A wide range of factors adversely influence services for people with dementia and can act as barriers both to maximising their care and to providing cost-efficient services, according to Directors of Adult Social Services.
In a report submitted today to Members of Parliament, ADASS warns that inconsistent and fragmented advice and information for service users and carers, fragmented services working in silos, and not having a shared approach to risk between the various professionals, carers and individuals concerned are among the major barriers to providing successful services.
These are closely followed by others which include:
* Inappropriate assumptions about what people with dementia can’t do, rather than basing planning and service delivery on what they can still do,
* Inadequate training,
* Lack of access to early diagnosis,
* Lack of clarity about what prevention and early intervention services are most effective.
* Inconsistent carer support, and not treating carers as partners in the support of people with dementia,
* Lack of support to care homes in their role.
Services for people with dementia not being mainstreamed within wider initiatives for health and social care, for example personalisation, long term conditions, access to appropriate accommodation, using telecare, improving hospital care.
While being neutral as to how widespread these barriers are, the ADASS report lists a number of remedies which, wherever actioned, could lead to better services for people with dementia achieved very often at reduced costs.
Some examples of good practice include:
* Avoiding admissions where possible both to general acute and to mental health inpatient wards through, for example, work with care homes and ambulance services, or through using community based crisis services
Shortening lengths of stay through better discharge processes.
* Training for hospital staff on caring for people with dementia
* Better co-ordination of person centred plans while the person is in hospital
Meanwhile ADASS says that care in people’s own homes would be improved by a number of measures including extra assistive technology, peer support for people with dementia and their carers, and flexible support “provided by staff who understand the impact dementia can have on the person and those around them, including positive risk assessment.”
A separate section deals with practices which could help care homes provide better and more cost-efficient services, while some excellent case studies are provided describing in some detail a number of services up and down the country where successful improvements have been made.
Simon Williams, ADASS Lead for dementia Said “I really have been impressed, while preparing this report, at the number of hugely successful examples of good practice to be found within our joint health and social care approaches to dementia.
“Dementia has a become a key area where close social care/health service integration can yield a better life for people with dementia, greater support for the people who care for them and greater savings for both sets of services. At a time when financial restraint is very much in our minds this must represent a win-win-win for all concerned.”