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People with dementia are prone to persistent walking (also known as ‘wandering’). Walking can bring physical and psychological benefits, but people with dementia also walk because of anxiety or confusion. People with dementia are at risk of becoming lost or involved in accidents, and this raises concerns for them and their carers. Electronic surveillance and tracking, as a form of safer walking technology, can be used to monitor people's whereabouts and is being used in dementia care. The technology raises a number of practical and ethical issues. This article reviews the key themes and arguments surrounding its use, with a view to raising issues for further debate. The article shows the need to carefully balance people's freedom and rights, including the right to take risks, with care and safety concerns.

The dementia-friendly housing charter was developed by the sector in response to the Prime Minister’s challenge on dementia and a need for this resource within the housing sector. The purpose of this paper is to highlight the positive impact the housing sector can have on people living with dementia and identify resources available which the sector can use to support this.

The charter identifies relevant resources and examples of good practice to encourage their integration into all aspects of people, places and processes, the three “pillars” which the charter is built around. To develop the charter, people with dementia were engaged to identify the challenges they face and potential solutions that could be provided. The feedback of people with dementia highlighted the importance of design in housing to ensure it meets an individual’s needs as their dementia progresses. This could include adaptations such as sensor lights, plug sockets at arm level, wet rooms and open plan living. The importance of good quality training for staff was also highlighted.

There are a number of areas that were not included in the housing charter. Some were consciously not included, such as care homes, while others such as issues apparent when considering the wider agenda of equality are now being explored and will be incorporated.

In the first three months, over 600 copies of the charter were downloaded by a range of organisations including housing with care providers, local authorities and housing associations. An evaluation of the effectiveness of the charter will take place during Autumn 2017 to understand more about the success and limitations of the charter after which amends will be made if required.

The Alzheimer's Society has developed a range of services including awareness campaigns, information for people with dementia and carers, peer support networks, dementia advisers and learning and education programmes. In our next article, Andrew Chidgey sets out the current evidence on dementia and advises on some of the big opportunities to change the quality of life for people with dementia. He also explains why the Alzheimer's Society has produced guidance on what commissioners need to consider when commissioning services for people with dementia.

This is the second of two papers that aim to propose a revised model of care for dementia based on the combined findings of a number of projects undertaken by the authors.

The paper is a conceptual discussion based on the findings from a series of projects in which the key methodologies included listening to people with dementia and carers, non‐participant observation of services, and reviews of good practice, policy and literature.

The paper challenges traditional approaches to dementia services, and offers a radical new approach, based on a five‐pronged model of care: guiding principles, the condition itself, the person with the condition, services and effectiveness.

This paper challenges commissioners and service planners to make a radical shift in their approach to dementia, people living with it and services and opportunities that should be in place. It proposes that dementia services should be delivered principally in the community, led by primary care, with opportunities for inclusion and social engagement. Specialist dementia services need to refocus on providing effective interventions, training, advice and support. People living with dementia have assets as well as needs; this means changing practice to work alongside people as partners in care, nurture their capacity and capabilities and recognise and pre‐empt increasing needs.

The revised model of care implies a radically different approach to commissioning, designing and delivering services. It is a challenging, but optimistic, model, in which high quality, focused, cost‐effective services and community developments could work together as a whole system, to make living well with dementia a real possibility.

The purpose of this paper is to share findings from the evaluation of dementia adventure (DA) holidays provided in 2016 and drawing on these data, to share reflections on positive risk-taking, which are inherent in outdoor activities, and consider the implications for research and practice with people with dementia.

Data are drawn from the 2016 internal evaluation report, using mixed methods design, of DA holidays independently reviewed by Dr Ruth Bartlett at the University of Southampton.

DA holidays are leading to a range of social, emotional and physical well-being outcomes, as well as wider benefits for the community of people with dementia, their family and carers.

Drawing on what positive risk-taking means for individuals, families and organisations, top ten considerations for positive risk taking outdoor activities are presented.

The number of organisations providing adventure experiences and holidays for people with dementia in the UK remains very low with just a handful of organisations. The impact and evaluation of these holidays is just emerging and whilst compelling needs replication, with larger sample sizes supported by clinical and scientific expertise to deepen our understanding of the impact of positive risk-taking outdoor activities. Additionally, there is a need for thinking and acting differently summarised by the phrase “THINK OUTSIDE” in developing a wide range of nature based positive risk-taking activities with people with dementia.

The perspectives of people with dementia and their care partners regarding “extra care” housing are currently unknown. The purpose of this paper is to report findings of a consultation study exploring the perceived barriers and facilitators of a relocation to extra care housing, from the perspective of people living with dementia, and their care partners.

Fieldwork consisted of paired or 1-1 interviews and small focus groups with potential users of an alternative model of extra care support for people living with dementia in the South of England. The consultation took place between June and August 2013. The interviews and focus groups were audio recorded, transcribed verbatim. The transcripts were analysed thematically.

