Supporting people with dementia to die at home in Ireland
•Download as PPT, PDF•
1 like•170 views
Irish Hospice Foundation nurses for night care service and results of audit on referrals to the service of people with dementia.
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Supporting people with dementia to die at home in Ireland
Similar to Supporting people with dementia to die at home in Ireland (20)
More from Irish Hospice Foundation
More from Irish Hospice Foundation (20)
Recently uploaded
Recently uploaded (20)
Supporting people with dementia to die at home in Ireland
- 1. Marie Lynch, Head of Healthcare Programmes Sarah Cronin, Dementia Development Officer Deirdre Shanagher, Development Officer Supporting people with dementia to die at home
- 2. “ While a good death at home may not be feasible or desirable for everyone, it could undoubtedly be a reality for many more people if we nurture the services to support it” NHS 2012
- 3. Supporting people with dementia to die at home Dementia Referrals 2015 14% (n=118) Total No Referrals 2015 86% (n=742) Dementia referrals versus total no of referrals 2015
- 4. People with dementia accessing NNC Service
- 5. Presentation Today Where do people with Dementia die? What are the factors that support people with dementia to die at home? What would help to enable more people with dementia die at home?
- 6. Where do people with Dementia die? • Home deaths remain rare for people with dementia across Europe with rates varying from 3.3% in Wales to 16.4% in Belgium (Houttekier et al 2010) • Less than 5% of dementia patients died in home (Public Health England 2014) • People with dementia are 4 times more likely to die in residential care (Murtagh et al 2012) • 2 in 5 people with dementia die in hospital (Sleeman et al 2014)
- 7. What are the factors that support people with dementia to die at home? Personal and Demographic Factors • Carers • Gender • Age • Marital Status • Level of Education • Presence of Advance Care Plan • Socioeconomic Status Disease-related factors • Diagnosis • Co-morbidities • Symptom management • Pain Environmental factors • Urban vs rural location • Availability of local services and supports – GP, OOH, SPCT • Hospital and residential care beds • Access to equipment • Formal supports References at end of presentation
- 8. What are the factors that support people with dementia to die at home? Audit on Dementia Referrals Supplementary information gathered on 52 referrals of people with a diagnosis of dementia who were referred to the NNC service: • Demographics – gender, age, address, living situation, length of time living with dementia, co-morbidities, presence of an ACP • Length of time involved with SPCT • Reason for referral • Supports – informal and formal • Care in the home provided by family versus homecare packages/ other formal supports What are the key components of care which enable a person with dementia to die at home in Ireland?
- 9. What are the factors that support people with dementia to die at home?
- 10. Care provided to the person at home
- 11. Formal Supports
- 12. What would help to enable more people with dementia die at home? “ Where someone with dementia dies should be led by their needs, what is known of their wishes and the needs of the people caring for them” (Kane, 2012)
- 13. What would help to enable more people with dementia die at home?
- 15. References • Weafer, J (2014). Irish attitudes to death, dying and bereavement 2004-2014. Dublin: Irish Hospice Foundation. • Murtagh, F.E.M, Bausewein, C., Petkova, H, Sleeman, K.E., Dodd, R.H., Gysels, M., Johnston, B., Murray, S., Banerjee, S., Shipman, C., Hansford, P, Wakefield, D., Gomes, B and Higginson, I.J. (2012). Understanding place of death for patients with non malignant conditions: a systematic review. NHS: National Institute for Health Research Service Delivery and Organisation Programme. • Sleeman, K.E., Ho, Y.K, Verne, J, Gao, W. and Higginson, I.J. on behalf of the GUIDE_Care project (2014). Reversal of English trend towards hospital death in dementia: a population-based study of place and death and associated individual and regional factors, 2001-2010. BMC Neurology 14:59. • Houttekier, D., Cohen, J., Bilsen, J., Addington-Hall, J., Bregie, D., Onwuteaka-Philipsen, Deliens, L. (2010). Place of Death of Older Persons with Dementia. A Study in Five European Countries. Journal of the American Geriatrics Society, 58(4):751-6 • NHS National End of Life Care Programme(2012). Critical success factors that enable individuals die in their preferred place of death. A report based on contributions from End of Life Care commissioners and providers of services within 7 PCT areas. UK: Department of Health. • Kane, M (2012). My Life until the end: Dying well with Dementia. Alzheimers Society UK.
Editor's Notes
- Nurses for nightcare is a service which is funded by the IHF and provided through the Irish Cancer Society. 548 people received the service last year with a total of 1734 nights delivered. This supports people with non malignant illnesses to die at home. 14% of total referrals
- 37% increase last year In 2016, 28 referrals so far this year , representing a 180% increase on the same period
- Population based study in the UK In the US, home deaths are more common Two in five people with dementia die in hospital, Less than 5% of dementia patients died at home or in hospice. Care home bed provision has been found to be the key to this trend reversal. Home/hospice death was more likely in affluent areas, for women, and for those with cancer as underlying cause of death, and less likely in the unmarried.
- Literature
- Referrals are made through SPCT -
- Most people required full nursing care with seizures, recurrent respiratory tract and urinary tract infections frequently reported. Difficulties with hydration and nutrition referenced ++ Use of profiling beds, pressure mattresses, hoists, wheelchairs in the home common. Many family members living in close proximity to the person with dementia, allowing them to stay between their own home and the home of the person with dementia Having a supportive GP was cited as extremely important in 40% of the sample. DNACPR and not for transfer to hospital info shared with OOH providers in a number of cases HCPs – PHN involved in 77% of cases – geriatrician, POLL, commmunity psy nurse People really valued specialist input re dementia – available in 31% of sample Respite 89% of the sample were availing of some formal (paid supports). Many families supplemented the homecare packages using private funding with a small number of families (7%) paying for live in 24 hour care.
- Having a supportive GP was cited as extremely important in 40% of the sample. DNACPR and not for transfer to hospital info shared with OOH providers in a number of cases HCPs – PHN involved in 77% of cases – geriatrician, POLL, commmunity psy nurse People really valued specialist input re dementia – available in 31% of sample Respite 89% of the sample were availing of some formal (paid supports). Many families supplemented the homecare packages using private funding with a small number of families (7%) paying for live in 24 hour care.