Digital checks that can prevent dementia and falls in older people are among a range of tools being made available in hospitals across the country, as part of the NHS Long Term Plan | Via NHS England
One in eight hospital patients is affected by delirium, which can make people unsteady on their feet, increases the risk of developing dementia and can result in longer hospital stays or admission to a care home.
However, these problems can be avoided through timely and effective care, with a scheme in Salford increasing the number of patients correctly diagnosed with delirium by 34%, through the introduction of screening for all over-65s who are admitted to hospital. Doctors and nurses run through a symptoms checklist on a mobile computer or handheld device.
The new electronic assessment tool for delirium has increased screening of over 65-year-olds on admission to hospital and has increased assessment of those who become newly confused when they are in hospital, with the number of identified cases per year having risen by 34% and the length of stay for these patients has reduced by 11%, saving an estimated £1.7m in the first year. Readmissions for delirium patients has also reduced from 15% to 13% saving an estimated £101,000 for the same period.
The scheme is just one of a series that is being rolled out across the country through the adoption of toolkits, known as blueprints, that allow any NHS hospital to implement improvements quicker and more easily to transform care and improve services for patients and staff.
As life expectancy increases so people often develop a range of conditions and disabilities in the years before death | British Journal of Community Nursing
Multimorbidity represents the most common ‘disease pattern’ found among the elderly and is characterised by complex interactions of co-existing diseases where a medical approach focused on a single disease does not suffice. People with dementia who also have other comorbidities do not always have their comorbid conditions managed as those without dementia which often lead to a high number of hospital admissions with longer lengths of stay and greater treatment costs. This case study presents the case management approach taken by Admiral Nursing in managing the complexities where there is comorbidity of a long-term condition and a diagnosis of dementia. By empowering the person and their carer with information and choices and through good case management and communication, people can be supported to live well and avoid inappropriate hospital admissions.
Gustafsson, M. et al. European Journal of Clinical Pharmacology | Published online: 8 April 2017
Purpose: To assess whether comprehensive medication reviews conducted by clinical pharmacists as part of a healthcare team reduce drug-related hospital readmission rates among people with dementia or cognitive impairment.
Conclusion: Participation of clinical pharmacists in healthcare team conducting comprehensive medication reviews did not significantly reduce the risk of drug-related readmissions in patients with dementia or cognitive impairment; however, post-hoc and subgroup analyses indicated significant effects favoring the intervention. More research is needed.