Meeting the specialist care/dementia needs of older people

Making the decision to go into a nursing home or for you or your partner is life changing. This is especially true when a dementia diagnosis is also involved.

The vision for the iReach care home model is to enable people with nursing/dementia care needs to enter the care home and remain there as their illness progresses, through a tiered approach to care.

The aim is for the care home to also be a hub for care in the local community. Using the Harmony and Horizon models of older persons housing sitting alongside the home means any care needed by the residents can easily be achieved by utilising the 24-hour care team.

Care could also be provided to other people in the community as and when needed.

We are all living longer and therefore many more of us are likely to live with dementia in some form.

Whilst many people with dementia are cared for at home either by family members or carers when there is a health crisis this can result in hospital admissions, which further exacerbate the symptoms of dementia and possibly result in longer hospital stays.

It has been estimated that people with dementia occupy 25% of hospital beds often when medical need is not acute.

The shortage of good quality nursing/care home beds and dementia specialist homes is an issue in many areas.

Local Context

Has an older than average population compared to England and a growing population particularly those in older age groups

PCTs and local authorities are required to produce a Joint Strategic Needs Assessment Devon (JSNA) of the health and well-being of their local community as a requirement of The Local Government and Public Involvement in Health Act 2007. The Department of Health requires Local Strategic Partnerships, Primary Care Trusts and Local Authorities to consider the needs of their local population and respond with effective commissioning of services to meet those needs.

The Devon JSNA Overview 2018 found that Devon has an older and growing population attributable to longer life expectancy and internal migration.

Some of the main findings were:
  • In 2012, there were 13,312 people estimated to have dementia in Devon (1%) of Devon population
  • This is expected to increase to 21,858 by 2030.
  • The total cost to Devon of people with dementia is estimated to be £333.6 million and will rise to £556.8 by 2030
  • Estimates that approximately 40% of nursing home residents and 37% of residential residents had dementia in Devon.
National Context

It is estimated approximately 850,000 people are currently living with dementia in the UK. This will increase to 1m by 2025 and 2m by 2050. The current cost of dementia in the UK is £26billion.

On average 69% of people living in care homes have dementia. An estimated 540,000 people in England act as primary careers for people with dementia.

The iReach Model

Making the decision to go into a nursing home or for you or your partner is life changing. This is especially true when a dementia diagnosis is also involved.

Those organisations who deal directly with dementia care identify individuals with dementia who will need more care and support as their condition progresses. The time may come when a care home where staff can provide continuous, 24-hour support when needed, may better meet the needs of the person.

For many people with dementia moving more than once can make them disorientated or unsettled and therefore moving into residential care which can allow them to remain as their needs increase is very important.

The vision for the iReach model is to enable people with nursing/dementia care needs to enter the home and remain there as their illness progresses, through a tiered approach to care.

The aim is for the care home to also be a hub for care in the local community. Using the Harmony and Horizon models of older persons housing sitting alongside the home means any care needed by the residents can easily be achieved by utilising the 24-hour care team.

The care could also be provided to other people in the community as and when needed.

The care home will also enable those family and friends who live in the adjoining homes and community to visit their loved ones more easily and allow them to spend quality time with the person without having to focus on providing day-to-day care.

With rising numbers of people living much longer and dementia therefore becoming more prevalent it would seem imperative we look to deliver an innovative approach to care and support in communities.

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