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  • Mental health in dementia patients costs £500 million a year
    2 June 2016

    In our blogs we have been exploring the importance of developing models of care which integrate physical and mental health. Joined-up care is essential for people with long-term conditions like dementia who have myriad needs.

  • Why good data must underpin mental health care
    2 June 2016

    Ambitious new models of care which integrate mental and physical healthcare are being spearheaded by the NHS Vanguards as part of the NHS Five Year Forward View. But how effective will service redesign be without in depth mental health data at its core?

  • NHS vanguards leading mental health integration
    2 June 2016

    The NHS Vanguards are rapidly gathering momentum to transform and integrate mental healthcare.

  • No health without mental health
    2 June 2016

    In his new role as NHS England’s National Clinical Director for Mental Health, Professor Tim Kendall has highlighted the unprecedented opportunity to ensure parity between mental health and physical health.

Thursday, 2 June 2016

Mental health in dementia patients costs £500 million a year

In our blogs we have been exploring the importance of developing models of care which integrate physical and mental health. Joined-up care is essential for people with long-term conditions like dementia who have myriad needs.

An estimated 850,000 people in the UK have dementia – that’s an awful lot of people with complex care needs. But how accurate is that estimate?

Around 80% of care homes residents suffer from dementia or severe memory problems but it is believed that many of them do not have a formal diagnosis, which puts the potential number of people with dementia much higher.

Without a diagnosis people with dementia are at risk of not having the understanding of care workers, family members and friends, and crucially getting the support and treatment they need. This can have serious implications for the health of one of the most vulnerable groups of people in society.

In a survey of 1,000 people living with dementia, almost one in 10 said they only leave the house once a month. Not only does this indicate that dementia patients (and their carers don’t forget) are more likely to be isolated, but it also suggests that many are susceptible to poor mental health.

Indeed a report published in April by the International Longevity Centre-UK found that depression alone among people with dementia is costing the health system over £500 million a year.

However, physical health comorbidities are also a great concern - adding in the costs for diabetes and urinary tract infections, the report’s figure for dementia mismanagement approaches an astonishing £1 billion a year.

The report authors found that patients with dementia are less likely to have health problems diagnosed and treated. This obviously has a detrimental effect on a person’s dementia, reduces quality of life and reducing life span.

Looking at hospital admissions they found that the most common reasons were also amenable to prevention with the right anticipatory care – falls, hip fracture, urinary tract infection and respiratory infection.

Jeremy Hughes, Chief Executive of Alzheimer’s Society, said:

“The reality for many people with dementia is that they have to contend with other long-term conditions, all of which greatly impact their quality of life. As this report highlights, to view dementia in isolation not only makes poor economic sense, but can cause unnecessary suffering. While initiatives to integrate health and social care services are a step in the right direction, it is clear government plans need to go much further to truly meet the needs of people with dementia and other health conditions.”

Of course people with dementia may struggle to communicate with carers and professionals about their health, which may hinder treatment, but services need to step up their game to ensure these patients get the care they need.

NICE guidance (CG161) already recommends older people in contact with healthcare professionals should be routinely asked about whether they have experienced a fall in the past year. This focuses on ensuring that falls risk assessments in memory services are optimal. Effective treatments are available to help prevent falls, such as strength and balancing training, and timely referral to falls prevention services is clearly especially important for people with dementia.

Putting a holistic care plan in place which comprehensively addresses all aspects of health for a person with dementia is essential. This needs to include mental health, falls assessment, diabetes, urinary tract health and so on, so that problems are picked up earlier and treated.

And as discussed previously, if a global care plan were implemented which unifies primary and secondary care, it can give us a huge amount of data which helps us to further refine the services on offer in line with the specific needs of people with dementia. This approach would be a huge step forward for people with dementia, because currently we’re not joining the dots up properly and that means patients are suffering.

About the Author

Sarah Mehta has a varied background in health writing and developing materials for patient, professional and commissioner audiences, and now supports the NHiS team with their activities. Sarah initially worked as a medical writer for physician audiences and then moved to the voluntary sector with roles at the MS Society and Sense About Science focused on communicating evidence based medicine and research to the public in creative ways.

Having developed an interest in neurological conditions, Sarah joined Neurological Commissioning Support (NCS) and was responsible for marketing, communications and digital activities aimed at engaging NHS commissioners. Much of her work has involved meeting patients and professionals to better understand the challenges they experience in staying well / keeping their patients well.

More recently Sarah completed a certificate in science communication at Stellenbosch University in South Africa. During that time she guest blogged for a number of organisations including the World Health Organization and she also currently writes for the British Journal of Neuroscience Nursing.