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Early diagnosis for people with dementia has been shown to have benefits in terms of patient and carer quality of life and independence. There is also evidence to show that there is a financial benefit as a result of delayed need for care.
Representatives from Oxfordshire County Council Adult Social Care, Oxfordshire Clinical Commissioning Group and the Dementia Support Service will share with the Committee how they are working together to support people with dementia and their families, particularly in the context of recent changes to other services such as daytime support. A presentation to the Committee will provide an overview of dementia diagnosis, the dementia pathway, dementia support services and end of life care for dementia patients.
More information about dementia support services can be found on the website
http://www.dementiaoxfordshire.org.uk/
Minutes:
Early diagnosis for people with dementia had been shown to have benefits in terms of patient and carer quality of life and independence. There was also evidence to show that there was a financial benefit as a result of a delayed need for care.
The following representatives from Oxfordshire Clinical Commissioning Group, Oxfordshire County Council’s Adults Social Care and the Dementia Support Service attended to share with the Committee how they were working together to support people with dementia and their families, with particular reference to recent changes to other services such as daytime support:
- Sonja Janeva – Oxfordshire Clinical Commissioning Group (OCCG)
- Mandy Carey – Dementia Oxfordshire
- Nicola Luxton – Dementia Oxfordshire
- Benedict Leigh – Oxfordshire County Council
A slide presentation was given to the Committee which provided an overview of dementia diagnosis, the dementia pathway, dementia support services and end of life care for dementia patients.
During the question and answer session that followed, the Committee established the following:
· Representatives were unaware of any new drugs on the market except for ones which allowed the slowing down of the degeneration process, which had appeared in recent years;
· In recent years there had been a significant emphasis put on research and funding;
· All care homes specialising in dementia came under Sonja’s remit;
· There were benefits from the early diagnosis of dementia. It was important to know who had been diagnosed with dementia within a locality, so that need could be planned and support given. Furthermore early diagnosis also presented circumstances where personal preference would be taken into consideration alongside support;
· There were two types of mental health services, one for older people, which largely focused on dementia, and one for working age people suffering from illnesses such as depression or psychosis. Those of a younger age diagnosed with dementia were automatically referred to the working age team. The cut-off age from one to the other was 65. Currently Oxford Health was exploring all age mental health teams and more teams focused on the frail elderly;
· There was no strong evidence to suggest that a person’s existing mental health condition could be masking dementia, even though they could be suffering from other mental health problems. However, there was an increased prevalence for people with a learning disability to develop dementia at a younger age than the norm. Ideally they should be offered an annual GP health check;
· Many people suffering from dementia lived alone. This was dependent on how the person felt about that. Services such as ‘Phone Friends’ were available to them and there were other means of support given, such as dementia friendly aisles in Sainsbury’s. The Alzheimer’s Society also ran a ‘dementia friends’ service and Carers Oxfordshire, which came under the auspices of Age UK, also ran a ‘Guideposts’ service;
· In response to a question about how we can prevent people with dementia being placed out of county, Benedict Leigh explained that the Orders of St John and other partners were exploring the possibility of building specialist dementia care homes in Oxfordshire. A key challenge was sourcing an organisation equipped to run a good care home for specialist placements. They were also looking at existing provision in Oxfordshire, with a view to it becoming more specialised in favour of dementia patients. He agreed to return to a future meeting of this Committee with the case for investment in specialist units;
· Dementia funding was a challenge that was increasingly being picked up by local authorities and Oxfordshire was one of the lowest funded authorities per individual. This was a significant issue that had not however been picked up as part of the discussions around the Oxfordshire Transformation Plan. More funding was needed particularly around the County Council’s ability to provide community support. Oxfordshire was very fortunate in having a large pooled budget which met the majority of patient needs. Sonja reminded the Committee that Continuing Health Care funding was available for dementia patients. She also informed the Committee that some work on the dementia pathway and diagnostics had been undertaken as part of the Phase 2 proposals of the Oxfordshire Transformation Plan. Health were at a stage where testing was required to ascertain if further work was needed. A workshop with users was being held in July to look at how the pathway was working for them;
· Health were keen to enable other services to care for people with dementia, rather than develop dementia specialist services. District nurses were being trained in giving support to dementia patients living in the community, with the support of a dementia adviser (of which there were 9 fte in Oxfordshire) should a person require a clinical input. A large number of sessions had already taken place on raising awareness of dementia. Advisers, who each had background in casework and were trained to NVQ level, had been assigned GP surgeries and follow-up clinics from which to work. They were also happy to post information out to people via their computer;
· With regard to a question about the extent to which people could be supported in their own home and what the tipping points were for a family when coping with a relative’s dementia, Benedict Leigh recognised the importance of respite care. Respite could be accessed through nursing and care homes nursing home. However, he recognised the difficulties experienced by families of self-funders as care homes tended to favour long-term clients. Furthermore, patients and families did not tend to want bed-based care. He undertook to provide a briefing on respite care.
The Committee recognised the importance in assisting society to better understand the different stages of the illness and the kind of support required for that person. It followed that as society aged then there would be less anxiety and concern about the kind of support that would be given. To this end it was hoped that the ‘Dementia Friends’ course would become more valued in the years to come. It was also noted that the local Fire Station in Witney had also rolled out this course.
The Committee AGREED to thank the representatives for attending, commenting that they looked forward to their return to the Committee at a future date to present on the:
(a) outcomes of work being undertaken with the Orders of St John to explore the use of land within the county to develop dementia specialist units; and
(b) provide a briefing on respite care for patients.