Produced by Wessex LMCs Dementia Produced by Wessex LMCs in partnership with: Wessex AHSN Dr Nicola Decker, GP Alzheimer’s Society

Contents: Why are we here? Understanding Dementia The Brain Symptoms – four main dementias Case Studies Models Visual problems Communication Further Resources Questions

This is designed as an interactive session to use in general practice to increase the understanding of a condition that affects many of your patients and has a significant impact on their family.

Becoming a……… Dementia Friendly Practice

Figures 1 in 14 people over 65 have dementia. 1 in 6 people aged 80 and over have dementia. 850,000 people live with dementia in the UK today.  20,000 people living with dementia in Hants 108 diagnosed at Oakley Surgery Scrutiny committee report

Facts Two thirds of people with dementia are women At end of life, one third of people will have dementia Dementia is most common in older people but younger people (under 65) can get it too. 40-64 years: 1 in 1,400 65-69 years: 1 in 100 70-79 years: 1 in 25 80+ years: 1 in 6

Case Studies

Small Changes…… Big Differences….. Make sure all health-care staff know whether a patient has dementia before they are seen Remember! People living with dementia may need a longer appointment Don’t let people with dementia fall out of the system if they don’t keep appointments NB! If someone without a dementia diagnosis repeatedly forgets to attend appointments, it may be a sign that they should be screened If possible, send appointment reminders to both patient and carer Where appropriate, include family carers in decision making Ensure family members have copies of relevant documents – letters, monitoring equipment, appointments, changes to medication etc Continuity of care is very important to the person with dementia – it is better to be seen by the same health-care professional on each visit This information has been collated from the summary of findings from some research at Bradford Uni.

Communication Before you speak When you speak What to say Listening Body Language and Physical Contact  

Perceptions of what life is like for people with dementia… 58% thought quality of life was fairly bad or very bad 52% thought that care provided was fairly bad or very bad 61% thought inclusion in communities was fairly bad or very bad YouGov survey 2011

People with dementia feel that their community could help by: Better understanding of dementia and less social stigma More public awareness of the condition More local activities and opportunities to socialise More tolerance and patience from others More community spirit Source: Alzheimer’s Society Dementia 2012 Report

NHS Commitment to raising awareness Awareness – understanding symptoms, recognising signs, challenging behaviour; Knowledge of the condition – types of dementia, differences between dementia, delirium, depression etc. Communications, listening skills and supporting people with dementia; Person centered care – sign posting to advice and guidance, medication, ethics, impact on families.

Risk factors for developing dementia Age Lack of physical exercise Obesity Mental activities in mid life Diabetic Current Smoking Excess alcohol Genetics Learning disabilities

Modifiable Risk Factors

Diagnosis – the earlier the better Only 1/3 of people with dementia have a proper diagnosis. Early diagnosis means that: There is more time to plan ahead and support self management The carer is able to cope for longer The need for placement of the patient away from their home is delayed

Support for Carers and Family Registering as a carer with GP Carers Together/Princess Royal Trust for Carers Carers assessment Information and resources Alzheimer’s Society/Andover Mind Memory advisors and support teams Adult services

What can we do? Become “dementia friends” (see ’Video about dementia friends’ if access to the internet is available) Support national campaigns Become a ‘Dementia Friendly Practice’

Our role as a dementia friendly practice Maximise health and well-being and help people to remain independent Improve patient and carer experience Improve teamwork Improve clinical consultations – better prescribing & improved referrals Improved care planning for the future Improved quality of life for our patients Know & be able to sign post patients to available services

Where can you find more information? www.alzheimers.org.uk www.dementia.org.uk. www.dementiafriends.org.uk www.scie.org.uk (e-learning)

So………… What do we want to do as a practice?