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Chapter 7 - Crisis and Assessment of Need in Dementia

Development of a Home Treatment Package

Published online by Cambridge University Press:  10 June 2021

Juanita Hoe
Affiliation:
City, University of London
Martin Orrell
Affiliation:
University of Nottingham
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Summary

The population is ageing, and dementia is the greatest global challenge for health and social care in the twenty-first century.1 A recent review estimated that the financial cost of dementia overall to the United Kingdom is £34.7 billion, and this is set to rise sharply over the next two decades to £94.1 billion in 2040.2 In the United Kingdom, there are currently around 850,000 people living with dementia, and this is expected to almost triple by 2050.3 While approximately two-thirds of these people with dementia live in the community,4 one-third are living alone in their own homes5 and are supported mainly by their families.6,7 Dementia symptoms can occur alongside other mental health conditions, including depression and anxiety,8 together with an increased risk of physical health co-morbidities.1 The progressive nature of dementia is often coupled with other health and social needs, and management is complex.9 Given the multifaceted nature of dementia, crises can often occur and lead to hospital admissions and care home placements.10,11 Consequently, people with dementia account for 42% of people over the age of 70 who experienced unplanned admissions to hospital, rising to 48% of people aged over 80 years.12 However, people with dementia have poorer outcomes when admitted to hospital, including increased confusion, risk of infection, longer bed stays and lower quality of life.13

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Publisher: Cambridge University Press
Print publication year: 2021

