AIGNA Conference 2018 Mary Manning

1. AIGNA Conference, 3rd of May 2018
The National Dementia Strategy:
Charting Progress and Outlining
Future Plans
Mary Manning General Manager
National Dementia Office

2. Personhood
Citizenship
Key
principles

3. 6 Priority
Areas
• Better awareness and
understanding
• Timely diagnosis and early
intervention
• Integrated services and supports
• Training and education
• Research and information
• Leadership

4. Introducing the
National Dementia Office

5. Our vision is that people with
dementia and their family carers
receive the supports and services they
need to fulfil their potential and to
maintain their identity, resilience and
dignity as valued and active citizens in
society.

6. Where progress has been made to date
• Understand Together Campaign
• Education and Training
• Intensive Home Care Packages
• Dementia Pathways Projects
• Mapping of services
• Other initiatives

7. Better Awareness and
Understanding:
Led by HSE Communications & Health
and Wellbeing

9. www.understandtogether.ie

12. Community Activation
Inspire communities, groups and organisations to
take small practical steps to help build
understanding and inclusive communities.
Weave a connecting thread through all the vital and
committed local services.

13. Education and Training

14. Education and Training
• PREPARED Project; GP & Primary Care
Team Education
• National Dementia Education
programmes
• Education programme for homecare
workers
• Education review

15. Intensive Home Care
Packages for People with
Demetia:
Testing a Concept
Supported by HSE and Genio

16. Dementia-IHCP designed and resourced
to test the feasibility of providing a high
level of support to people with dementia
with complex needs. Care that is
personalised and flexible.

17. What works, for whom in what circumstances?
Closely monitored
In-depth evaluation to assess feasibility and
effectiveness
Implementation support to share learning
from experiences around country
Findings being used to influence future
service development

18. Early findings:
• Complexity of pathways;
• Communication;
• Challenge to move away from a task-
orientated approach;
• There is an appetite for personalised
supports;

19. Dementia Pathways

20. Dementia Diagnostic Pathway
• Importance of timely diagnosis highlighted in the
National Dementia Strategy
• Lack of standardisation in practice
• NDO review of memory clinics - variation in the
structure, availability and function of memory clinics
How can we establish
integrated multidisciplinary
diagnostic services for people
with dementia?

21. Work to date
• Steering group established October 2017
• Scoping exercise
- Memory clinic review completed
- Needs analysis from meetings with IDWG &
DCCN completed
- Secondary analysis of PREPARED GP data
- Mapping of additional diagnostic practices
• Review of international best practice
-Literature review on diagnosis in Primary Care
and diagnosis ‘disclosure’ complete
-Literature review on diagnosis in generic vs
specialist clinics due end April 2018.

22. Post-diagnostic Support
Project

23. An Identified Gap
“Following a diagnosis, the person with dementia
will need considerable emotional and practical
support. Local, well-co-ordinated support services
are needed to assist people and their families to
cope with the choices and dilemmas confronting
them at this often distressing and challenging
time” (National Dementia Strategy, 2014)
“Services offered may be
fragmented, poorly coordinated,
inflexible and inequitable” (Foley
and Swannick, 2014)
“Emotionally it is a hammer
blow. It is a serious, it is a
depressing thing, it just knocks
you sideways. All I was left with
was the sickening sense of
loss" (person with dementia,
PDS needs analysis)

24. Aims
• To develop a post-diagnostic pathway for both people with
dementia and family carers responding to each individuals’
social, clinical and behavioural needs.
• To support the development of appropriate programmes
and interventions after a diagnosis is confirmed.
• To support the roll-out of these programmes and
interventions through the identification of funding streams.
• To provide guidance on the implementation of the pathway
and disseminate information about the pathway and related
project outputs.

25. Current Activity?
• Work of the national steering group is on-going;
• Development of a PDS framework;
• Grant scheme to support cognitive therapies and post-
diagnostic psycho-educational programmes (18 posts)
• Master-classes planned for Q4 2018;
• Guidance for health and social care professionals on
PDS psycho-education programmes in development;
• Key worker project connected and on-going.

26. Mapping Dementia-Specific
Community-based Services
ASI/NDO Project

27. WHO: Is providing dementia-specific services in
each Community Health Organisation (CHO) area?
WHAT: Is the nature of the dementia-specific service
being provided?
WHERE: Are dementia-specific services being
provided?
WHEN: Are these dementia-specific services
available e.g. 7 days a week, once a month etc?

28. Clinical Guidelines for the
Appropriate Prescribing of
Psychotropic Medication for
People with Dementia

29. Clinical Guidelines for the Appropriate Prescribing of
Psychotropic Medication for People with Dementia
• Focus: Antipsychotics and benzodiazepines, and anticonvulsants
• Target users: HCPs in any setting
• Goal: Appropriate prescribing (not necessarily reduced prescribing)
• To be considered by the National Clinical Effectiveness Committee as
National Clinical Guidelines (standards and audit and cost)
• Also simple guidance notes for HCPs on medications in general: matching
the goals of the medication, and form of delivery to the person’s overall
status. (IHF guidance notes exist)

30. Process…
…
Expert
stakeholder
group
Literature
review
Draft
guidelines
Expert peer
review
External
consultation
Final
guidelines
NCEC
review
Training
materials
Audit tool

31. Other Activities
• Memory Technology Resource Rooms;
• Dementia Registry Project;
• Dementia Good Practice Hub:
• Repeat of Dementia Audit of Acute Care;
• Residential Design Guidelines;
• Acute Design Guidelines:
• External Strategy Evaluation;
• Department of Health Mid-Term Review Report.

32. Concluding Remarks:
• Progress being made but still a way to go;
• Notable advancements in:
- addressing dementia public awareness;
- education and training;
- development of dementia pathways;
- improving data and evidence on dementia to
inform service planning and development.
• Cultural change required – more than training and
education.
• Increased ring-fenced funding required.
• A key element - working in collaboration.

33. Get in
touch
National Dementia Office
Tel: 00 353 (0) 57 9318436
Email: dementia.office@hse.ie
www.understandtogether.ie
www.hse.ie/dementia