Dementia Strategy for Kingston upon Thames Helen Raison Consultant in Public Health

What is dementia? Dementia is caused when the brain is damaged by diseases Alzheimer’s Disease (AD) Vascular Dementia Mixed dementia Dementia with Lewy bodies Fronto-temporal dementia Rarer causes

Symptoms of dementia: unique, progressive Thinking or memory problems – Day-to-day memory - difficulty recalling events that happened recently – Concentrating, planning or organising - difficulties making decisions, sequencing tasks eg cooking – Language - difficulties following a conversation or finding the right word for something – Visuo-spatial skills - problems judging distances (eg on stairs) and seeing objects in three dimensions – Orientation - losing track of the day or date, or becoming confused about where they are Changes to mood – frustrated or irritable, withdrawn, anxious, easily upset or unusually sad. Visual hallucinations or believe things that are not true (delusions) in some types of dementia Behaviours that seem unusual or out of character – repetitive questioning, pacing, restlessness or agitation. They can be distressing or challenging for the person and their carer. Physical symptoms may be seen in the later stages of dementia – muscle weakness or weight loss, altered sleep pattern and appetite

Dementia Video Grace: A progressive disease Carer stress Living with dementia SCIE Q8tM Q8tM Experience alz dis (USA) Y&feature=player_detailpage Y&feature=player_detailpage

Our Kingston population 1600 residents over the age of 65 have dementia (diagnosed and undiagnosed) which is expected to rise to over 1800 by people registered with GPs (Year 2014/2015) have dementia (diagnosed and undiagnosed) and will rise to 1900 by 2015/ % of older people with learning disabilities have dementia A small number of younger people with early-onset dementia. Most people with dementia have at least one other co-existing illness and nearly two thirds have two or more co-existing illnesses, such as depression, falls, mobility problems and urinary tract infections, diabetes

Local people’s views on living with dementia, and on local services Summer 2014, 200 people consulted Most of this you learn as you go along either word of mouth or months down the line, we need to know about these services from the start.’ (Carer of: 65-79, Dementia ) Improving standards of (home)care and consistency of (home)carers was cited most frequently. (Report on Consultation with Older People with Mental Health Problems in Kingston, 2014) ‘[I am] lonely, as only support worker visits’ (Local person with depression and memory problems)

Our Vision People with dementia, their carers and family feel Kingston is a place where they can live well in the community, and is one of the best boroughs in the country for dementia care and support.

The Strategy A document that sets out the case for change for the way that organisations and communities in the borough should respond to the needs of people with dementia A comprehensive set of objectives Draws on a Consultation in Summer 2014 Requires a multi-agency response Requires co-ordination

Outcomes for People with Dementia I was diagnosed early I understand, so I make good decisions and provide for future decision making I get the treatment and support which are best for my dementia Those around me and looking after me are well supported I am treated with dignity and respect I know what I can do to help myself and who else can help me I can enjoy life I feel part of a community and I am inspired to give something back I am confident my end wishes will be respected, I can expect a good death Adopted from the National Dementia Strategy

Strategy has four parts: The strategy makes the case for change for each part Builds on last years Consultation exercise Sets out objectives i.e. what we want to achieve Improving Wellbeing, Raising Awareness, Reducing risk Timely Diagnosis and Assessment and Intervention Living Well with dementia: Increasing Support in the Community High Quality Care – in times of crisis, care home care and end of life care

Person-centred response Person with dementia Family & Carers Memory Assessment Carers support Choice of place to live (home or good quality care home) Crisis support End of life care Information and advice Ongoing help to navigate services Personal home care Support groups Promotion of health and wellbeing for all Dementia friendly communities – dementia friends -dementia champions Dementia Friendly environments – towns, transport, shops, hospitals Good public awareness and understanding Universal services accessible to people with dementia Help with entitlements, advocacy, legal issues Co-ordinated health, social and voluntary care

Timeline Summer 2014 – Exploratory Consultation with people who have dementia and their carers Spring 2015 – Age-Related Mental Health Board draft the strategy 12th May Kingston CCG Council of Members reviewed draft strategy and agreed to direction of travel 11th June Stakeholder Event - stakeholders refine, revise and sign up to strategy, begin setting priorities and action plan 11th June Health Overview Panel -scrutinise the strategy 17th June RBK Residents Health and Care Services Committee will review and recommend adoption to the HWBB 24th June Health and Wellbeing Board will consider and adopt the strategy Summer 2015 onwards – Implementation

Stakeholder Event – 11 th June Statutory sector, voluntary sector, independent organisations, people with dementia and their carers Review and revise the strategy Select the most important areas for action Start detailed action planning

Contacts Donal Hegarty, Mental Health Commissioner Phil Moore, Clinical Sponsor Helen Raison, Consultant in Public Health