream has created guidance for professionals to support people with dementia and carers immediately following diagnosis. The guidance covers prognosis, mediations, assessing carers needs, signposting, post diagnosis support, information on services available, and signposts the reader to further information.
This guidance has been produced primarily for professionals working with people with dementia in health and social care settings; however it may also be useful to commissioners.
All support should be tailored to the individual’s needs and wishes in order to provide a personalised approach.Not all information below will be appropriate for everyone and it is the diagnosing clinician’s decision what to discuss. It is unlikely that all topics will be covered in one meeting; it is anticipated that support will be offered over a series of meetings as necessary.
All areas should use these indicators as a guide to ensure that…
Latest guidance from NICE recommends people should be encouraged to stop smoking, be more physically active, reduce their alcohol consumption, and adopt a healthy diet to help lower the risk of developing dementia, disability and frailty in later life.
Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset
This guideline covers mid-life approaches to delay or prevent the onset of dementia, disability and frailty in later life. The guideline aims to increase the amount of time that people can be independent, healthy and active in later life.
Who is it for?
Commissioners, managers and practitioners with public health as part of their remit, working in the public, private and third sector
The guideline includes recommendations on promoting a healthy lifestyle to reduce the risk of or delay the onset of disability, dementia and frailty by helping people to:
be more active
reduce their alcohol consumption
improve their diet and,
lose weight and maintain a healthy weight if necessary.