20 Dementia in Kent - Facing the Moving Target - Need for Dementia Friendly Communities [Update 2 - 28/11/13]

Kent has been developing or refreshing policies and practices for those with dementia. The number of dementia friendly communities is now six, namely  

• Westgate
• Northfleet
• Swanley - in Sevenoaks District
• West Malling - in Tunbridge and West Malling District
• Canterbury
• Eastry.

Each place is developing in its own manner with with guiding hands of the Project Officer for Dementia Friendly Communities (in the Kent County Council SILK office). What is the nature of the task for Kent?

Diagnosis of those with dementia in Kent is improving and stands at about 30,000. Nevertheless the prevalence of those diagnosed with dementia is less than 50% (but probably higher than 45%). It seems that some individual General Practices have rates of diagnosis as high as 70%. Dartford Gravesham and Swanley Clinical Commissioning Group have, it is understood,  a rate of 51% and a target of 66% by 2015!

Commissioning and developmental policies in the area of the DGS CCG have included:

• training of GPs (those primary care doctors' surgeries) in assessment of those with memory problems
• specialist dementia nurses appointed to cover two surgeries in a community
• application of the NICE dementia protocol
• shared development of the volunteer Dementia Buddy Scheme at Darent Valley hospital
• shared development of the upgrading of dementia care settings in hospitals and care homes
• specialist dementia nurses appointed to liaise with staff at the Ellenor Lions Hospice
• assessment for memory problems or dementia  of all patients (aged 75 and over) admitted to hospital for at least 72 hours.   

All this suggests that increasing numbers of residents with dementia will be diagnosed, but the target is moving. The natural growth in the the numbers of those in each of the 10 year-cohorts of residents over the age of 65 years means greater numbers of those diagnosed with dementia! The demand for social care, including end-of-life care will increase. One reason for dementia friendly communities lies in this growth "vector".

Those with dementia tend to have relatively more acute injuries and illnesses which arise from the nature of their symptoms. Once in hospital they tend to stay longer and are relatively challenging patients - again because of their symptoms.

Dementia friendly communities might address these issues in several ways:

• greater friendliness usually means less stress, etc and greater help when those with dementia are out and about in busy streets and business premises
• greater friendliness usually means everyday transactions are easier to handle for those with dementia
• greater friendliness usually means more opportunities for leisure and relaxation for carers as well as those with dementia
• greater friendliness usually means that homes, care settings, other buildings and green and town or village environments are adapted or designed to be helpful to those with dementia.   

Finally, a successful dementia friendly community comes about because residents, visitors, health and social care workers, businesses and others take the trouble to find out what those with dementia:

• say they need, 
• say they want to do,
• say they have decided / chosen X or Y or Z.