Representatives of the Stockport Clinical Commissioning Group, the Alzheimer’s Society and the Memory Assessment Clinic (Pennine Care NHS Foundation Trust) have been invited to the meeting to outline the role their organisation has in supporting those with dementia and their carers, and the challenges facing them.
Minutes:
Carol Rushton (Clinical Lead, Memory Assessment Services), Brigid Flanagan (Manager, Memory Assessment Services), Nicole Alkemade (Older People’s Joint Commissioning Manager, Stockport Clinical Commissioning Group), Helen Hinks (Locality Manager, Alzheimer’s Society) and Maureen Hughes (Project Manager, Adult Social, Stockport Council) attended the meeting and gave a presentation which outlined the role their organisation had in supporting those with dementia and their carers and the challenges facing them.
The presentation highlighted the following issues:-
· Stockport Memory Assessment Clinic saw people with Alzheimer’s disease, Dementia, Vascular Dementia and people who have had strokes.
· There are at least 100 types of dementia, of which Alzheimer’s disease is the most common.
· People who have been diagnosed with the differing types of dementia can present with different behaviours and different symptoms, each of which has its own challenges. It is important that carers are aware of all the differing aspects of the condition.
· Interventions can vary depending on which part of the brain is affected.
· A diagnosis of dementia is life changing not only for the patient, but also for the carer.
· Health professionals are very aware of the possibility of carers becoming isolated, depressed or suicidal.
· Carers have reported that when they need out of hours support, organisations such as Mastercall often do not know how to help. Patients and carers can then find themselves having to attend Accident and Emergency Departments, where they may find that they have to wait for over four hours to be seen.
· Soon after diagnosis, support workers visit patients to discuss which options and services may be available to them, some people however will refuse services until such time as the situation significantly deteriorates.
· Support groups have proved helpful in the past to support those who have lost a loved one. There was now an ex-carers group set up in the Hat Works museum. This costs nothing to run. Having a resource pack to give to people would be very useful.
· A business case has been put together for an In Reach team to go into care homes to help staff with issues such as end of life care and challenging behaviours.
· Unfortunately all too often Stockport residents with dementia were being placed in Manchester and Tameside for example, and this meant that their elderly relatives were forced to travel in order to visit them.
The following comments were made/issues raised:-
· Councillors queried whether GP’s were good at spotting dementia. In response it was stated that the Memory Assessment Service had worked very hard with GP’s in Stockport and there were now link nurses in four locations. Some GPs have expressed that they are wary of diagnosing dementia, as they are worried that there may be no secondary services available, they also need to rule out a physical cause for the presenting symptoms. GP’s tend to refer in to psychiatry services. The Alzheimer’s Society have also started trying to raise awareness of dementia, they have managed to contact 44 of 49 GP surgeries, to offer information and advice. The issue of whether some missed appointments may be a result of patients having memory problems, has also been raised.
· Members questioned whether GPs pick up on the needs of carers of dementia. It was felt that this was unlikely.
· Carers have varying experiences. Some carers have accessed community based support whilst others have struggled to find any support at all. Church organisations have been very supportive in the past.
· It can be very difficult for a carer to get out of the caring environment even for a short time, for example to attend a medical appointment.
· Members raised the issue of how Services link in with care homes. In response it was stated that this was a huge issue. People tend to be discharged from Services once they go into a care home. Services have to determine where they will concentrate their finite resources. Very often care settings do not recognise end of life care and are not having those difficult conversations with relatives.
· Members discussed what it was that put off people volunteering to work with dementia patients. It was felt that the safeguarding issue may be a factor but that the most likely explanation was fear of the unknown.
· Members asked what it was they could do to help. In response it was stated that a co-ordinator for all the drop in groups would be very useful. In addition, Members could spread the word about the need for volunteers to help with transport, as this was a huge issue for some people.
RESOLVED – That Nicole Alkemade, Maureen Hughes, Brigid Flanagan, Carol Rushden and Helen Hinks be thanked for their attendance and presentation.