Lack of care home choice leave families 'settling' for inadequate places - Alzheimer’s Society comment

New research by Which? has found that almost half of people who had arranged care for themselves or a loved one said there weren’t any places in at least one of the local care homes they considered.

The Which? survey asked people who had arranged care for themselves or a loved one in the past 12 months to share their experiences of the care sector and highlights a worrying trend of people not being able to find suitable local care provision.

The research found that a lack of good local places means many people are staying in, or moving loved ones into, care homes they aren’t satisfied with, with almost one in five people (17%) saying they settled for a care home they had reservations about.

A similar number (16%) ended up opting for a home away from friends and family.

Commenting on the Which? research, Alzheimer’s Society Senior Policy Officer Dominic Carter said: 

'These findings echo what we hear every day through our helpline – time and again we are called by families of people with dementia who’ve been refused places at care homes because their needs are ‘too complex’.

'Even worse, we hear of people with dementia in care homes handed four-week eviction notices – one woman told us her husband was shown the door after seven weeks at a care home because he was viewed as 'challenging and the manager did not have enough staff available to provide the one-to-one support he needed’.

'While it could be easy to scapegoat care homes, we know they are finding themselves between a rock and a hard place. They can’t sustain their businesses if local authorities don’t have big enough budgets to cover the care home’s costs. The only way to give people with dementia the care, security and reassurance they deserve is for the Government to inject more money into social care.'

SOURCE: Alzheimers Society

My wife's dementia has her rummaging through the house. How do I cope?

Though this behaviour isn't uncommon, it can pose dangers to a lot of individuals living with dementia.

My wife has had Alzheimer’s for a few years and I have coped with many issues. Lately, she has taken to going through all the drawers in the house. This is making me very upset. 

This is not a unique behaviour your wife is exhibiting. A lot of individuals with dementia start looking through different places in search of items. I have witnessed this searching in the fridge, closets, cabinets and many other household locations.

It is critical to deal with the safety factor related to this behaviour. Rummaging, as it is often called, can end up with a person accessing things that are dangerous, such as: toxic products, household cleaning supplies or tools and equipment. Some people rummage and then taste the items that they open, so it is critical to look around and lock up areas that may pose a potential safety issue.

Some individuals take valuable or important items like chequebooks, jewelry, keys or important personal papers and place them in other locations. Ideally, you should ensure that these items couldn’t be found if a person is rummaging. Mail is also often a rummaging target that is easy to find.

If it were clear and evident why a person was rummaging it would be easier to contend with this behaviour. People with dementia may rummage for a variety of reasons. Some people may have a logical reason for this behaviour, as they may be thinking of something specific or are in search of something that has been recently triggered in their memory.

SOURCE: Nira Rittenberg, thestar.com

Dukinfield care home 'bathed residents once a month'

Dementia sufferers living at a care home were only bathed once a month and lived in "disgusting" conditions.

A Care Quality Commission (CQC) inspection in July at Yew Trees in Dukinfield, Greater Manchester, said it was "not safe".

Inspectors found nine breaches of health and safety at the home, which has been placed in special measures.

The owners said it has made immediate changes to address the issues.

The CQC said some residents "looked unkempt" and records showed some people were only given baths or showers once a month, twice at the most, even those who were incontinent.

One relative of a resident asked inspectors if they could have more baths "because I have to wash my relative down".

Meals 'chaotic'

A woman who said her late mother lived there for 18 months said it was "absolutely disgusting" and she "kept a diary of incidents but it made no difference".

Inspectors found the home was not safe, effective, caring, responsive or well led.

Claire Ingham said her mother, who had dementia and died earlier this year, was physically attacked by other residents.

Inspectors also said mealtimes were "chaotic" and had been told by a relative a resident lost four stone in weight since being at the home.

The relative told the CQC: "We shouldn't have to come in and help out as we are paying for the support."

The inspection also highlighted:

  Care was not safe because of insufficient suitably trained staff

  People were not always safeguarded from abuse

  Risks of harm was not always properly assessed or monitored

  There was no stimulation or activities

  Complaints had not been acted upon

At the time of the unannounced inspection, Yew Trees had 41 residents, the majority of whom have dementia.

A spokesman said residents' health, safety and wellbeing were its "utmost priority" and it "immediately put in place a detailed action plan" to address the issues highlighted by the CQC.

SOURCE: BBC

Where’s the best place to locate a new specialist dementia care home?

Supporting a person in the later stages of dementia to live in their own home is very challenging for all involved. As a result, Alzheimer’s Society states that 283,000 people with dementia live in care homes, and dementia is often one of the main reasons behind their move. As every care home operator knows, dementia is more than just memory loss. The care of people with dementia requires expertise and, often, specialist dementia care commands higher fees.

