According to Age UK, 1 in 3 people with dementia are not receiving the NHS support they need. Age UK has warns of an urgent and growing need to provide much better support for individuals diagnosed with dementia. The press release is available here
In response to these findings, Age UK has published a report which outlines a a number of interventions that are evidenced, cost effective and scalable, and which could be replicated by NHS Trusts, care providers and primary care services.
This report focuses on what works in supporting people with dementia to live well –looking at services and supports beyond the traditional domains of health and care services.
It was developed through a programme of work rooted in a rights-based approach to
dementia, and in the social model of disability. The programme focused on what people with dementia told Age UK ‘living well’ meant to them.
The key factors identified were broadly grouped under three domains of quality of life:
• personal wellbeing
• positive relationships
• active daily lives.
The report showcases approaches which relate to these three domains, either directly or by improving key aspects of life which people with dementia said were related to their quality of life (such as social connection, sense of self-worth, getting on with day-to-day activities).
It also proposes a new framework for understanding these approaches, to help to make sense of the way in which these approaches could be brought together in communities. Alongside this it also signposts interventions, and there are also a number of case studies from a number of organisations, programmes and services.
Age UK| Promising Approaches to living well with dementia
Although literature describing and evaluating training programmes in hospital settings increased in recent years, there are no reviews that summarise these programmes | Aging & Mental Health
Objectives: This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals.
Results: Fourteen peer-reviewed studies were identified with the majority being pre-test post-test investigations. No randomised controlled trials were found. Methodological quality was variable with selection bias being the major limitation. There was a great variability in the development and mode of delivery although, interdisciplinary ward based, tailor-made, short sessions using experiential and active learning were the most utilised. The majority of the studies mainly evaluated learning, with few studies evaluating changes in staff behaviour/practices and patients’ outcomes.
Conclusion: This review indicates that high quality studies are needed that especially evaluate staff behaviours and patient outcomes and their sustainability over time. It also highlights measures that could be used to develop and deliver training programmes in hospital settings.
Hobday, J.H. et al. (2017) Research in Gerontological Nursing (10)2 pp. 58-65
The current project tested the feasibility and utility of the CARES® Dementia-Friendly Hospital™ (CDFH) program, a 4-module, online training program for nursing assistants (NAs) and allied hospital workers (AHWs) who provide care to individuals with dementia.
A single group pretest/posttest design was used for 25 hospital NAs/AHWs, and quantitative and qualitative data were collected to determine whether NAs’/AHWs’ knowledge of hospital-based dementia care significantly increased, and if CDFH was perceived as useful and acceptable.
Dementia care knowledge increased significantly (p < 0.001). Open- and closed-ended data suggested that the delivery of online training to NAs/AHWs to enhance dementia care is feasible, useful, and efficient.
Ongoing gaps in care exist for individuals with dementia in hospitals, and delivering robust training for NAs/AHWs may serve as an effective modality to enhance quality of dementia care in such settings.
Scerri, A. et al. Dementia. Published online: October 6 2016
The quality of care of persons with dementia in hospitals is not optimal and can be challenging. Moreover, staff may find difficulty in translating what they have learned during training into practice. This paper report the development and evaluation of a set of workshops using an appreciative inquiry approach to implement person-centred dementia care in two hospital wards.
Staff worked collaboratively to develop a ward vision and to implement a number of action plans. Using appreciative inquiry approach, staff attitudes towards persons with dementia improved, inter-professional collaboration was enhanced and small changes in staff practices were noted. Dementia care in hospitals can be enhanced by empowering staff to take small but concrete actions after they engage in appreciative inquiry workshops, during which they are listened to and appreciated for what they can contribute.
UCL Institute of Health Equity | Published online: 30 September 2016
This report focuses on inequalities in the experience and prevalence of poor mental health, cognitive impairment and dementia and the impact of social isolation, lack of mental stimulation and physical activity, before and after retirement, and in later old age. These issues can exacerbate the risks of poor mental health, cognitive impairment and dementia in later life and are experienced disproportionately by people in lower socio economic groups.
The report also provides a brief summary of life course social determinants that increase the risk of poor mental health, early onset of cognitive decline and the symptoms of dementia. In particular, the report examines the role of ‘cognitive reserve’, built throughout the life course, through educational and employment opportunities, and providing older people with a wider and more flexible set of skills, abilities and resources to delay onset of cognitive decline and dementia, and to cope better with the conditions should they occur.
The report also makes recommendations, at a national and local policy level, in addition to providing example interventions for action on the social determinants of poor mental health, cognitive decline and dementia.