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Content Article
Age-Friendly Health Systems (AFHS) is an initiative that aims to follow evidence-based practices while minimising harm in older patients. The evidence-based elements of high-quality care are known as the 4Ms: What Matters Medication Mentation Mobility During the early days of the Covid-19 pandemic, a team from the Oregon Health & Science University (OHSU) decided to examine the equity of their care for older adults. The resulting study published about the age-friendly work at OHSU is the first to include data about health equity as part of AFHS outcomes and illustrates the importance of creating equitable care at clinical and institutional policy levels. This blog looks at the process the team went through to assess and collect data about age-related equity. -
News ArticleHealthcare leaders are rolling out new NHS training to help speed up dementia diagnoses among Black and Asian people following criticism about a lack of support for patients from minoritised communities, The Independent has revealed. An awareness campaign is being launched in England to help those from ethnic minority communities receive a prompt diagnosis and get the support they need at the earliest opportunity. The announcement follows a critical report which found that thousands of south Asian people with dementia are being failed by “outdated health services designed for white British patients”. Dr Bola Owolabi, director of the Healthcare Inequalities Improvement programme at NHS England, said: “The pandemic put a greater spotlight on longstanding health inequalities experienced by different groups across the country. “While there are many factors involved, the NHS is playing its part in narrowing the gap and ensuring equitable access to services through taking targeted action where needed to improve outcomes." Read full story Source: The Independent, 21 May 2023
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Content ArticleThe Department of Health and Social Care is seeking views and ideas on how to prevent, diagnose, treat and manage the six major groups of health conditions that most affect the population in England. These are: cancers cardiovascular disease, including stroke and diabetes chronic respiratory diseases dementia mental ill health musculoskeletal disorders The views and ideas gathered will inform the priorities and actions in the major conditions strategy. The consultation will close at 11:59pm on 27 June 2023.
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Content ArticleThis guide aims to help health and social care workers provide dementia care, which corresponds to the needs and wishes of people from a wide range of ethnic groups, especially minority ethnic groups.
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News Article
Quarter of people with dementia symptoms delay seeing doctor
Patient Safety Learning posted a news article in News
Almost a quarter of people with dementia symptoms waited more than six months before seeing a doctor, new research shows. A new survey for the Alzheimer’s Society to mark Dementia Action Week also found one in three people who notice they or a loved one has symptoms keep their fears to themselves or dismiss them as old age. Just 15% of the 1,137 people surveyed raised the issue straight away and 11% said they hadn’t raised concerns after first spotting symptoms. Kate Lee, chief executive of the Alzheimer’s Society, said: “We can’t continue to avoid the ‘d’ word – we need to face dementia head-on. “As soon as you realise something is not right, come to Alzheimer’s Society – you can use our symptoms checklist to help have that all-important first chat with your GP.” An early diagnosis is crucial to help manage symptoms, according to the charity, which has launched a new campaign called – It’s not called getting old, it’s called getting ill – to encourage people to seek support in getting a diagnosis. Read full story Source: The Independent, 15 May 2023 -
Content Article
At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That's why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples. Dementia is an umbrella term for a number of diseases that affect the brain, with Alzheimer’s disease its most common cause. We have picked nine resources and reflections about keeping people with dementia safe in health and care settings, and when considering medication choices. -
Content ArticleA formal diagnosis of dementia can help people living with the condition and their families gain a better understanding of what to expect and help to inform important decisions about treatment, support and care. Alzheimer’s Society estimate that in England, Wales and Northern Ireland there are over 300,000 people living with dementia who do not have a diagnosis. In this report they highlight barriers to accessing a timely and accurate dementia diagnosis and advocate for practical changes and tangible solutions to overcome them.
