1. Dementia in the community Justine.Schneider@nottingham.ac.uk

2. Memory Clinic Appointment Acute Hospital Admission

3. For 9% of people admitted with memory problems, no carer could be identified. Carer strain related to sleeplessness, agitation and irritability in the person cared for Co-resident carers (mostly spouses) had higher levels of strain than other carers 66% of carers had nobody to back them up Acute Hospital Admission

4. Today is Monday http://www.owendavies.info/TODAY-IS-MONDAY Acute Hospital Admission

5. 32% of study participants had died 29% had been admitted to residential or nursing care Of these, 79% survived Carer strain had reduced only slightly and not at all in the latter group Six months after Acute Hospital Admission

6. Memory Clinic Appointment Acute Hospital Admission

7. Memory assessment services Single point of referral Should include a full range of assessment, diagnostic, therapeutic, and rehabilitation services Should ensure an integrated approach in partnership with local health, social care, and voluntary organisations NICE Guidelines CG42, updated May 2016 Memory Clinic Appointment

8. Diagnosis – mixed reactions 1.4.6.1 Healthcare professionals should be aware that people with dementia and family members may need ongoing support to cope with the difficulties presented by the diagnosis. NICE Guidelines CG42, updated May 2016 Memory Clinic Appointment

9. Written information should be provided on: (1.4.6.2) the signs and symptoms of dementia the course and prognosis of the condition treatments local care and support services support groups sources of financial and legal advice, and advocacy medico ‑ legal issues, including driving local information sources, including libraries and voluntary organisations. NICE Guidelines CG42, updated May 2016 Memory Clinic Appointment

10. Alzheimer Scotland, 2011

11. Future decision making Power of Attorney – financial and welfare Advance Directive Nominate a consultee under MCA

12. Understanding Dementia Radford Care Group Carers’ course Online resources Self-care strategies – Cognitive Stimulation Therapy – Music & Art – Relaxation & Exercise – Diet and Nutrition

13. Care options Domestic support Respite care Crossroads Residential care preferences and hopes

14. Peer Support Both for the carers and for the people with dementia, e.g. Men in Sheds Carers’ Federation

15. Community Connections Day centres/Memory Cafes Befriending Activity groups Dementia Adventure Singing for the Brain

16. Post-Diagnostic Support Guarantee A named person to work alongside the individual with dementia, their partner and family for 12 months to address these five dimensions. The purpose of the post diagnostic input is to enable the individual and their family to develop a robust personal plan that utilises all their own natural supports to live well and independently with dementia for as long as possible. Alzheimer Scotland

17. Take-home message Ongoing support can be provided through careful identification and use of natural supports. It doesn’t have to draw on NHS resources BUT health care providers are in a powerful position to mobilise natural supports.

18. Where do we have room for improvement? How do existing services map onto these five dimensions of support? What is missing?