Dementia Training Standards Framework

Health Education England, Skills for Health & Skills for Care, | July 2018 |Dementia Training Standards Framework

Health Education England (HEE) have released the Dementia Training Standards Framework, the resource was previously known as Dementia Core Skills Education and Training Framework, its recent update and review include a number of additions regarding food, drink and oral health.

The framework is  an extraordinarily useful resource which details the essential skills and knowledge necessary across the health and social care spectrum. Three tiers are described:

  • Awareness, which everyone should have;
  • Basic skills which are relevant to all staff in settings where people with dementia are likely to appear and;
  • Leadership.

This framework will help ensure quality and consistency in dementia education and training if you are an organisation or an individual working in health, social care or housing.

The framework will allow the differentiation of high quality services, ensure personalised care and support for people living with dementia, and support organisations and individuals to meet requirements of regulators  (source: HEE).

You can access the framework here

Alternatively, the framework can be downloaded from the Skills for Health website

Ten minutes of social interaction improves wellbeing  in dementia care

Alzheimer’s Society | July 2018 | Ten minutes of social interaction improves wellbeing  in dementia care

Spending ten minutes interacting with people with dementia in care homes can benefit their wellbeing. The Wellbeing and Health for people with Dementia (WHELD) programme trained care home staff to increase social interaction from two minutes a day to ten, combined with a programme of personalised care.  Carers were encouraged to discuss the patient’s interests and involve them in decisions about their care.  The Improving Staff Attitudes and Care for People with Dementia e-Learning (tEACH) study, conducted by the University of Exeter Medical School and King’s College London in partnership with the Social Care Institute for Excellence (SCIE), was presented at the recent Alzheimer’s Association International Conference 2018. The study involved 280 residents and care staff in 24 care homes over a nine- month period.

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Carers participated in an e-learning programme, carers who participated via Skype  continued to deliver improved resident wellbeing four months after the trial was completed. Although boh treatment arms improving resident wellbeing and staff attitudes to person-centred care.

Dr Doug Brown, Chief Policy and Research Officer at Alzheimer’s Society, said:
‘It’s unacceptable that people in care homes only get ten minutes of social interaction each day. What we need is a person-centred approach to care, that takes into account each individual’s unique qualities, abilities, interests, preferences and needs.

‘This study supports what we know from our own research – training is crucial in order to provide this type of individualised care, activities and social interactions, which can have a significant impact of the well-being of people living with dementia in care homes (Source: The Alzheimer’s Society).

Related:

Press release, University of Exeter Just ten minutes of social interaction a day improves wellbeing in dementia care

In the news:

Science Daily  Just 10 minutes of social interaction a day improves wellbeing in dementia care

Watching England at the world cup ‘good for your nerves’ claims NHS doctor

NHS England | July 2018 | Watching England at the world cup ‘good for your nerves’ claims NHS doctor

A senior NHS doctor NHS England Clinical Director for Dementia, Alistair Burns, has emphasised the benefits of watching football to our well-being.  The NHS director  said: “Although fans may not feel it this week, football can be good for your nerves.  The beautiful game really can help your mind and body.” 
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“As well as being great physical exercise, there is a positive link between watching classic football matches and keeping the mind active. For people in old age and dealing with dementia, rewatching matches can rekindle past memories, connect people with their past and keep the brain active.

According to the Clinical Director for Dementia  sport can stimulate emotion which can be revived many years after the event. Emotional memory, which is one of two main types of memory in the human brain, can be more powerful than memory for personal events, so as people in later life relive exciting or tense moments, this can stimulate memories, potentially strengthening brain activity.

Across the UK, 850,000 people are estimated to live with dementia, while mental ill health affects almost eight million people aged over 55. A survey last year from Age UK showed that conditions like depression and anxiety affect over half of people aged over 55 – nearly eight million people – with one in five of these people saying that their condition deteriorates as they get older.

(Source: NHS England)
The news item is available to read in full from NHS England

Dementia risk now included as part of NHS Health Check

Public Health England | June 2018 | Dementia risk now included as part of NHS Health Check

Public Health England (PHE) have announced that healthcare professionals in GP surgeries and the community will soon give advice on dementia risk to patients as part of the NHS Health Check. Adding the dementia element to the NHS Health Check programme will enable healthcare professionals to talk to their patients about how they can reduce their dementia risk, such as by maintaining their social life, keeping mentally and physically active and stopping smoking (Source PHE).

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It is estimated that over 850,000 people are living with dementia in the UK with little public understanding of how it’s possible to reduce the risk. While much of the NHS Health Check focuses on reducing cardiovascular disease (CVD) risk, the advice for preventing CVD is much the same as for dementia: ‘what’s good for the heart is good for the brain’. (Public Health England)

Full details are available from Public Health England

In the media:

BBC News Over 40s health check to include dementia advice

Study finds an association between systolic blood pressure in middle age and dementia

A study published in the latest edition of the European Heart Journal has found that individuals aged over 50 with systolic blood pressure  over 130 mmHg had a increased risk- they were one and a half times more likely to develop dementia- than peers with ‘ideal’ blood pressure. 