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News ArticleThe world is “on the cusp of a first generation of treatments for Alzheimer’s disease”, experts have said, as a new drug was found to slow cognitive and functional decline. The drug donanemab, made by Eli Lilly and Company, slowed decline by 35% to 36% in a late-stage phase 3 clinical trial, the company said. Donanemab appeared to slow the decline associated with Alzheimer’s compared to placebo in 1,182 people with early-stage disease based on those with intermediate levels of a protein known as tau. The drug also resulted in 40% less decline in the ability to perform activities of daily living, according to the firm. Dr Susan Kolhaas, executive director of research and partnerships at Alzheimer’s Research UK, said: “This is incredibly encouraging, and another hugely significant moment for dementia research". “The treatment effect is modest, as is the case for many first-generation drugs, and there are risks of serious side effects that need to be fully scrutinised before donanemab can be marketed and used. “However, this news underlines the urgency of preparing the NHS to make these treatments available should regulators deem them safe and effective". Read full story Source: The Independent, 3 May 2023
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News Article
UK on verge of new dawn for dementia treatments, says taskforce chair
Patient Safety Learning posted a news article in News
Today’s generation of elderly people could be the last to face the spectre of untreatable Alzheimer’s disease, according to the co-chair of the government’s new dementia mission. Hilary Evans, the chief executive of Alzheimer’s Research UK, appointed by ministers last month, said the world was “on the cusp of a new dawn” for dementia treatments that meant devastating neurodegenerative illness would no longer be regarded as an inevitable part of old age. However, she warned that an overhaul of NHS dementia care was required to ensure that patients could access the first effective Alzheimer’s drugs, which could be approved in the UK as soon as next year. Evans was appointed last month to co-chair the UK government’s national dementia initiative, which aims to draw lessons from the Covid vaccine taskforce to accelerate dementia research and comes with a commitment to double funding for dementia research to £160m a year by 2024–2025. Read full story Source: The Guardian, 26 April 2023 -
News Article
Covid no longer the leading cause of death in England and Wales
Patient Safety Learning posted a news article in News
Covid-19 has dropped out of the top five leading causes of death in England and Wales for the first time since the start of the pandemic, figures show. Coronavirus was recorded as the main cause of death for 22,454 people in 2022, or 3.9% of all deaths registered, making it the sixth leading cause overall. In both 2020 and 2021 Covid-19 was the leading cause of death, with 73,766 deaths (12.1% of the total) and 67,350 (11.5%) respectively. By contrast, dementia and Alzheimer’s disease was the leading cause in England and Wales in 2022, with 65,967 deaths registered (11.4% of the total), up from 61,250 (10.4%) in 2021. The other causes in the top five were ischaemic heart diseases (59,356 deaths and 10.3% of the total); chronic lower respiratory diseases (29,815 deaths, 5.2%); cerebrovascular diseases such as strokes and aneurysms (29,274 deaths, 5.1%); and trachea, bronchus and lung cancer (28,571 deaths, 5.0%). Read full story Source: The Independent, 11 April 2023 -
News Article
Trust told to pay more than £200k over dementia patient’s death
Patient Safety Learning posted a news article in News
A hospital trust has been told to pay almost a quarter of a million pounds after pleading guilty to failing to provide safe care to a patient with advanced dementia who fatally injured himself. The Care Quality Commission (CQC) brought the prosecution against University Hospitals of Derby and Burton Foundation Trust after an incident in July 2019, when a patient died after absconding from the hospital. Peter Mullis – who had advanced dementia – was admitted to Queen’s Hospital Burton emergency department and absconded twice. When he tried to a third time, he was followed by trust staff. The CQC described how, despite being followed, Mr Mullis was able to climb over a barrier, fall down a grass bank and hit his head on concrete at the bottom. He was airlifted to the local trauma centre, but died of multiple traumatic injuries. The CQC said UHDB did not take “reasonable steps” to ensure safe care was provided and that failure exposed Mr Mullis to “significant risk of avoidable harm”. -