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References

Livingston, G, Sommerlad, A, Orgeta, V, et al. Dementia prevention, intervention, and care. Lancet 2017; 390(10113):2673–734.CrossRefGoogle ScholarPubMed
Wittenberg, R, Knapp, M, Hu, B, et al. The costs of dementia in England. International Journal of Geriatric Psychiatry 2019; 34(7):1095–103.CrossRefGoogle ScholarPubMed
Prince, MJ. World Alzheimer Report 2015: The Global Impact of Dementia: An Analysis of Prevalence, Incidence, Cost and Trends. London: Alzheimer’s Disease International; 2015.Google Scholar
Schneider, J, Hallam, A, Murray, J, et al. Formal and informal care for people with dementia: Factors associated with service receipt. Aging & Mental Health 2002; 6(3):255–65.CrossRefGoogle ScholarPubMed
Miranda-Castillo, C, Woods, B, Galboda, K, et al. Unmet needs, quality of life and support networks of people with dementia living at home. Health and Quality of Life Outcomes 2010; 8(1):132–4.Google Scholar
Schulz, R, Martire, LM. Family caregiving of persons with dementia: Prevalence, health effects, and support strategies. American Journal of Geriatric Psychiatry 2004; 12(3):240–9.CrossRefGoogle ScholarPubMed
Dowrick, A, Southern, A. Dementia 2014: Opportunity for Change. London: Alzheimer’s Society; 2014. Available at www.alzheimers.org.uk/sites/default/files/migrate/downloads/dementia_2014_opportunity_for_change.pdf.Google Scholar
Korczyn, AD, Halperin, I. Depression and dementia. Journal of the Neurological Sciences 2009; 283(1–2):139–42.Google Scholar
Hutchings, R, Carter, D, Bennett, K. Dementia – The True Cost: Fixing the Care Crisis. London: Alzheimer’s Society; 2018. Available at www.alzheimers.org.uk/sites/default/files/2018–05/Dementia%20the%20true%20cost%20-%20Alzheimers%20Society%20report.pdf.Google Scholar
National Institute for Health and Care Excellence. Transition between inpatient hospital settings and community or care home settings for adults with social care needs. National Institute for Clinical Excellence [online], December 2015. Available at www.nice.org.uk/guidance/ng27.Google Scholar
Gallagher, D, Ni Mhaolain, A, Crosby, L, et al. Dependence and caregiver burden in Alzheimer’s disease and mild cognitive impairment. American Journal of Alzheimer’s Disease & Other Dementias 2011; 26(2):110–14.Google Scholar
Sampson, EL, Blanchard, MR, Jones, L, et al. Dementia in the acute hospital: Prospective cohort study of prevalence and mortality. British Journal of Psychiatry 2009; 195(1):61–6.Google Scholar
Health Foundation Spotlight on dementia care: Improving care for people with dementia. Health Foundation Improvement Report, London; 2011. Available at www.health.org.uk/publications/spotlight-on-dementia-care.Google Scholar
Department of Health. Prime Minister’s Challenge on Dementia 2020: Implementation Plan. London: Department of Health; 2015. Available at www.gov.uk/government/publications/prime-ministers-challenge-on-dementia-2020.Google Scholar
National Audit Office. Improving dementia services in England: An interim report. Stationery Office, London; 2010. Available at www.nao.org.uk/wp-content/uploads/2010/01/091082.pdf.Google Scholar
Department of Health. Dementia commissioning pack [online], 2011. Available at http://dementia.dh.gov.uk/dementia-commissioning-pack-launched/.Google Scholar
House of Lords Select Committee on Public Service and Demographic Change. Ready for ageing report. Stationery Office, London; 2013. Available at https://publications.parliament.uk/pa/ld201213/ldselect/ldpublic/140/140.pdf.Google Scholar
National Health Service. Five-year forward view. London; 2014. available at www.england.nhs.uk/five-year-forward-view/.Google Scholar
Dementia Action Alliance. Dementia statements: National dementia declaration. London; 2016. Available at www.dementiaaction.org.uk/nationaldementiadeclaration.Google Scholar
Menne, HL, Whitlatch, CJ. Decision-making involvement of individuals with dementia. Gerontologist 2007; 47(6):810–19.CrossRefGoogle ScholarPubMed
Gräßel, E, Adabbo, R. Perceived burden of informal caregivers of a chronically ill older family member. GeroPsych 2011; 24(3):143–54.CrossRefGoogle Scholar
Parker, J, Penhale, B, Forgotten People: Positive Approaches to Dementia Care. Farnham, UK: Ashgate Publishers; 1998.Google Scholar
Parker, J. Crisis intervention: A practice model for people who have dementia and their carers. Practice 2007; 19(2):115–26.Google Scholar
Toot, S, Hoe, J, Ledgerd, R, et al. Causes of crises and appropriate interventions: The views of people with dementia, carers and healthcare professionals. Aging & Mental Health 2013; 17(3):328–35.CrossRefGoogle ScholarPubMed
Johnson, DK, Niedens, M, Wilson, JR, et al. Treatment outcomes of a crisis intervention program for dementia with severe psychiatric complications: The Kansas Bridge Project. Gerontologist 2013; 53(1):102–12.Google Scholar
Sörensen, S, Duberstein, P, Gill, D, Pinquart, M. Dementia care: Mental health effects, intervention strategies, and clinical implications. Lancet Neurology 2006; 5(11):961–73.CrossRefGoogle ScholarPubMed
George, K. Psychiatric admission in dementia care: Cultural and social factors may determine outcome. Asian Journal of Psychiatry 2010; 3(2):73–5.CrossRefGoogle ScholarPubMed
Eska, K, Graessel, E, Donath, C, et al. Predictors of institutionalization of dementia patients in mild and moderate stages: A 4-year prospective analysis. Dementia and Geriatric Cognitive Disorders Extra 2013; 3(1):426–45.CrossRefGoogle ScholarPubMed
Toot, S, Devine, M, Orrell, M. The effectiveness of crisis resolution/home treatment teams for older people with mental health problems: A systematic review and scoping exercise. International Journal of Geriatric Psychiatry 2011; 26(12):1221–30.CrossRefGoogle ScholarPubMed
Vroomen, JM, Bosmans, JE, van Hout, HP, de Rooij, SE. Reviewing the definition of crisis in dementia care. BMC Geriatrics 2013; 13(1):112.Google Scholar
Mukaetova-Ladinska, EB, McKeith, IG. Delirium and dementia. Medicine 2004; 32(8):44–7.Google Scholar
Philp, I, McKee, KJ, Armstrong, GK, et al. Institutionalization risk amongst people with dementia supported by family carers in a Scottish city. Aging & Mental Health 1997; 1(4):339–45.CrossRefGoogle Scholar
Pinquart, M, Sörensen, S. Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging 2003; 18(2):250–67.CrossRefGoogle ScholarPubMed
