Dementia

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National Dementia Strategy

Scotland’s third National Dementia Strategy, covering the years 2017 to 2020, was published in June 2017 following a series of dialogue events and public consultation. The new strategy identifies the following priorities for the next three years:

  • Continuing timely, person-centred and consistent treatment and care for people living with dementia and their carers, in all settings
  • More progress on the provision of support after diagnosis and throughout the disease, taking account of individual needs and circumstances
  • Responding to the increasing proportion of older people developing dementia later in life, often alongside other chronic conditions.

There are 21 commitments in the Strategy in total. Within these, the Scottish Government states that it will:

  • 1: Revise the national post-diagnostic dementia service offer to enhance its focus on personalisation and personal outcomes in the delivery of post-diagnostic services
  • 2: Test and independently evaluate the relocation of post-diagnostic dementia services in primary care hubs as part of the modernisation of primary care
  • 3: Support the Integration Authorities to improve services and support for people with dementia as part of our implementation of key actions on delayed discharge, reducing unscheduled bed days, improving palliative care and end-of-life care and community care
  • 4: Consider the learning from the independent evaluation of the 8 Pillars project on the benefits and challenges of providing home-based care coordination and proactive, therapeutic integrated home care for people with dementia
  • 5: Test and evaluate Alzheimer Scotland’s Advanced Care Dementia Palliative and End of Life Care Model
  • 6: Work with stakeholders to identify ways to make improvements in palliative and end of life care for people with dementia
  • 7: Continue to implement national action plans to improve services for people with dementia in acute care and specialist NHS care, strengthening links with activity on delayed discharge, avoidable admissions and inappropriately long stays in hospital
  • 9: Continue to support the ongoing implementation of the Promoting Excellence dementia health and social care workforce framework
  • 10: Support the implementation of the new national AHP Framework Connecting People, Connecting Support
  • 11: Implement the Technology Charter for People in Scotland with Dementia, ensuring that everyone with a diagnosis of dementia and those who care for them are aware of, and have access to, a range of proven technologies to enable people living with dementia to live safely and independently. We will continue to explore innovative ways in which technology can be used and adapted for people living with dementia
  • 12: Work with national and local stakeholders to implement actions in the refreshed Age, Home and Community: A Strategy For Housing For Scotland’s Older People: 2012 – 21 to support people to live safely and independently at home for as long as possible
  • 13: Consider what national action is required to support further improvements in transport for people with dementia
  • 14: As part of supporting local activity on dementia-friendly communities, work with partners to explore the potential to promote and support increased participation in dementia befriending
  • 15: Support implementation of NHS Health Scotland’s report recommendations on dementia and equalities
  • 16: Consider the upcoming recommendations of Police Scotland Missing Persons report for the dementia client group
  • 17: Support the clinical and non-clinical research community in Scotland, including supporting linkages to the UK-wide research institute, linking policy and research in Scotland, and showcasing examples of dementia research in Scotland
  • 18: Commission and publish a renewed study on trends in the prescribing of psychoactive medications for people with dementia
  • 19: Commission fresh work to assess dementia prevalence, and consider which current prevalence model applies best
  • 20: Assess if there is any need for updated dementia clinical guidelines or guidelines on specific elements of clinical dementia treatment
  • 21: Establish a national policy governance structure for monitoring and implementing the third national dementia strategy.

The 2017-2020 strategy builds on the progress made since the introduction of the first and second strategies. The National Dementia Strategy 2013 - 2016 set out the work that the Scottish Government and its partners in NHS Scotland, local government and the voluntary and private sectors are planning to improve support, care and treatment for people with dementia, their families and carers. The Scottish Government's first strategy, published in 2010, focussed on improving the quality of dementia services through more timely diagnosis and on better care and treatment, particularly in hospital settings. 

The 8 Pillars Model of Community Support

Developed by Alzheimer Scotland, the 8 Pillars Model of Community Support is designed to provide a coordinated approach to supporting people to remain at home for as long as possible. The framework sits within an overall model of which the 5 Pillars Model of Post Diagnostic Support is the first stage. The End of Life (Advanced Dementia Model) is the final stage of the overall model.

The 8 Pillars are:

  • Pillar 1: The Dementia Practice Coordinator
  • Pillar 2: Therapeutic interventions to tackle the symptoms of the illness
  • Pillar 3: General health care and treatment
  • Pillar 4: Mental health care and treatment
  • Pillar 5: Personalised support
  • Pillar 6: Support for carers
  • Pillar 7: Environment
  • Pillar 8: Community connections

The Scottish Government’s National Dementia Strategy 2013-16 piloted the 8 Pillars Model and the new National Strategy for 2017-20 also bases its commitments on care co-ordination in the community on the Model.

An evaluation of the 8 Pillars Model, commissioned by the Scottish Government, was published in 2017. 

Promoting Excellence

NHS Education for Scotland (NES) and the Scottish Social Services Council (SSSC) have developed Promoting Excellence: A framework for health and social services staff working with people with dementia, their families and carers. Designed to support delivery of the aspirations and actions outlined in the Scottish Government's first National Dementia Strategy, the framework details the knowledge and skills that health and social services staff should aspire to achieve in relation to the role they play in supporting people with a diagnosis of dementia, and their families and carers.

They have created an accompanying learning resource, Promoting excellence in supporting people through a diagnosis of dementia, to help health and social services staff further develop their ability to support people with dementia and their families before, during and after receiving a diagnosis of dementia.

Dementia Standards

The Standards of Care for Dementia in Scotland were published in 2011. These relate to everyone with a diagnosis of dementia in Scotland, regardless of where they live, their age, the supports they receive or the severity of their illness. This includes younger people, people with a learning disability and people with rare types of dementia. They apply to people living in their own homes, care homes or hospitals, especially general hospitals.

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