Cumbria Dementia Strategy Improving Recognition

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Cumbria Dementia StrategyImproving
Recognition diagnosisDavid Storm- Clinical
Lead Dementia
Memory matters
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• Why early recognition and diagnosis is important
• Positive Step- Early recognition can help
  identify and manage treatable forms of confusion
  and dementia
• Positive Step- diagnosis enables the person and
  their family to access advice, information,
  treatments interventions and support that can
  make a difference to their quality of life
• Positive Step- There are many services,
  treatments Interventions and supports available
  to help the person and their family. Some of
  these can slow down the progression of dementia
  and help the person continue to live well.

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• Modernisation of Memory services across Cumbria
• Enable improved access and greater recognition

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Memory matters

• Improved early recognition and diagnosis
• GP/ Primary Care protocol developed to encourage
  early referral (as part of developing Cumbria
  Dementia strategy Integrated care pathway)
• Closer working with GPs and practice staff (roll
  out following pilot of dementia training to
  practice nurses)
• Integrated approaches with dementia training and
  screening tool developed for staff in Community
  services, Community Hospitals with links to
  Community Memory services
• Memory services developed to offer flexible
  diagnosis and support irrespective of setting
  (e.g. clinic based, home based, surgery based)
• Improved information packs

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Improving Recognition of Dementia

• At the start of this work 45 people with
  dementia were known as per GP records
• Current number of people on GP records is now
  over 3800
• We are now up to 63

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How can we improve this further?

• Support people with memory concerns
• Enable them access to diagnosis
• Facilitate extra support
• Ensure the diagnosis is recorded by the GP
• Enhance training for GP Practice Teams
• Improve links and support to practices
• Improve dementia friendly communities and
  awareness

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Developments in the Pathway

• Primary Care Pathway
• Memory Matters Screening Form (3 Ds)
• Smoother referral process
• Clear work up prior to referral
• Closer Liaison with memory services and Dementia
  Support
• Each practice to have a Link Worker from the
  Memory Matters Service

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Memory matters

• Improving Early Recognition
• Link worker to work with practice (improve
  coordinate referrals where required- enable easy
  access to memory clinic)
• Link worker able to provide training, advice,
  information ( GPs, Practice staff etc)
• Link worker provide training on 3Ds screening
  tool and act as support to use of tool.
• Local Dementia training
• Use of 3 Ds Screening tool in Community
  Hospitals, Community Nursing, Adult Social Care

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What can you do?

• Recognise early signs of memory problems
• Alert the person, family, supporters
• Encourage understanding and access dementia
  awareness training
• Reduce unnecessary confusion within environments
• Maintain good lighting etc

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Memory matters
Improved early recognition
3Ds screening tool
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Memory matters
Working together to improve quality of life for
people with dementia

• Developing evidence based services with improved
  equity in line with Cumbrian Dementia Strategy
  enabling local variations but improved access to
  quality services
• Ability to wrap services around natural
  communities while still ensuring access to
  specialist interventions
• Training development key to improving outcomes
  in all settings
• Quality of life central to improving health and
  well being
• Services focus on PERSON not illness- supporting
  person centred care and working in an integrated
  way to support the persons changing needs
• Services working together to focus on Family and
  their well being- not illness in isolation

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Further developments
Improving the environment of care for people with
dementia Improving closer to home Memory
Assessment Improvements to Entrances, Reception
and Way Finding within Community Hospitals
throughout Cumbria- Joint application with
Cumbria County Council, Dementia Friendly Extra
Care Housing Cumbria County Council The
principles for the project will reflect the
Kings Fund overarching design principles for
developing supportive Design for People with
dementia namely Legibility, Meaningful Activity,
Familiarity, Wayfinding, and Orientation.
Refurbishment of reception, way finding and
memory room in 11 sites across Cumbria
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Memory matters

• References
• National Institute of Clinical Excellence, (2006)
  Supporting People with Dementia and their Carers
  in Health and social Care. NICE Guideline 42.
  www.NICE.org uk
• National Institute of Clinical Excellence,
  (2010), Quality standards for Dementia.
  www.NICE.org uk
• NICE technology (2011) appraisal Donepezil,
  galantamine, rivastigmine andmemantine for the
  treatment of Alzheimers disease (review)
  www.nice.org.uk/guidance/TA217
• Dept. of Health (2009) Living well with dementia-
  a National Dementia Strategy. Dept. of Health
  London.
• Implementing the National Dementia Strategy
  working together to improve life with dementia
  in Cumbria www.cumbria.gov.uk/adultsocialcare/part
  nerships/dementiagroup
• Smith S.C., Lamping D.L., Banerjee S., Harwood
  R., Foley B., Smith P., Cook J.C., Murray J.,
  Prince M., Levin E., Mann A., Knap K. (2005)
  Measurement of health related quality oif life
  for people with dementia development of a new
  instrument (DEMQOL) and an evaluation of current
  methodology Health Technology Assessment, Vol 9
  Number 10. NHS RD HTA Programme.