Cumbria Dementia Strategy Improving Recognition & diagnosis David Storm- Clinical Lead: Dementia Memory matters

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.

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

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 Memory matters

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%

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

Developments in the Pathway Primary Care Pathway Memory Matters Screening Form (3 D’s) 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

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 3D’s screening tool and act as support to use of tool. Local Dementia training Use of 3 D’s Screening tool in Community Hospitals, Community Nursing, Adult Social Care Memory matters

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

Improved early recognition 3D’s screening tool 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 person’s changing needs Services working together to focus on Family and their well being- not illness in isolation Memory matters

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 King’s 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

Memory matters References: National Institute of Clinical Excellence, (2006) Supporting People with Dementia and their Carers in Health and social Care. NICE Guideline ukwww.NICE.org National Institute of Clinical Excellence, (2010), Quality standards for Dementia. uk NICE technology (2011) appraisal Donepezil, galantamine, rivastigmine andmemantine for the treatment of Alzheimer’s disease (review) 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 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 R&D HTA Programme.