New report highlights the need to improve dementia care

Services need to be improved urgently for people with dementia and their carers, as the costs of care could triple within 20 years if we don’t take action, says a new improvement report on dementia care by the Health Foundation.

There are 750,000 people with dementia in the UK and this is forecast to increase to over a million by 2021. The burden and costs of care are huge: around £8bn in direct care costs, with an estimate of £20bn associated costs to the economy as a whole.

Spotlight on Dementia Care brings together data on performance, case studies, research evidence and key recommendations from major policy documents. The summary of recommendations broadly align to form a ‘road map’ for high quality care, but the performance data shows that this level of care is not in place across our health and care systems.

The report also details how the care pathway can be improved at every stage from diagnosis and support in the community, through to appropriate care in hospital and better residential care. It highlights examples of good practice and data on current performance, demonstrating widespread variation in care provision across the country.

The report concludes that both the level and the style of care provision are not meeting people’s needs and this is resulting in a poor experience of care and higher costs.

In order to help services address the gap between current provision and best practice, the report summarises the research evidence on ways to improve care in the most cost-effective way.

Martin Marshall, Clinical Director and Director of Research and Development at the Health Foundation, said, ‘The rising numbers of people with dementia presents a major challenge to the health and social care services. This report highlights where the challenges lie and suggests ways of improving outcomes for people with dementia and their carers, and how resources could be used more effectively. We aim to help raise the quality of practice in dementia care, signposting people to sources of research and good practice evidence and hope it will encourage clinicians, managers and policy makers to take concrete action.’

Based on the evidence, the Health Foundation calls for action to improve care along the dementia care pathway:

Action on support in the community

• Providing early diagnosis support through memory clinics is a relatively inexpensive intervention but could save thousands of pounds in care costs, by supporting informal carers to cope for longer in their own homes.
• Better provision of community support groups, both for people with dementia and carer support groups, respite care and ‘sitting services’ to give carers a weekly break, are all cost-effective ways to enable people to live at home for longer, thus reducing the huge costs of residential care.

Action for hospital care

• Better care is needed for people with dementia when they are admitted to general hospital for an unrelated condition.
• Hospitals need to implement systematic dementia assessment for elderly patients, have liaison psychiatry arrangements in place and ensure that all care staff has training to recognise and respond to the needs of people with dementia. Appropriate care in hospital has the potential to dramatically reduce length of stay, releasing acute bed capacity, saving costs and also enabling more patients to return to their own home

Action to reduce inappropriate prescribing

• Inappropriate use of anti psychotic drugs, as a way of chemically modifying behaviour, is not acceptable.
• Research has shown that within current prescribing patterns less than a quarter of those prescribed anti-psychotic medication gain any benefit and these drugs can have serious adverse effects ranging from death, to strokes, to problems with walking, which need to be weighed up against possible benefits in every instance. Every prescription of anti psychotics needs to be backed up with a rigorous needs assessment.

 Action on research

• Increasing the scale of bio-medical research will help to identify causes, treatments and a cure for dementia.
• Statistics show that while dementia care costs are three times that of cancer care, the investment in medical research for dementia is less than one-sixth of the total for research into cancer. New treatments which could reduce the burden and costs of care both for the NHS and for individual carers would provide a huge return on the research investment that would be felt across society.

 Download the full report: Spotlight on Dementia Care