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Improving care for people with dementia in Devon.

There are approximately 800,000 people living in the UK with dementia, and this is estimated to rise to 1 million by 2021. Dementia is most common in older people; one in 14 over 65 years and one in six over 80 years have a form of dementia. It is estimated that this costs the NHS 24bn [pounds sterling] a year, which includes social care, accommodation and informal care costs (Department of Health (DH), 2009).

In Devon, UK, the number of people living with dementia in 2012 was 14,000 and this is expected to rise to 18,000 by 2021. This must lead to an increase in understanding of care needs and support for patients, and their families or carers.

The mid-Devon town of Tiverton is a busy market town with a population of 38,331. In recent years new houses and industry have been developed in the area, increasing the need for education and healthcare facilities.

As resources in the NHS are stretched to meet the needs of the ever-growing population, the professional healthcare team wanted to look at how to use resources to meet people's needs.

A large proportion of long-term conditions affect the older population, including dementia, which often has other co-morbidities. In 2006 there were 7,151 people over 65 years suffering from dementia in the area; this is expected to rise to 10,818 in 2021. The number of sufferers over 85 years in 2006 was 997 and is expected to rise to 1,557 in 2021 (Northern Devon Healthcare NHS Trust, 2013).

A group of health, social care, voluntary, private sector workers and service users got together to gain a better understanding of the needs of the Tiverton cluster with regard to dementia. In addition, it was agreed to look at two other local towns--Crediton and Cullompton.

The group looked at other long-term conditions that older people predominantly live with. Often, a type of dementia is another disability the person has to cope with alongside their long-term condition. This only increases the need to have a better awareness and understanding of people living with dementia. With that in mind, it is imperative that the professionals attending to those patients develop effective strategies and methods of working.

The team worked in partnership to make the dementia care pathway (Figure 1) simpler and easy to read for everyone, including service users. Using guidance from the National Service Framework (NSF) for Long Term Conditions (DH, 2009), we worked to ensure the service was:

* Quicker and easier to use

* More closely matched to people's needs

* Better co-ordinated so that people do not see a lot of different professionals and repeat the same information about themselves

* Provided for as long as people need it, so that treatment continues without the need for

a referral every time the person has a new problem

* Better at helping people with neurological conditions and their carers to make decisions about care and treatment

* Provided by people with knowledge and experience of specific conditions

* Giving people with long-term neurological conditions better results from their treatment

* Planned around the views of people with long-term neurological conditions and their carers

* Able to give people more choice about how and where they get treatment and care

* Better at helping people to live more independently.

We also took into account the NSF for mental health, No Health Without Mental Health (2011). The team used the values from this report to ensure freedom, fairness and responsibility, meaning that mental health is everyone's business. This led on to the user-friendly version of a care pathway now being piloted in the Tiverton complex care team and acknowledged by the trust's dementia leads. This has led to better inter-partnership working and understanding of each other's roles and responsibilities within the pathway.

It is expected that this will lead to a seamless, person-centred approach to all aspects of care for people diagnosed with dementia and long-term care needs in the future.

It is anticipated the new user-friendly dementia care pathways will be rolled out to all areas and clusters with Northern Devon Healthcare NHS Trust to benefit the ever-growing numbers of people living with dementia, and their families and carers.

References

Department of Health (DH). (2009) Living Well with Dementia, A National Dementia Strategy. London: DH. DH. (2011) No Health Without Mental Health. London: DH.

Northern Devon Healthcare Trust (NDHT). (2013) Dementia Strategy (2013 to 2015). Exeter: NDHT.

Susan Nyandoro

Community Matron for Long-Term Conditions

Shiobhan Pickering

Community Matron for Dementia

Northern Devon Healthcare NHS Trust
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Author:Nyandoro, Susan; Pickering, Shiobhan
Publication:Community Practitioner
Geographic Code:4EUUK
Date:Oct 1, 2014
Words:754
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