Inspiration: Dementia case-finding tool in care homes
Organisation: Health Innovation Network South London
We have worked with care workers in care homes to design a dementia case-finding tool. The case-finding tool empowers care workers to identify and refer those residents showing signs of confusion or memory problems to their general practice or memory services for further assessment.
The Alzheimer’s Society estimates that up to 80% of residents in care homes suffer from dementia or severe memory problems. However, it is believed that many of them do not have a formal diagnosis. This disparity between the actual number of those who have a dementia and the number of diagnoses means that many people are not being given the opportunity to make informed choices about their future or access appropriate services.
We aim to increase the identification and diagnosis rates of dementia in care homes by developing a dementia case-finding instrument similar to those used in acute hospitals for identifying dementia.
We have held focus groups with care workers where we discussed participants’ thoughts around dementia, the signs of dementia, their thoughts around the benefits of a diagnosis, and we discussed a number of well-known case-finding tools and how these might be adapted for use in the care home. We found that care workers had a very good understanding of the signs of dementia; they also thought that they were best placed to identify these signs because they are close to the residents.
Based on these focus groups a case-finding tool – which includes a short memory test and observation chart – has been developed which is in the process of being tested with care workers. It is being tested in 3 care homes in South London. Care workers will use the tool to identify residents who need a referral to their GP for a more detailed memory assessment. They will pass the completed tools to the relevant GP or specialist nurse, and we will work with the GP/nurse specialist to analyse the results.
We will then share our learning with the South London Care Homes Network (a network of over 700 care homes, supported by the HIN), the London Dementia Strategic Clinical Network and Dementia Ambassadors. Our aim is to encourage other care homes to use the dementia case-finding tool and for referrals to be followed up in general practice.
Through this project, we hope to contribute to the Prime Minster’s Challenge on Dementia: aiming to increase diagnosis rates and to improve the quality of life of people living in care homes with dementia.
Area of work
In relation to the four foundations of our declaration, this project aims to:
- Make London healthier and happier
Service user involvement?
When care workers test the case-finding tool in their care home they will ask for informed consent from residents to ask them a few questions about their memory, and will then ask them 4 simple questions. Residents will be asked for consent to refer any significant problems to their general practice or memory service.
We are planning some focus groups with residents and their carers on what have been the benefits for them, if any, of receiving a diagnosis.
Advice for others
Establishing and maintaining good relationships with care homes is an important way to build their commitment to a project like this.