Content Article
In this video interview, consultant geriatrician Dr Elena Mucci talks about patient safety in geriatrics and end of life care. She describes the importance of: taking a whole-person approach to caring for older people reviewing medications regularly equipping patients to manage their own health. engaging patients and their families in planning for end of life care at an early stage Elena also explains how she is sharing these messages with both patients and healthcare professionals. -
Content Article
The haunting brain science of Long Covid (Stat,16 February 2023)
Patient-Safety-Learning posted an article in Blogs
In this article for Stat, E. Wesley Ely, Professor of Medicine and Critical Care at Vanderbilt University Medical Center, looks at the impact Covid-19 and Long Covid can have on people's brains. He speaks to people with Long Covid who have experienced a sharp decline in brain function, leading to them losing their jobs, struggling to hold a conversation and in some cases developing early-onset dementia. He also highlights biomedical research that has shown changes to the brain in people with confirmed Covid-19 infections, including a reduction in grey matter, problems in the cells lining the blood vessels and impaired cellular metabolism in the frontal lobe six months following acute Covid. -
News ArticleA dementia home care agency spent as little as three and a half minutes on taxpayer-funded care visits and filed records claiming far more care was given, according to evidence seen by the Guardian. The hasty care was exposed by Susan Beswick’s family, who called it “totally inadequate”. They say they had been told visits to 78-year-old Beswick, who has Alzheimer’s disease, were supposed to last 30 or 45 minutes. Across nine visits this month, care workers formally logged close to six hours of care. But security cameras suggest they were in the house for under one hour 20 minutes – less than nine minutes a visit on average. On one evening visit, footage showed two carers entering, asking if Beswick had eaten and checking her incontinence pad, before leaving three minutes and 15 seconds later. But they appeared to log on a care tracking app that they had been with her for one hour and 16 minutes. Beswick, who for years was a care worker herself, “deserves so much better”, said her daughter-in-law Karen Beswick. “It’s upsetting us the way mum is being cared for here,” she said. “They come in and check her [incontinence] pad and go. They are supposed to be encouraging her to drink. They don’t really talk to mum a lot. It’s not good at all. I will start crying. We are all trying to get the best for mum.” Read full story Source: The Guardian, 30 January 2023
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Content ArticleThis study in the journal Acta Neuropathologica Communications examined neuropathological findings of patients who died following hospitalisation in an intensive care unit with Covid-19. The researchers conducted brain autopsy on 20 people who had died, followed by ex-vivo imaging and dissection. They found that acute tissue injuries and microglial activation were the most common abnormalities discovered in Covid-19 brains. They also found evidence of encephalitis-like changes despite the lack of detectable virus. The majority of older subjects showed age-related brain conditions even in the absence of known neurologic disease. The findings of this study suggest that acute brain injury alongside common pre-existing brain disease may put older subjects at higher risk of post-Covid neurological issues.
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News Article
NHS in England will have one strategy for all major conditions, including cancer
Patient Safety Learning posted a news article in News
The NHS in England is set to have a major conditions strategy to help determine policy for the care of increasing numbers of people in England with complex and often multiple long-term conditions. Conditions covered by the strategy will include cardiovascular disease, chronic respiratory disease, dementia, mental health conditions, and musculoskeletal disorders. Cancer will also be included and will no longer have its own dedicated 10 year strategy. England’s health and social care secretary, Steve Barclay, told the House of Commons on 24 January that the strategy would build on measures in the NHS long term plan. Read full story (paywalled) Source: BMJ, 25 January 2023 -
Content ArticleHow can leaders move from understanding to taking actions? Listen to the Dementia UK podcast on moral injury in nursing.
