[A version of this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 1 Issue 11, June 2011].
Current service provision for dementia sometimes fails to support patients and carers in many aspects of day-to-day life, resulting in many patients going into inappropriate care settings.
There is often inconsistency in the diagnosis of dementia, and in the way that care is commissioned and provided. The lack of adequate data makes it hard to quantify the true costs of dementia to the state, to patients and to carers.
Policymakers, organisation leaders, patient and carer representatives, academics and practitioners attended a workshop in London, held early in 2011. Their purpose was to examine the opportunities and challenges faced by those living with, or caring for, people with dementia; to explore the future of services for people with dementia; and to look at delivery options for home-based service models.
A key issue concerned how a home-based model of care might be created in order to keep dementia patients out of hospital. An estimated 25% of patients admitted to hospital have dementia, and it is thought that many hospital admissions could be prevented if patients and their carers were better supported at home.
This report explores the definition of an alternative model. It explores areas where patients are being let down currently, and the stimulation of genuine cooperation across sectors. The group developed a new approach to dementia care, outlining practical steps to improve the experience patients and carers at a lower cost to the NHS and local government.
Topic headings in this report cover today’s care settings, identifying and mapping unmet need (“mind the gap”), bridging the gaps (a suggested model of care), and building the case for change based on conclusions and recommendations drawn by the meeting. This report:
- Identifies where patients and carers are currently being let down within today’s system of care: demonstrating unmet needs for stimulation, respite care and access to round-the-clock clinical care.
- Lists the care settings in which such needs are most at risk of going unmet (such as residential homes, state-funded care).
- Defines and maps a new model of care intended to result in better, more efficient care, and reduce hospital admissions.
- Proposes a model providing a single point of access to service and support, which would be available 24 hours a day / 7 days a week, improve care and reduce hospital admissions.
- Indicates that transferring patients into a properly mapped home-based care pathway could save the NHS over £127 million per year in avoidable hospital admissions.
- Proposes that the Department of Health should identify the actual cost of dementia care in today’s system. It is asserted that developing a usable tariff or capitated payment method would help identify the true costs of dementia.
The report finds that the cost of caring for dementia patients can be reduced by up to a quarter if the recommendations for a home-based model of care were implemented.
The role of the Dementia Care Coordinator is discussed, as are methods of empowering and assisting patients, carers, care home staff and primary care in order that persons with dementia can be managed outside of hospital more successfully.
Poole, R. Kafetz, A. [and] Bedford, Z. (2011). Understanding out of hospital dementia care: report 2011. Burton on Trent (Staffordshire): Healthcare at Home Ltd (HaH), May 2011.