The opportunity to develop specialist dementia care homes is significant. As people with dementia are living longer and with more complex health conditions, their need for care is increasing. Alzheimer’s Society urges that providing care to people with dementia must be the primary concern and focus of the care home sector.

The well-publicised study by The Lancet in August 2017 predicts that more than 70,000 care home places will be needed by 2025. Since it’s estimated by Alzheimer’s Society that in excess of 80% of residents living in care homes have significant memory issues or dementia, to meet this challenge the sector is going to need 56,000 more dedicated dementia beds within eight years. The question then is, ‘where’?

In order to build a detailed picture of local dementia provision, Carterwood has launched a new dedicated dementia analysis. We have surveyed more than 10,000 care homes and updated our comprehensive database through over 4,000 telephone interviews, covering private, not-for-profit and local authority homes.

For any given location in England, Northern Ireland, Scotland or Wales, as part of our improved market assessment report, we can now provide a unique and comprehensive overview of the dementia competition and its quality.

If you want to be continually creative over time, you need a culture of creativity and innovation.

Our new data shows that today, around a quarter of older people’s care home beds are dedicated to dementia, and circa 7,500 homes are registered to provide some form of dementia care. This leaves around 4,200 homes not registered for dementia.

The proportion of dedicated dementia beds is, however, gradually increasing, with operators recognising there will soon be a shortfall of dementia beds. Some 61% of homes for older people built since 2010, for example, provide some form of dedicated dementia care, and 36% of all care home beds built since 2010 are dedicated to people with dementia. Significantly, 37% of all older people’s care homes registered for both frail and dementia care offer a dedicated dementia unit.

What does dementia care look like?

Before we look at geographical differences and opportunities in dementia provision, it’s important to first analyse in greater detail what dementia care looks like in the UK.

A dedicated dementia environment not only provides a safe, therapeutic space for residents living with dementia, but gives a home the added advantage of enabling the other care home residents to have appropriate access to outside space at all times.

Just 10% of care homes are entirely dedicated to older people with dementia, and the average size of a dedicated dementia-only home built since 2010 is 47 beds.

While this proportion would need to increase in order to stay in touch with the growing demand for dementia care, there will always be people who need personal and nursing care. This generally makes mixed registration homes with a dedicated unit more attractive for operators.

Availability of dementia beds

There is almost no difference in the availability of dementia beds in rural versus urban locations, and the level of provision is evenly split between private and not-for-profit operators. Perhaps not surprisingly, care homes with nursing are almost twice as likely to contain specialist dementia beds as personal care homes. Some 41% of care homes with nursing provide a form of dedicated dementia care.

Furthermore, the larger the home, the more likely it is to cater for dementia. The vast majority (83%) of homes with more than 60 beds registered for dementia, for example, provide a dedicated unit within the home. The average size of a dedicated unit is 27 beds, often occupying an entire floor.

Geographical differences in supply of dementia beds

If we analyse the geographical differences, it’s clear that while people with dementia live throughout the UK, the current supply of dementia beds is not evenly distributed. Notably, the South West has the lowest proportion of total registered dementia beds at 21%, with Devon’s dementia beds accounting for just 12.2%. In contrast, Northamptonshire’s proportion of dedicated dementia beds tops the UK at 35.8%.

Demand and supply for dementia care also varies considerably depending on the locality. In Hackney, for example, there are no homes providing any form of dedicated dementia care. Travel 11 miles down the road to Barking and Dagenham, and you’ll find 60% of beds can support residents with dementia. The reasons behind local differences may stem from the profile of the local population. Differences such as these most certainly reinforce the need for a sound market understanding when deciding where best to locate a new specialist dementia care home.

Opportunity for dementia provision

To a large extent, the local demand and dementia opportunity will also depend on the quantity and quality of existing provision. Our dementia research, combined with mystery shopping, means that for the first time we can build a detailed picture of the local provision by answering questions such as: Is the physical environment fit-for-purpose? Can people be cared for safely and without undue restriction? Can people stay in the home for life, or will they have to move on?

This information can be used to assist in planning a new development, or to determine what changes could be made in the category of care being provided in an existing home to meet local demand. According to Alzheimer’s Society, approximately a third of family members have reported that the person with dementia had moved since first going into care, the most common reason being an increase in needs.

To conclude and answer the first question, ‘where’s best to locate a new specialist dementia care home?’, you’ll need to appreciate that locational differences, ranging from the age profile of a population to the existing and planned dementia bed supply, can have a very significant impact on the success of your new scheme. Obtaining market information specific to your shortlist of preferred areas is an essential prerequisite for planning and due diligence.

SOURCE: CMM, Ben Hartley

Children at Iceni Academy light up the lives of care home residents at Stanway Green Lodge

The pupils from Iceni Academy in Colchester, who regularly visit residents at Stanway Green Lodge, took part in an arts and crafts session in time for Diwali - the festival of light.

