How and why we need new approaches to caring for people with dementia
With “shocking” shortages predicted to leave 50,000 people with mid or late-stage dementia without a bed by 2030, there is an urgent need for radical changes in how we support those living with dementia. But recent headlines only compound concerns raised by reports of a “dementia pandemic”, accelerated by COVID-19 but precipitated by an overreliance on medication and widespread burnout among care staff.
What we now need, therefore, to ease the pressure on the social care sector, is to place greater emphasis on therapeutic interventions which can address longstanding issues such as limited resources, overburdened carers, and loneliness which worsens the symptoms of dementia.
Ensuring early support
An underwhelming announcement on social care reform could hardly have come at a worse time for the sector, with dementia diagnoses decreasing nationally since February 2020, falling below the national target of 66.7%. Moreover, NHS data suggests that as many as one in 10 dementia diagnoses may have been missed during lockdown, leaving many in the dark and delaying access to treatments which could help to slow the progress of dementia.
However, failure to spot the tell-tale signs of dementia has been an issue long before the pandemic. Often typecast as a memory loss disease, the declining cognitive function which characterises dementia can present itself in various ways, from reduced comprehension and learning capacity to impaired language skills and judgement.
We urgently need to challenge misconceptions around what it means to have dementia, so we can improve how we recognise and diagnose the condition, particularly in its early stages when treatments are often most effective.
Along with a backlog of undiagnosed cases, scientists have warned that the degenerative effect of Covid-19 on the brain could intensify the global dementia pandemic. By the end of the decade, scientists have predicted that dementia cases could reach 80 million, up more than 45% on the estimated 55 million living with dementia today.
This will only increase the burden on an already overstretched social care sector. Research carried out prior to the pandemic found that a third of UK care home workers experienced high levels of burnout, with 17.1% suffering from emotional exhaustion, 2.4% from depersonalisation, and 14.8% from feelings of low personal accomplishment.
We must ensure that the sector supports its workers wellbeing long after the International Week of Happiness At Work, which took place in September. Technology will be critical here, as 91% of care home workers believe that tech has reduced their workload in the last year. Appropriate investment could ease pressure on care workers, ensuring they are in the right state of mind to take care of vulnerable residents.
Tackling a loneliness epidemic
With technology to automate admin tasks, manage rotas, and keep track of schedules, staff will have more time to focus on tackling a major issue affecting dementia patients in the care home environment: loneliness.
Lockdown has left people living with dementia struggling particularly badly with their mental health. According to the Alzheimer’s Society, 56% have felt “completely isolated” during the pandemic. Failure to address this issue will risk accelerating cognitive decline among residents, placing yet more strain on resources and staff.
We must re-establish bonds between residents and those around them now that lockdown restrictions have eased. Encouraging fellow residents to come together for communal activities can help stave off feelings of isolation and slow the progress of dementia. Moreover, a person-centric approach promoting happiness through interactive games can help assuage feelings of isolation.
Overreliance on anti-psychotic medications is arguably the greatest longstanding issue undermining dementia patient care, with care home residents prescribed an average of seven medicines per day – and in many cases more than ten.
This approach has adverse side effects for patients, such as increased risk of suffering a fall. Moreover, it costs the NHS an estimated £250m annually, which would clearly be better spent elsewhere.
Instead, we should invest in long-term therapeutic treatments which prioritise sensory stimulation, relaxation, and reminiscence. Social-Ability’s Happiness Programme, for instance, focuses on supporting those living with dementia and other physical and cognitive challenges with interactive light-based activities as well as the care staff with structured training. Interactive games played with a light projector keep residents physically and cognitively active, encourage social interaction, and raise spirits among residents and staff.
Time for change
Covid-19 has given us a glimpse of a new normal which looms if dementia care fails to adapt: widespread staff burnout, too few resources, and isolated, overmedicated residents. This should come as a warning shot to the sector. We must use this insight as an opportunity to pursue positive change, address longstanding issues, and help make people happier and healthier for longer.