29A Dementia Statistics - 1 Diagnosis 2 Cost [Update 1 - 10/12/13]

1       People living with Dementia in England: 

   All                              Diagnosed                        Not diagnosed
670,000                           319,000   (48%)                   351,000

                                Range of Percentages  
                                     
   Highest:  Corby 75%             Lowest: Herefordshire  32.8%

   2      Cost to the Economy

   Estimated cost to the economy:      £23 billion.

29 Dementia - Statistics, Statistics and yet more Statistics

The statistics given in this series of posts are intended to demonstrate the scale of problems for those dealing with dementia.

The posts in the series are likely to need updating frequently. It is intended as a running note of findings from newspapers and other sources. It may contain fortuitous inaccuraties, but attempts will be made to cross-check findings. 

Broadly covering several levels, it will include:

• 29A   International numbers
• 29B   UK and England numbers
• 29C   Kent numbers, and 
• 29D  Sevenoaks District, 
• 29E  Swanley numbers.
• etc.

30 Dementia - Awareness of Possible Memory Problems or Cognitive Decline

Memory problems do not necessarily signpost dementia: depression, accidental brain injury or other conditions may be  the cause. With this in mind, as a start, much of dementia friendliness towards a person with memory difficulties hinges on a family member, friend, neighbour, or another person becoming aware of seeming memory problems. Secondly, a sensitive approach may be needed to encourage a person to seek a professional assessment, usually by their GP.

A key is a basic knowledge and understanding of the main dementias, typical symptoms, and characteristic behaviours associated with memory problems. Typically, this will come from books, the internet, and so on: other sources are to hand. Of the latter, four examples are given in this post.

They are: 

1. An awareness and information session for prospective Dementia Friends - taking about one hour which is delivered by a Dementia Friends Champion
2. Trained staff at a NHS Health Check conducted in the public health staff of the district council (This will be for residents from 40 to 74 years.)
3. Nursing, etc staff at a hospital making a NHS assessment for those over 75 years staying in hospital at least 72 hours
4. Fire service staff following a call for assistance, eg at a fire incident or some other reason. They carry out an on-the-spot assessment of possible cognitve impairment in a person over 60 years - this would be carried out by fire and rescue service staff who are specially trained. 

28 Dementia - Lifestyle Choices, Illnesses and Other Possible Causes of Dementia [Update 3 12/12/13]

This post examines the content of two short pieces on dementia.

Five Life-style Factors
Firstly, I was in the local KCC Library and picked up a recent leaflet promoting the national NHS Health Check Scheme. It highlights the benefits of certain changes to my lifestyle (should I need to change). The purpose is to reduce my risk of developing dementia.  
Briefly, the following are key things that we all might want to do:

• Maintain a certain level of physical activity
• Measure your key biometrics, blood pressure, cholesterol
• Keep any alcohol drinking within certain levels
• Eat to a healthy diet
• Quit smokng. 

The leaflet's messages point to preventing or mitigating my chances of the following:

• diabetes
• heart disease
• kidney disease
• obesity  
• strokes or mini-strokes.

In a sense these checks may be regarded as part of a comprehensive dementia friendly community. For Swanley they are a local public health service programme carried out by the Sevenoaks District Council.  The purpose of these checks is to reduce  health inequalities, in the sense they hope to discover residents who do not visit their doctor regularly or are not registered with NHS GP surgery. 

Causes
Secondly, this weekend when opening my newspaper I found a short newspaper report which looked at possible causes of dementia. It emphasised the prevalence of dementia to be linked to diabetes, and other chronic long term conditions. 

Dementia Populations 
The projections of dementia population growth with, furthermore, increasing numbers of us with these diseases, augers for a gathering pace of those with dementia (see Posts 29, 29A, and 29B). 

Medicines
Another aspect of dementia is some evidence that regularly taking medicines following, for instance, a mini-stroke, may help to prevent or delay dementia. I suppose the jury is out on this one, but hopefully the G8 Dementia Summit induced spurt on research expenditure will enable the veracity or otherwise of this one.

27 Awareness, Assessment and Diagnosis for Memory Problems - Limbo Time [Update 2 - 13/11/13]

As the population gets older, the numbers with dementia are growing year by year. It is also likely that current life-style choices are  affecting younger citizens who may not otherwise develop to life with a dementia as they reach any decade over say 60. [Although seniors get dementia, younger persons, say 35 years onwards, may get young onset dementia.]    

