Dementia Resources

Dementia is an umbrella term used to describe a group of symptoms characterised by behavioural changes, loss of cognitive and social functioning brought about by progressive neurological disorders. There are estimated to be 850,000 people living with dementia in the UK and estimates indicate that this will increase to one million people by 2025 and two million by 2051. Left undiagnosed, dementia can have an insidious and devastating impact on the outcomes for patients and their families. However, we know more about its causes and some of the factors that may increase a person’s risk of developing the condition. This paper is the first in a series relating to dementia that will follow two families through their progression with dementia and considers the recognition and initial cognitive tests that can be used in a primary care setting. Each of the papers in the series will build upon our understanding of both families, as they face different issues and scenarios over the life course of the dementia.

There is no doubt that families affected by dementia have faced many new challenges as a result of Covid-19. The suspension and closure of support services, enforced lockdown and changes to important daily routines have influenced the way in which families affected by dementia have gained support. Health and social care services have recognised the need to adapt by incorporating telehealth as a substitute to existing care models; however, some have faced challenges in providing such care to this patient population. This paper explores the use of telephone helplines as a means of support for families affected by dementia during Covid-19, commenting on the advantages and disadvantages and reflecting on the experience of a dementia specialist helpline nurse.

The increase in dementia diagnosis and the recognised negative outcomes of acute hospital admission for this patient group, has led to a call for improved community care for people with dementia and their families. Primary care organisations are now exploring ways in which to provide high quality dementia care from peri-diagnosis through to end of life. Here, Emily Oliver, consultant Admiral Nurse and Victoria Lyons, senior consultant Admiral Nurse, explain how Dementia UK is supporting primary care networks (PCNs) to do this through the provision of Admiral Nurses.

(Emily Oliver: emily.oliver@dementiauk.org, @emilyoliverdem; Victoria Lyons: victoria.lyons@dementiauk.org, @viclyons)

• What is your background in dementia care nursing and how did you becoma an Admiral's Nurse?
• What is the most important piece of equipment that you regularly use?
• What advice would you give someone interested in becomin an Admiral Nurse?
• What does your typical day look like?
• Do you have one practice experience that has taught you something valuable about caring and supporting patients and their families?
• What needs to be done to improve clinical practice?

In each issue we investigate a hot topic currently affecting you and your practice. 

Here, Jason Beckford-Ball looks at the wealth of information provided about dementia and asks the question...

The management of incontinence is often a neglected area of community care, even more so when allied to older people, and it is essential that community nurses consider the effect of the ageing process and its impact on continence. Often, this can involve the specific effects of dementia and the management of urinary incontinence can then become complex due to the range of practical approaches required and the need to adjust these for each patient. A large percentage of the community nurse’s time is spent supporting carers; therefore, it is essential to consider their feelings when suggesting any strategies as they may feel that they are already incorporating them in the patient’s daily activities. It is also important to focus on few key elements of advice around incontinence and to listen empathetically to appreciate the challenges experienced by carers, which will help in identifying suitable strategies.

The management of nutrition in people with dementia is complex as it involves weight loss due to cognitive and physical problems caused by the condition. There is a range of practical approaches that the community nurse can implement, but these must be adjusted to suit each person. Often, a large proportion of the community nurse’s time is spent supporting carers, family and friends who are looking after a relative who has dementia at home. This can be a demanding role and carers often experience physical and emotional fatigue. For those working with patients with dementia in nursing, residential and care homes, it is particularly important that staff are supported with strong leadership to provide a flexible approach to meal times and that suitable menu options are available.

As with many conditions, diet has a crucial but often underrated relationship with serious mental health problems. In this article the author examines how diet, nutrients and different food types can have a deleterious or beneficial effect on mental health problems such as dementia, schizophrenia and bipolar disorder. Understanding the complex reactions between healthy eating and cognitive and emotional development can help community nurses provide holistic care for their patients.

Beth Britton is a freelance campaigner and writer specialising in issues affecting older people, health and social care, and specifically dementia. Her father had vascular dementia for the last 19 years of his life and she aims to provide support and advice to those faced with similar situations, as well as informing healthcare professionals and the wider population on how to improve dementia services.