Improving Care for People with Advanced Dementia

Greenwich & Bexley Community Hospice are working with the Oxleas Advanced Dementia Service to improve care for people with advanced dementia. Supported by a grant from the St James Place Foundation, we have seconded a Palliative Care Clinical Nurse Specialist to a new 2 1/2 day a week role specifically supporting people with advanced dementia.

In the first 3 months of the project, the CNS received 30 referrals, of these people seen, 15 had died within the same time period, all in their preferred place of care ( 7 at home, 5 in a care home, 2 in the hospice and 1 in hospital).

In addition to the specialist nursing support, patients and their carers have benefitted from access to 24 hour telephone advice and support, access to the wider multi-professional team and access to our volunteer Hospice Neighbours, and bereavement support.

Below is a quote from one carer about the support received from our CNS: “Further to your visit when I told you that I had written to (The Health Secretary, my MP and local Council). Regarding the unfairness of the NH continuing care funding, to no avail; you have in a matter of hours succeeded where I have failed, for which I thank you, would also like to convey my appreciation for all concerned. Being a carer for my wife who has vascular dementia. You will know more than most is both physically and mentally draining with no light at the end of the tunnel. However, I draw comfort from the fact that (the CNS) is a phone call away and responds diligently to both our needs for which I am truly grateful.”

By working closely with partners to ensure appropriate case finding and learning from the start, all referrals have been appropriately managed; the volume of clinical activity clearly demonstrates a need for Hospices to support people with advanced dementia and their carers.

As well as the clinical work, the CNS has engaged in internal and external teaching and is helping to shape the Hospice's dementia strategy. Although this project is in its infancy, it is already a huge success and one which I am proud to sponsor as Chief Executive.
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