England has over 300,000 individuals living with dementia which is not diagnosed. Also, many more persons have memory problems which may have dementia-like symptoms. Nationally as a policy it is recognised that early assessment and diagnosis are important. This post addresses issues surrounding this policy. 

 The West Kent CCG has recently issued a document which says that Sevenoaks has 1840 persons with dementia.
 http://www.e-watch.co/articles.php?viewarticle=4359&UID=4272&viaNL

Please note that the reference to Sevenoaks is likely to mean that part of the Sevenoaks District within the West Kent CCG area, ie roughly 100 square km. 

Awareness and Information
The country needs its people to be able to recognise dementia-like symptoms. The reason is that those with undiagnosed dementia will be encouraged to seek assessment and diagnosis. Where dementia is not the cause of the memory problems appropriate treatment for the condition follows, eg depression, drug abuse.

To this end a million volunteers who are being recruited to become Dementia Friends.  They have attended an awareness and information session about life with dementia and will spread this information to others. 

Preparedness of Health and Care Professionals
About 12 years' ago about 50% of doctors would probably be insufficiently trained to deal with assessment of dementia. Five or six years ago 30% of doctors in London would have said the same. By today many more local surgeries have doctors, practitioner nurses, reception staff  who are alerted respond to those with memory problems. More GPs are able to confidently carry out assessments and have the back up specialists in dementia who are based in local memory clinics. 

Specialist clinical training in assessment for dementia has been commissioned by the local Clinical Commissioning Group and given to doctors. Specialist nurses in dementia are being or will be attached to each of two surgeries.

In North West Kent the Alzheimer's and Dementia Support Services (ADSS), a charity, has devised a digital dementia appraisal package for dementia asssessment by doctors who want to use it.  

Limbo Time

As the local rate of assessments rises and and the diagnostic investigations are carried there may be an unfortunate delay - a person with memory problems may have to wait for the the result. 
In some areas the delay - limbo time - is sometimes as long as three months. Given that the national target is to increase diagnoses from about 45% to 66% Clinical Commissing Groups will need to consider any need to increase resources in memory clinics.

26 Dementia - Living at Home Alone [Update 1 - 07/12/13]

Living at home alone is often difficult and lonely for a person with dementia.  Life could be easier, safer and more enjoyable if he or she had visitors, help and advice. A better life is much less likely for the many who are not assessed or diagnosed. For the latter changes will often come about after a crisis - a serious illness, an accident, or when other type of emergency arises, eg the person is lost and found by the emergency services. 

From then any assessment will, on referral, be followed by diagnosis of a dementia (if that is the case). As a result in a care pathway is likely to be established. Hopefully, if this is the person's wish this will be at home but his or her destination may well be in a dementia care home.    

Where the diagnosis and appropriate treatment results in life at home changes which could result in adaptations and improvements to make life easier, safer and less stressful. So called assistive technology covers many devices and systems used by local organisations. For instance, the fire and rescue service may fit fire safety equipment. Many homes are fitted with water mist sprinklers - so reducing the impact of a fire caused by the person with dementia not remembering that a cooker is on and a pan catches fire.  

25 Dementia - Planning, Development, and Building for Homes and Care Settings {Update 1 - 09/12/13]

Dementia is at the forefront of the health and social professions policy concerns at the moment. However, this post signposts some of the concerns for entrepreneurs and professionals in property and building industries which will arise from the ever-formulating national strategy for dementia.

In some areas some of the spin-offs from the National Declaration include calls for:

• increased assessment, diagnosis and treatment of those who may have dementia, say, some 300,000 as yet not so diagnosed
• emphasis on those living with a dementia residing their home  
• adaptation of dementia wards and care homes to make them more dementia friendly
• dementia friendly improvements and changes in residences for a) fire safety, b) falls safety, c) retro-decoration, d) retro-furnishing, and e) assistive tecnology 
• planning applications for homes, care homes and other care settings suitable for those with dementia.  

Kent County Council are preparing advisory documentation for developments which involve aspects of dementia in project proposals. 

Details are awaited but I would expect the report to include concerns for:

• housing - both social and private sector developments
• developments for dementia care settings, eg care homes. 

Also, given the pending growth in neighbourhood planning it might be timely to include advice on making townscapes, green infrastructure, etc more dementia friendly.