Dementia Care: a marginalised but important speciality!

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Dementia Care a marginalised but
important speciality!

• Dr Trevor Adams
• Honorary Fellow
• University of Brighton

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This is a photo of my mother (far left ), my
father (far right) and myself (next to my
father). It was taken at Butlins in August 1965.
My father died five months later, and my mover
later remarried. My mother developed dementia in
the late 1980s. The photo is significant
because dementia arises within the family and is
set against a backdrop of all that has happened
in that family. Dementia is a family affair.
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• After six months in certain hospitals, there are
• ways in which psychiatric nurses are no longer
• like ordinary people. Their attitude to mental
• illness changes - as it does to old age, to
  cruelty,
• to peoples needs, and to dying. It is as if they
  
• become numbed to these things.
• (Sans
  Everything 1967)

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Living Well with Dementia a national strategy
(DH 2009)

• Objectives
• 1 Improving public and professional awareness an
  understanding of dementia.
• 2 Good-quality early diagnosis and intervention
  for all.
• 3 Good-quality information for those with
  diagnosed dementia and their carers.
• 4 Enabling easy access to care, support and
  advice following diagnosis.

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• 5 Development of structured peer support and
  learning
• networks.
• 6 Improved community personal support services.
  
• 7 Implementing the Carers Strategy.
• 8 Improved quality of care for people with
  dementia in
• general hospitals.
• 9 Improved intermediate care for people with
  dementia.
• 10Considering the potential for housing support,
  housing-
• related services and telecare to support
  people with
• dementia and their carers.

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• 12 Improved end of life care for people with
  dementia.
• 13 An informed and effective workforce for
  people with
• dementia.
• 14 A joint commissioning strategy for dementia.
  
• 15 Improved assessment and regulation of health
  and care
• services and of how systems are working for
  people
• with dementia and their carers.
• 16 A clear picture of research evidence and
  needs.
• 17 Effective national and regional support for
• implementation of the Strategy.

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• Prepared to care
• Challenging the skills gap
• All-Party Parliamentary Group on Dementia
• June 2009

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• The negative attitudes surrounding dementia,
• which incorporate ageism, have acted as a
• barrier to workforce development in terms of
• individual practice and public policy. The
• mistaken, but lingering, belief that attempts to
• improve well-being in people with dementia are
• hopeless has resulted in little priority being
• assigned to developing a workforce with
• appropriate skills.

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• anecdotal evidence that the proportion of staff
• receiving dementia care training is low, even
• among those working in specialist dementia
• Services.

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Recommendations of Prepared to Care 1. The
Group urges the Department of Health to
prioritise early work on achieving Objective 13
of the National Dementia Strategy for England
An informed and effective workforce for people
with dementia. 2. We need to move towards a
situation where the workforce as a whole
demonstrates effective knowledge and skills in
caring for people with dementia.
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3. It is important that workforce development
programmes are carefully designed to meet the
needs of care staff and ultimately improve the
lives of people with dementia. 4. There must be
greater regulation of dementia care trainers to
combat the current inconsistencies in quality. We
recommend the development of a kitemarking
system. 5. There must be greater recognition of
the level of skill required to provide good
quality dementia care as well as the importance
of maximising the quality of life of individuals
who develop dementia.
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6. It is vital to develop effective working
relationships between commissioners and service
providers that are based on a good knowledge of
what good dementia care is and what is required
to provide it. 7. Good dementia care is reliant
on well-integrated working between social care
and healthcare.
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• Higher education provision for professionals
• working with people with dementia A scoping
• exercise.
• David Pulsford, Kevin Hope and Rachel
• Thompson
• Nurse Education Today 27, 1,
• January 2007, pp. 5-13.

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• National UK survey of higher education
• provision related to dementia care.
• coverage of dementia within the mental health
• branch of pre-registration nursing programmes
• is very variable, and may be related to the
• presence of an experienced and committed
• lecturer within the HEI.

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• Coverage of dementia on adult branch
• programmes is limited, and sometimes non-
• existent, despite reported deficits in the
  ability
• of general nurses to work effectively with people
  
• with dementia.

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• Two recent areas I have been involved with at
• the University of Surrey are
• the use of web based material to help teach
  general nurses about dementia care.
• http//www.scie.org.uk/publications/elearning/me
  ntalhealth/index.asp
• (2) SCEPTrE Fellowship on develop freely
  available dementia care learning materials on
  YouTube.
• http//sceptrefellows.pbworks.com/Trevor-A
  dams