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Abstract

Aims

To examine associations of diastolic and systolic blood pressure (SBP) at age 50, 60, and 70 years with incidence of dementia, and whether cardiovascular disease (CVD) over the follow-up mediates this association.

Methods and results

Systolic and diastolic blood pressure were measured on 8639 persons (32.5% women) from the Whitehall II cohort study in 1985, 1991, 1997, and 2003. Incidence of dementia (n dementia/n total = 385/8639) was ascertained from electronic health records followed-up until 2017. Cubic splines using continuous blood pressure measures suggested SBP ≥130 mmHg at age 50 but not at age 60 or 70 was associated with increased risk of dementia, confirmed in Cox regression analyses adjusted for sociodemographic factors, health behaviours, and time varying chronic conditions. Diastolic blood pressure was not associated with dementia. Participants with longer exposure to hypertension (SBP ≥ 130 mmHg) between mean ages of 45 and 61 years had an increased risk of dementia compared to those with no or low exposure to hypertension. In multi-state models, SBP ≥ 130 mmHg at 50 years of age was associated with greater risk of dementia in those free of CVD over the follow-up.

Conclusion

Systolic blood pressure ≥130 mmHg at age 50, below the conventional ≥140 mmHg threshold used to define hypertension, is associated with increased risk of dementia; in these persons this excess risk is independent of CVD.

The full article is available to read at European Heart Journal 
In the media:

BBC News Unfit in middle age:Are you doomed?

Full reference:
Abell, J.G., et al | 2018| Association between systolic blood pressure and dementia in the Whitehall II cohort study: role of age, duration, and threshold used to define hypertension | European Heart Journal  ehy288| https://doi.org/10.1093/eurheartj/ehy288

After diagnosis of dementia: what to expect from health and social care services

Department of Health and Social Care | May 2018 | After diagnosis of dementia: what to expect from health and social care services

A new report from the Department of Health and Social Care examines the role of advanced care planning and explores the barriers to its implementation as identified by people with incurable cancer and health and social care professionals.  It also examines opportunities for change and sets out responsibilities of governments and policy makers.

This document is for anyone diagnosed with dementia and the people who care for them. It has details about what support they should get.  It also includes information about:

  • what is in a care plan
  • how health care and social care services can help
  • support available to family and friends who are carers
  • how to take part in research

The full guidance is available to read from Department of Health and Social Care 

UCL researchers: Anxiety in mid-life might be linked to dementia in later life

University College London | May 2018 | Mid-life anxiety may be linked to later life dementia

A new research paper published in the BMJ Open analysed studies looking at the association between mid-life anxiety, depression, and the development of dementia. The researchers from University College London (UCL) and the University of Southampton  searched databases for published studies. While only four out of over 3500 studies  met their criteria for inclusion this was equivalent to nearly 30000 people.  They suggest that an abnormal stress response, experienced in moderate to severe anxiety, may increase brain cell ageing and degenerative changes in the central nervous system, so increasing vulnerability to dementia. For this reason they  suggest that anxiety should be considered by doctors as a risk factor for dementia.  Currently, it remains unclear if treatment for anxiety could potentially curb dementia (via UCL).

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Abstract

Objectives Anxiety is an increasingly recognised predictor of cognitive deterioration in older adults and in those with mild cognitive impairment. Often believed to be a prodromal feature of neurodegenerative disease, anxiety may also be an independent risk factor for dementia, operationally defined here as preceding dementia diagnosis by more than or equal to 10 years.

Design A systematic review of the literature on anxiety diagnosis and long-term risk for dementia was performed following published guidelines.

Setting and participants Medline, PsycINFO and Embase were searched for peer-reviewed journals until 8 March 2017. Publications reporting HR/OR for all-cause dementia based on clinical criteria from prospective cohort or case–control studies were selected. Included studies measured clinically significant anxiety in isolation or after controlling for symptoms of depression, and reported a mean interval between anxiety assessment and dementia diagnosis of at least 10 years. Methodological quality assessments were performed using the Newcastle-Ottawa Scale.

Outcome measure HR/OR for all-cause dementia.

Results Searches yielded 3510 articles, of which 4 (0.02%) were eligible. The studies had a combined sample size of 29 819, and all studies found a positive association between clinically significant anxiety and future dementia. Due to the heterogeneity between studies, a meta-analysis was not conducted.

Conclusions Clinically significant anxiety in midlife was associated with an increased risk of dementia over an interval of at least 10 years. These findings indicate that anxiety may be a risk factor for late-life dementia, excluding anxiety that is related to prodromal cognitive decline. With increasing focus on identifying modifiable risk factors for dementia, more high-quality prospective studies are required to clarify whether clinical anxiety is a risk factor for dementia, separate from a prodromal symptom.

Full reference:

Gimson ASchlosser MHuntley JD, et al | Support for midlife anxiety diagnosis as an independent risk factor for dementia: a systematic review|