They joined the elderly residents in making candle holders out of old CDs and decorating them.

Pupils visit the care home twice a month to build relationships with the residents.

Aniket Kanitkar, manager at the care home, said: “As the children have had contact with the elderly they just bound into the room.

“They have been coming here for about a year now, it works really well.

“They come in once a month with the vicar at All Saints Church too.”

Lou Cotter, community cohesion lead at the school, said it was a fantastic opportunity for the children to help in the community.

She said: “They have been taking along their maths and English books and discussing their learning with the ladies and gentlemen. The children benefit hugely.”

SOURCE: Essex County Standard, Katherine Palmer

Family carer is 'frightened for the future' over plans to close dementia ward

A FAMILY carer has said he is “frightened about the future” if plans to close a dementia ward at Chepstow Community Hospital go ahead.

Armand Watts, 49, of Chepstow, cares for his mother, Pauline, who was diagnosed with dementia last October.

His mother, 77, is an outpatient at the community hospital and is visited by doctors once a week.

Mr Watts, who is also a town and county councillor, fears his family and hundreds of others would be hit under plans set out by the Aneurin Bevan University Health Board to close the St Pierre Ward.

Patients such as Ms Watts would be treated at St Woolos Hospital in Newport, or Ysbyty Tri Chwm in Ebbw Vale, depending on where in Monmouthshire they live.

Mr Watts said his mother is currently at the “beginning stages” of dementia, but that she may need to be treated at the ward in the future.

“What it means for our family is that we would potentially have to go to St Woolos and that will affect hundreds of families across the county,” said Mr Watts, whose dad was also treated for dementia at the ward. “Sadly we have experienced this before with my father a couple of years ago so we know what’s coming, therefore I can tell you how important it is to retain that local service.”

Mr Watts fears closing the ward would lead to a “demise” in dementia care in Monmouthshire, with families being forced to travel elsewhere. The town councillor for Thornwell believes the move will particularly hit patients who do not have family to support them.

He added: “My view is the Trust should be ashamed of themselves for even contemplating it and I think Aneurin Bevan would turn in his grave if he knew what they were attempting to do.”

Ms Watts, a former councillor, also said she disagreed with the plans.

Aneurin Bevan University Health Board’s proposals would leave three dementia units - at Ysbyty Tri Chwm in Ebbw Vale, St Woolos Hospital in Newport, and Ysbyty Ystrad Fawr in Ystrad Mynach - and a single functional mental illness unit at County Hospital, Griffithstown.

This would leave 67 beds, five fewer than at present, but requiring11 fewer nurses. Difficulties in recruiting nurses for older adult mental health inpatient units are a factor, but reorganisation of services is also a means of creating more community-based services, the board says.

A spokesman for the health board said: “In order to deliver the highest standard of services to older adults with mental health needs we have worked with our staff, patients and their families, and our partner organisations to develop a preferred option for the future of these services.

“We believe that this preferred option will enable our us to strengthen our local community-based services for older people with mental health needs in all areas of the health board. For those who need inpatient care, we would develop three centres of excellence which would offer the very best care for people with dementia. We now want to share our ideas with the public and will listen to their feedback before any decision is made.”

SOURCE: South Wales Argus, Saul Cooke Black

Alzheimer's Society responds to figures showing dementia remains leading cause of death

Dementia is still the leading cause of death in England and Wales.

Dementia and Alzheimer’s disease remain the leading cause of death in England and Wales, accounting for 12.0% of all deaths registered in 2016, up from 11.6% in 2015, according to new Office of National Statistics (ONS) figures.

This increase is attributed by ONS to people living longer, due to improved lifestyles and medical advances. With people living longer and surviving other illnesses, the number of people developing dementia and Alzheimer disease is increasing.  Improved identification and diagnosis of dementia has also contributed to the increase.

Alzheimer’s Society Head of Policy and Campaigns Nicola O’Brien said:

“Once again, dementia is the biggest killer in England and Wales. It’s a further wake-up call that the UK is woefully underprepared to cope with the scale of the challenge. Dementia is both a terminal illness, and a condition that people can live with for many years, but our health and social care system is not in a position to cope. As a result we know thousands and thousands of people with dementia aren’t getting access to the right care and support to allow them to live well, and to die well. 
“With the numbers of people with dementia tragically set to rise, exceeding one million by 2021, inaction is no longer an option. Political inertia to improve basic services for people with dementia from diagnosis to end of life, and reform the crumbling social care system they rely on, is unacceptable. Vulnerable people with dementia deserve far better.
“Until a desperately needed long-term solution materialises, the 700,000 spouses, adult children or friends who are providing 1.3 billion hours of care for people with dementia will continue to buckle under the strain of propping up a failing social care system.”

SOURCE: Alzheimers Society