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News Article
FDA greenlights new Alzheimer's drug amid safety concerns
Patient-Safety-Learning posted a news article in News
The FDA is greenlighting the drug Leqembi after it appeared to slow cognitive decline in some early stage Alzheimer’s patients in spite of some potential risks. In this video, Kristen Dahlgren has more details about findings from the clinical trial. Watch full story Source: NBC News, 7 January 2023 -
News ArticleThe US Food and Drug Administration (FDA) has granted accelerated approval for the Alzheimer’s disease drug lecanemab, one of the first experimental dementia drugs to appear to slow the progression of cognitive decline. Lecanemab will be marketed as Leqembi, the FDA statement said. It has shown “potential” as an Alzheimer’s disease treatment by appearing to slow progression, according to Phase 3 trial results, but it has raised safety concerns due to its association with certain serious adverse events, including brain swelling and bleeding. In July, the FDA accepted Eisai’s Biologics License Application for lecanemab under the accelerated approval pathway and granted the drug priority review, according to the company. The accelerated approval programme allows for earlier approval of medications that treat serious conditions and “fill an unmet medical need” while the drugs continue to be studied in larger and longer trials. If those trials confirm that the drug provides a clinical benefit, the FDA could grant traditional approval. But if the confirmatory trial does not show benefit, the FDA has the regulatory procedures that could lead to taking the drug off the market. Read full story Source: CNN Health, 7 January 2023
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News ArticleWoodside Care Village in Warwick is staged like a town centre in miniature, with benches and a fountain, cafe tables and front doors to homes styled as either “town”, “country” or “classical”. But none of the places are quite what they seem, because here everything has a greater purpose: to improve the wellbeing of people with dementia. Modelled on a groundbreaking Dutch experiment in looking after people with Alzheimer’s disease, the purpose-built facility, which opened in 2019, is quietly breaking new ground for a better kind of dementia care. “Everything is dressed and staged to look familiar,” said Jo Cheshire, the communications manager for the home’s operator, WCS. “We try to make sure people aren’t severing their links with the past. We have one lady who works in the launderette with a badge, because that’s what she did before. It feels like they are contributing to the community.” “The idea is you have freedom,” said Cheshire. “If you come upon a locked door it can increase agitation, that’s unsettling for the other residents and it makes the carer’s job harder.” Staff ratios are higher than normal, at two staff for every five or six people rather than the usual one. This means staff can spend more time interacting with the residents. Staff are briefed with a “this is me” document, which details the likes and dislikes of each person with dementia and has photos through their lives, the time they like to get up, when they like to eat. A clinical trial of such “person-centred” dementia care in 69 care homes in London and Buckinghamshire published in 2020 showed that it improved quality of life for people with dementia and reduced agitation and the burden of depression or aggression. It also reduced hospital and GP visits. Read full story Source: The Guardian, 30 December 2022
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News ArticleFamilies of people with dementia have said there is a national crisis in care safety as it emerged that more than half of residential homes reported on by inspectors this year were rated “inadequate” or requiring improvement – up from less than a third pre-pandemic. Serious and often shocking failings uncovered in previously “good” homes in recent months include people left in bed “for months”, pain medicine not being administered, violence between residents and malnutrition – including one person who didn’t eat for a month. In homes in England where standards have slumped from “good” to “inadequate”, residents’ dressings went unchanged for 20 days, there were “revolting” filthy carpets, “unexplained and unwitnessed wounds” and equipment was ”encrusted with dirt”, inspectors’ reports showed. Nearly one in 10 care homes in England that offer dementia support reported on by Care Quality Commission inspectors in 2022 were given the very worst rating – more than three times the ratio in 2019, according to Guardian analysis. Read full story Source: 29 December 2022
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News Article
Secret footage reveals abuse of woman with dementia at luxury UK care home
Patient Safety Learning posted a news article in News
