Hertfordshire’s Dementia
Strategy
 Colette Wyatt-Lowe, Executive Member - Adult Care &
Health.
 Simon Pattison, Head of Service, Integrated Health
and Care Commissioning Team.
 Roma Mills, Carers Involvement Manager, Carers in
Herts.
 Kristian Tizzard, Commissioning Manager, Integrated
Health and Care Commissioning Team.
Summary
 What is Dementia and who does it affect?
 What is Hertfordshire doing about Dementia?
 What is like to be a person with Dementia?
 How does Dementia affect carers?
 The 2015-19 Dementia Strategy and “having
your say”.
 Questions.
What is Dementia?
 "Dementia is like brain failure. It describes a syndrome:
a series of signs and symptoms, including changes to
memory, emotional state and ability to manage”.
(Professor Alastair Burns)
 Common causes include Alzheimer's Disease and
vascular dementia.
 Dementia is progressive and there is currently no cure.
 Dementia is often treatable.
 It is possible to live well with Dementia.
Dementia affects huge numbers of people.
 835,000 people in the UK have Dementia.
 21 million people have a close friend or family member
with Dementia.
 £26 billion a year (£4bn NHS, £10bn social care, £12bn
unpaid carers).
 Over 40,000 younger people (65 years of age or below)
with Dementia.
 An estimated13,792 people in Hertfordshire with
Dementia in 2014 rising to 15,403 by 2021.
What is Hertfordshire doing about
Dementia?
 A strategic priority since 2009.
 Over £90m spent every year on services for
people with Dementia.
 Specialist services to diagnose and support
people with Dementia.
 Specialist support to leave hospital.
 Better information available to people with
Dementia.
What is Hertfordshire doing about
Dementia?
 Improving the quality of care home provision for people with
dementia.
 Improving support for carers of people with dementia.
 Working towards Dementia Friendly communities:
 Tring now recognised as a ‘Dementia Friendly Community’
 Students at the Grove Junior School, Harpenden becoming
Dementia Friends
 “Singing for the Brain” (the Alzheimer’s Society)
 Dementia Friends clubs, Dementia cafes, and Young Onset
Dementia Activity Groups
What can it like to be a person with Dementia?
(national picture)
 Only 58% are “living well”.
 Less than half of people feel a part of their
community.
 40% of people felt lonely recently.
 Almost 10% only leave the house once a month.
 72% living with another medical condition or
disability as well as dementia.
(Dementia 2014: An Opportunity for Change, The Alzheimer’s Society)
What is it like to be a person with Dementia
in Hertfordshire?
 Less than half of people with dementia have been
diagnosed.
 The Alzheimer's Society asked 106 people about the
support that they received following diagnosis in
Hertfordshire:
 “I was diagnosed early” 66%
 “I understand, so I make good decisions and
provide for future decision making” 46%
 “I get treatment and support which are best for my
dementia, and my life”. 71%
What is it like to be a person with Dementia
in Hertfordshire? (2)
 Those around me and looking after me are well
supported”. 74%
 “I am treated with dignity and respect”.79%
 “I know what I can do to help myself and who else can
help me”.67%
 “I can enjoy life”. 69%
 “I feel part of a community and I'm inspired to give
something back” 46%
 “I am confident my end of life wishes will be respected. I
can expect a good death”. 65%
How does Dementia affect carers?
Jim
• Loss of friends
• Loss of job
• Loss of income
• Isolation
• Guilt
Sue
• Silos – no joined up
thinking!!!
• A focus on elderly
care and support
• Impact on children
within the family
How does Dementia affect carers?
Bill
Peggy
• Reluctant to tell
people
• Isolated - couldn’t
leave my husband
• Frightened of what
would happen next
• He didn’t sleep at
night.
• Felt abused
• Exhausted
• Did not know where
to go for help
• Depressed
What carers are asking for ………
• Reliable support at home with staff trained in
dementia care
• Consistent support – a named worker
• Personalised social activities, short breaks
(respite care) and day services
• Peer support networks and mentors
• Flexible ‘sitting services’ including evenings and
weekends
What carers are asking for ………..
• Easy access to Night Sitters
• Collaborative working between services,
Wheelchair – Continence – Dietician
• Diverse services that meet the needs of the
different people affected by dementia – younger
people, those with learning disabilities and older
people – and their families.
• Affordable services
What else could make a difference?
