George McNamara, Head of Policy at Alzheimer’s Society
In recent years, dementia has rocketed up the public agenda. With 850,000 people in the UK living with dementia and an annual cost of £26bn to the economy, the condition is finally been considered a national priority. But there is still a long way to go.
For too long, the necessity and value of social care has been neglected. The social care work force has a huge role to play in caring for people with dementia; staff must be empowered by their training and work conditions to provide the best quality of care.
Dementia is an umbrella term used to describe the symptoms in the brain caused by a number of different diseases or conditions. These symptoms can include memory loss, behaviour and/or mood changes and communication problems. The most common type of dementia is Alzheimer’s disease but there are over 100 other varieties. How these symptoms manifest themselves and the speed at which they progress will depend on the disease but will also differ from person to person.
Many reports have highlighted workforce training as a major issue for the provision of care to people with dementia. In the Care Quality Commission's 2013 Care Update, it was recommended that staff providing formal care for people with dementia must have adequate training and support. Particularly, staff should understand how to communicate with people with dementia to elicit views about their preferences and needs. Failure to appropriately communicate with the person with dementia can result in inappropriate decisions being made about their care.
Alzheimer's Society delivers tailored training to many front line social care staff. However it is our view that training should be mandatory for all staff providing formal care to people with dementia, this is especially important for new staff who may not have any experience working with people with dementia. Staff should focus on meeting needs and aspirations of people with dementia and promote dignity, respect and maintain human rights. Commissioners should ensure frontline care staff have access to specialist support, for example through commissioning community and hospital mental health liaison teams.
We know from talking to care workers that many want more training. Where staff are trained and supported, they gain greater reward from providing care to people with dementia, leading to lower rates of turnover and greater continuity of care.
Many people with dementia say they want to be able to live in their own homes for as long as possible. Indeed, two thirds of people living with dementia live in the community. Inadequate or poor care can deny people with dementia opportunities for a good quality of life and lead to higher overall care costs through early admissions to care homes and avoidable admissions to hospital as well as impacting on the physical and mental health of carers. Delaying individuals’ entry into a care home could save the NHS and local authorities around £72 million for each month of delay (APPG on Dementia, 2011).
As dementia progresses, care homes may become the right option. When that is the case, we need to ensure that the homes can successfully meet their needs – not just medical but also personal and social. There are many care homes providing this sort of excellent care, giving their residents a warm, friendly and safe haven – a veritable home from home. In these homes, care provision takes full appreciation of the complexities and difficulties of dementia while at the same time understanding the individual needs of each resident. But this is not the case for all.
Unfortunately, there is a historic problem of care home staff being underpaid and undervalued in parts of the sector. In this sort of environment it is difficult to improve and upgrade skills and this often leads to standards falling far short of what the many hard working staff and managers would like to see. Dementia care is a skilled profession and this status needs to be appreciated if a nationwide high calibre of staff is to be achieved.
Alzheimer's Society works with care providers across England, Wales and Northern Ireland to develop and deliver specialist dementia training programmes. For more information visit: http://www.alzheimers.org.uk/professionals