An 88-year-old woman with dementia was physically and mentally abused at a luxury care home charging residents close to £100,000 a year, the Guardian can reveal. Staff misconduct was exposed by secret filming inside the home run by Signature Senior Lifestyle, which operates 36 luxury facilities mostly in the south of England. It has admitted that Ann King was mistreated at Reigate Grange in Surrey earlier this year. Distressing footage from a covert camera inside her room shows: Care staff handling King roughly, causing her to cry out in distress. On one occasion she was left on the floor for 50 minutes. King being taunted, mocked and sworn at when she was confused and frightened. The retired nurse being assaulted by a cleaner, who hits her with a rag used to clean a toilet while she is lying in bed. The cleaner threatening to empty a bin on the pensioner’s head and making indecent sexual gestures in her face. The abuse was exposed by King’s children, Richard Last and Clare Miller. They became so concerned about her wellbeing at the care home, where she lived from January 2021 to March 2022, that they installed a hidden camera on her bedside table. They have shared the footage because they fear what happened to their mother may not be an isolated incident, and because: “She has always been horrified by this type of thing and we felt she would have wanted us to show this is going on.” Read full story Source: The Guardian, 13 October 2022 -
News Article
Signs of dementia may be detectable nine years before diagnosis
Patient Safety Learning posted a news article in News
Scientists have discovered that it may be possible to spot signs of dementia as early as nine years before patients receive an official diagnosis. The findings raise the possibility that, in the future, at-risk people could be screened to help select those who could benefit from interventions, or help identify patients suitable for clinical trials for new treatments. Researchers at Cambridge University published the study – funded by the Medical Research Council with support from the NIHR Cambridge Biomedical Research Centre – in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. Dr Richard Oakley, associate director of research at the Alzheimer’s Society, said the “important” findings suggested that “for some people who go on to develop Alzheimer’s disease, memory and thinking problems can begin up to nine years before they receive a diagnosis”. He added: “This opens up the possibility of screening programmes in the future to help identify people at risk and who may benefit from interventions, and identify more people suitable for clinical trials for new dementia treatments, which are both so desperately needed.” The study’s first author, Nol Swaddiwudhipong, said: “This is a step towards us being able to screen people who are at greatest risk – for example, people over 50 or those who have high blood pressure or do not do enough exercise – and intervene at an earlier stage to help them reduce their risk.” Read full story Source: The Guardian, 13 October 2022 -
Content ArticleThe CVDPREVENT audit contributes to a strategic objective outlined in the NHS Long Term Plan to prevent 150,000 strokes, heart attacks and cases of dementia over the next ten years. The audit works with system partners to drive cardiovascular disease (CVD) quality improvement. Mary Wills is a patient representative for the CVDPREVENT audit, and in this blog she describes her family's experience of CVD and why she was keen to get involve in CVDPREVENT. She talks about the value of hearing from other patients and carers in the first Patient Panel meeting and being invited to contribute to CVDPREVENT Steering Group meetings.
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News Article
Social care: 'Jo's care will cost £1.5k a week - the system is broken'
Patient Safety Learning posted a news article in News
It was only a year ago that Boris Johnson stood up in Parliament and said he was going to fix the long-term problems in social care. He announced a new tax - to raise about £12bn a year - would be spent on health and social care costs only. But the UK's new prime minister, Liz Truss, has already scrapped the plan. Families, carers and care providers have been left asking where the funding will now come from to fix a system, which they say is broken. Dr Jo Wilson was a high-flying international executive before she was diagnosed with dementia two years ago, aged 66. Her husband, Bill, insists he's her husband, not her carer. But he now sees to Jo's every need. Bill has had to find fight and persistence to navigate the world of dementia care. "It took me two years to get a care package in place for Jo," he explains. "And I only got that because Jo had a collapse at home and was taken into hospital." Even after it was confirmed Jo could have carers come to their home to help, Bill found the variety of staff, unreliable time keeping, and a lack of understanding of dementia, left him questioning whether it was worth it. He's now permanently exhausted, and frustrated. Professor Martin Green, chief executive of Care England, says without a complete restructure of the social care system "thousands, if not millions, will be left without support, and the NHS will be on its knees". It is a warning heeded by others. A new poll by Ipsos Mori for BBC News, suggests more than 70% of those over 55 are not confident that social care services will provide care to those in need. More than half of responses cited staff shortages and limited public funding as their main concerns. Care providers say it's these issues that are putting them under extreme pressure. "We know currently that three in five people with dementia do not get the support that they need once they have that diagnosis. And that leads to crisis in care", says Fiona Carragher, director of policy at the Alzheimer's Society." Read full story Source: BBC News, 7 October 2022