• Information and support for carers to enable
them to understand the condition, to learn
techniques for managing stress, diverting
anxiety and communicating effectively with the
person they care for
• Outreach services that respond quickly and
provide hospital at home support/assessment
• Easy access to clinicians – specialist dementia
nurses in the community
What if home is no longer the right place?
• Robust Dementia care accreditation standards
• Regular support from a multi-disciplinary team,
including psychologists, therapists, dieticians
• Programme of activities
• Regular monitoring
• Sufficient capacity to allow people to live near
their family
• Relatives/carers groups
The 2015-2019 Hertfordshire Dementia
Strategy: quality of life outcomes
• I have personal choice and control or influence over decisions about me
• I know that services are designed around me and my needs
• I have support that helps me live my life
• I have the knowledge and know-how to get what I need
• I live in an enabling and supportive environment where I feel valued and
understood
• I have a sense of belonging and of being a valued part of family,
community and civic life
• I know there is research going on which delivers a better life for me now
and hope for the future.
(National Dementia Declaration for England (2010).
The 2015-2019 Hertfordshire Dementia
Strategy Themes
Our work will focus on 6 key areas, each supported by an
action plan that will be finalised following our engagement
with our stakeholders:
1.Promoting health and wellbeing.
2.Developing dementia friendly communities.
3.Enabling equal access to diagnosis and support.
4.Supporting carers of people with dementia.
5.Preventing and responding to crisis.
6.Evidence based commissioning.
Promoting health and wellbeing.
 “What is good for your heart is good for your head”.
 Successfully encouraging healthy behaviours.
 Reducing the risk of dementia across the whole
population by reducing vascular risk factors.
 Delivering on Hertfordshire’s Public Health Strategy and
ensuring that our commissioning and enables selfmanagement of personal health and wellbeing.
Developing dementia friendly
communities.
 Building on the work that is already underway to develop dementia
friendly communities by actively encouraging and supporting all
partners and communities to commit to becoming dementia friendly.
 Possible approaches include the commissioning of Dementia
Friendly Community Co-ordinators.
 Ensuring that commissioned health and care services adopt
standards that lead to dementia friendly services.
 Putting dementia quality standards into practice, ensuring that
physical environments are dementia friendly (including at home)
and that ensuring that professionals who work with people with
dementia are well trained.
Enabling equal access to diagnosis
and support.
 We will aim to diagnose 75 % of our prevalent population by 2017.
 Equal care for to people with protected characteristics, such as younger
people and people with learning disabilities.
 “Staying in touch” with people to approach to prevent social isolation and
crisis (especially those who live alone).
 Access to personalised support through and individual health or social care
budgets.
 Access to dementia friendly information, advice and advocacy.
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Access to dementia friendly technology.
Access to person centred respite..
Access to good quality residential/nursing care.
Help with planning of care, including around future loss of mental capacity.
 Access to good quality, dementia friendly End of Life care.
Supporting carers of people with
dementia.
 Delivering on our Joint Carers Strategy by supporting carers of people with dementia
to:
 Work if they want to.
 Have a life outside caring.
 Stay fit and healthy and be safe.
 Access full benefits entitlements.
 Get good quality information when they need it.
 Feel respected as carers, as partners in care.
 Young carers should be able to achieve their full potential in education.
 We will undertake targeted work to understand and improve experience of young
carers.
 We are considering models of support for carers including around managing the
more difficult behavioural aspects of caring for a person with dementia.
Preventing and responding to crisis.
 We know that proactive support for people with
dementia is important to prevent crisis (Mental Health
Crisis Concordat).
 Continued focus on preventing unnecessary hospital
admission and delayed discharge
 Addressing support around the complex behavioural/
psychological symptoms of dementia , including for
people cared for by unpaid carers and for those in care
homes.
Evidence based commissioning.
It is important to commission services using local evidence, evidence based
models of care This will involve:
 Developing our approach in line with good practice in dementia
commissioning.
 Involving people with dementia and their carers in service design and
delivery.
 Developing our Joint Strategic Needs Assessment and improving our
understanding of local dementia issues.
 Making the best use of demographic indictors of health risk to
respond where our communities face an increased risk of dementia.
 Considering evidence around the prevention of dementia and
developing our models in response.
How do I “have my say”?
 If would like to have your say on the Strategy,
please visit:
https://consult.hertsdirect.org/dementiastrategy/
 We are at consultation until 31st December
2014.