Benefits of extra care were identified as the opportunity for couples to remain living together for longer, creating a supportive, dementia-friendly community, and a reduction in the strain experienced by the care partners. Barriers centred on a sense of loss, stress and uncertainty. Living and caring at home was perceived as preferable to shared care.

The findings presented here have limited generalisability for two reasons. First, the shared care approach consulted on was very specific. Second, the participants form a purposive sample and as such are not representative of a wider population. Despite best intentions, the voice of people with dementia, are underreported in this consultation. Only one person with early on-set dementia was interviewed and the remaining two people with dementia were interviewed alongside their care partner.

The findings cast doubt on the viability of extra care facilities, designed for couples living with dementia, if extra care continues to be conceptualised and marketed as a preventative lifestyle choice. The findings indicate the value of consulting with people with dementia, and their care partners, when designing new forms of housing with care specifically for people living with dementia.

The findings of this consultation exemplify the wish of couples living with dementia to remain together, in what they perceive to be “home”, for as long as possible. Couples living with dementia are therefore unlikely to wish to move into an extra care facility as a lifestyle choice option, early into their journey with dementia. This raises questions about the suitability of extra care, as a form of housing with care, for couples living with dementia.

This paper contributes to the body of literature, exploring the feasibility of new and innovative alternative care and housing options, for people with dementia. This paper is one of the first to explore extra care as a housing and social care option for couples with dementia.

People with Down's syndrome are at increased risk of developing early onset Alzheimer's disease. It has been recommended that all adults with Down's syndrome receive baseline neuropsychological testing for dementia. In certain areas prospective screening of people with Down's syndrome takes place to ensure the early diagnosis of the condition. However, little has been published on the value of this type of screening. The purpose of this paper is to report on a prospective screening programme and asks whether the programme is effective in identifying dementia-related changes in people with Down's syndrome and whether the current screening intervals are appropriate.

All adults with Down's syndrome in Plymouth (UK) are identified and offered a comprehensive test battery at baseline at the age of 20 and then have testing biennially from 40 to 50 and annually after 50. All individuals diagnosed with dementia between 2001 and 2013 were identified and their case notes examined. The symptoms at the time of diagnosis were identified and whether these symptoms had been identified through the screening programme or by other routes were recorded. Prevalence data and age at diagnosis were also recorded.

In total, 26 people were diagnosed with dementia during the study period. Of these, the diagnosis of dementia followed concerns being identified during the routine screening programme in 54 per cent of cases. In the younger age group (age 40-49) 63 per cent of people were identified through the screening programme. At the time of diagnosis a mean of 5.5 areas of concern were in evidence.

Limited by small sample size, however service development not original research. Implications for the use of prospective dementia screening in people with Down's syndrome.

Implications for how services choose to run their Down's syndrome and dementia screening programmes, including the frequency of screening.

The paper adds to a growing evidence base around the value of prospective dementia screening in people with Down's syndrome. It is also one of a few studies exploring the frequency of screening. Additionally, it adds further data about prevalence of dementia in people with Down's syndrome.

Services for people with dementia in the UK have developed piecemeal in the context of wider agency agendas. Health and social care agencies located in rural areas face particular challenges if they are to be able to support people with dementia within their communities. This article describes a piece of work carried out in three rural counties in East Anglia designed to map services across the statutory, voluntary and private sectors, and to describe the ways in which national policy is being interpreted to meet local need. Examples of innovative practice, as well as gaps in service design and delivery, were identified through an examination of local policy documents and qualitative interviews with strategic managers, frontline managers and practitioners, and local carers of people with dementia. The findings confirm that services for older people with dementia are under‐developed in comparison with services for older people generally, and in comparison with mental health services for working age adults. There are particular gaps with respect to rarer types of dementia, services for people with learning difficulties, and services for people from minority ethnic groups. Historically, a lack of strategic planning has meant that service development has been patchy and unco‐ordinated. Carers have been affected by a shortage of joined‐up information, high eligibility criteria and a change to short‐term working by practitioners. Nevertheless, the potential for developing community‐based and inclusive services for people with dementia is apparent, and the adaptability required of rural areas may, subject to further evaluation, provide a template for service development elsewhere.

The purpose of this paper is to describe a community-based peer support project in the London borough of Brent, led by people living with dementia for people living with dementia.

The Brent Dementia Peer Support Project is a collaboration between a social movement Community Action on Dementia Brent, Brent CCG, Brent Council, third-sector organisations and faith communities.

Stakeholder workshops, ethnographic research highlighted the need to support people living with dementia, especially by people who understand that experience. The findings also demonstrated the abilities and skills retained by people living with dementia, their wish to help others to contribute and to remain connected with their communities.

This is an account of one pilot project in a London borough, but is broadly applicable elsewhere. Further research is needed into the values and practicalities of peer support by and for people living with dementia.

People with dementia and their carers lack accessible information and empathetic support to cope with the condition and live independently. This can be offered through dementia peer support services.

There are growing numbers of people living with dementia who are motivated to share their knowledge, skills and experiences to improve the lives of other people with dementia.

This paper describes how people with dementia can be enabled to design, inform and deliver support to other people with the condition.