Pimouguet, C, Lavaud, T, Dartigues, JF, Helmer, C. Dementia case management effectiveness on health care costs and resource utilization: A systematic review of randomized controlled trials. Journal of Nutrition, Health & Aging 2010; 14(8):669–76.CrossRefGoogle ScholarPubMed
Wolfs, CA, Kessels, A, Severens, JL, et al. Predictive factors for the objective burden of informal care in people with dementia: A systematic review. Alzheimer Disease & Associated Disorders 2012; 26(3):197204.CrossRefGoogle ScholarPubMed
Grau, H, Graessel, E, Berth, H. The subjective burden of informal caregivers of persons with dementia: Extended validation of the German language version of the Burden Scale for Family Caregivers (BSFC). Aging & Mental Health 2015; 19(2):159–68.CrossRefGoogle ScholarPubMed
Sutcliffe, CL, Giebel, CM, Jolley, D, Challis, DJ. Experience of burden in carers of people with dementia on the margins of long‐term care. International Journal of Geriatric Psychiatry 2016; 31(2):101–8.Google Scholar
National Collaborating Centre for Mental Health. Dementia: Supporting people with dementia and their carers in health and social care (Clinical Guideline 42). National Institute for Health and Clinical Excellence, London; 2006. Available at www.nice.org.uk/guidance/cg42.Google Scholar
National Institute for Health and Clinical Excellence. Dementia: Assessment, management and support for people living with dementia and their carers (NICE Guideline NG97). National Institute for Health and Clinical Excellence, London; 2018. Available at www.nice.org.uk/guidance/ng97.Google Scholar
George, J, Long, S, Vincent, C. How can we keep patients with dementia safe in our acute hospitals? A review of challenges and solutions. Journal of the Royal Society of Medicine 2013; 106(9):355–61.Google Scholar
Yaffe, K, Fox, P, Newcomer, R, et al. Patient and caregiver characteristics and nursing home placement in patients with dementia. Journal of the American Medical Association 2002; 287(16):2090–7.Google Scholar
Banerjee, S, Wittenberg, R. Clinical and cost effectiveness of services for early diagnosis and intervention in dementia. International Journal of Geriatric Psychiatry 2009; 24(7):748–54.CrossRefGoogle ScholarPubMed
Roberts, AR, ed. Crisis Intervention Handbook: Assessment, Treatment, and Research. Oxford, UK: Oxford University Press; 2005.Google Scholar
Tam‐Tham, H, Cepoiu‐Martin, M, Ronksley, PE, et al. Dementia case management and risk of long‐term care placement: A systematic review and meta‐analysis. International Journal of Geriatric Psychiatry 2013; 28(9):889902.Google Scholar
Reilly, S, Miranda‐Castillo, C, Malouf, R, et al. Case management approaches to home support for people with dementia. Cochrane Database of Systematic Reviews 2015; 1(1):1150.Google ScholarPubMed
Clarkson, P, Hughes, J, Roe, B, et al. Systematic review – Effective home support in dementia care, components and impacts, stage 2: Effectiveness of home support interventions. Journal of Advanced Nursing 2018; 74(3):507–27.CrossRefGoogle ScholarPubMed
Koch, T, Iliffe, S, Manthorpe, J, et al. The potential of case management for people with dementia: A commentary. International Journal of Geriatric Psychiatry 2012; 27(12):1305–14.Google Scholar
Jansen, AP, van Hout, HP, Nijpels, G, et al. Effectiveness of case management among older adults with early symptoms of dementia and their primary informal caregivers: A randomized clinical trial. International Journal of Nursing Studies 2011; 48(8):933–43.Google Scholar
Backhouse, A, Richards, DA, McCabe, R, et al. Stakeholders perspectives on the key components of community-based interventions coordinating care in dementia: A qualitative systematic review. BMC Health Services Research 2017; 17(1):1–11.Google Scholar
Miller, R, Newcomer, R, Fox, P. Effects of the Medicare Alzheimer’s Disease Demonstration on nursing home entry. Health Services Research 1999; 34(3):691714.Google Scholar
Vickrey, BG, Mittman, BS, Connor, KI, et al. The effect of a disease management intervention on quality and outcomes of dementia care: A randomized, controlled trial. Annals of Internal Medicine 2006; 145(10):713–26.Google Scholar
Chien, WT, Lee, YM. A disease management program for families of persons in Hong Kong with dementia. Psychiatric Services 2008; 59(4):433–6.Google Scholar
Eloniemi‐Sulkava, U, Notkola, IL, Hentinen, M, et al. Effects of supporting community‐living demented patients and their caregivers: A randomized trial. Journal of the American Geriatrics Society 2001; 49(10):1282–7.Google Scholar
Gaugler, JE, Kane, RL, Kane, RA, Newcomer, R. Early community-based service utilization and its effects on institutionalization in dementia caregiving. Gerontologist 2005; 45(2):177–85.CrossRefGoogle ScholarPubMed
Chu, P, Edwards, J, Levin, R, Thomson, J. The use of clinical case management for early stage Alzheimer’ patients and their families. American Journal of Alzheimer’s Disease & Other Dementias 2000; 15(5):284–90.Google Scholar
Challis, D, von Abendorff, R, Brown, P, et al. Care management, dementia care and specialist mental health services: An evaluation. International Journal of Geriatric Psychiatry 2002; 17(4):315–25.Google Scholar
Department of Health, Care Services Improvement Partnership. Everybody’s business – Integrated mental health services for older adults: A service development guide. London; 2005. Available at www.scie-socialcareonline.org.uk/everybodys-business-integrated-mental-health-services-for-older-adults-a-service-development-guide/r/a11G00000017vMyIAI.Google Scholar
Royal College of Psychiatrists. Raising the standard – Specialist services for older people with mental illness: Report of the faculty of old age psychiatry. Royal College of Psychiatrists, London; 2006.Google Scholar
Draper, B, Low, LF. What is the effectiveness of acute hospital treatment of older people with mental disorders? International Psychogeriatrics 2005; 17(4):539–55.CrossRefGoogle ScholarPubMed
Orrell, M, Hoe, J, Charlesworth, G, et al. Support at Home – Interventions to Enhance Life in Dementia (SHIELD): Evidence, development and evaluation of complex interventions. Programme Grants for Applied Research 2017; 5(5):184.Google Scholar
Toot, S, Devine, M, Akporobaro, A, Orrell, M. Causes of hospital admission for people with dementia: A systematic review and meta-analysis. Journal of the American Medical Directors Association 2013; 14(7):463–70.Google Scholar
Ledgerd, R, Hoe, J, Hoare, Z, et al. Identifying the causes, prevention and management of crises in dementia: An online survey of stakeholders. International Journal of Geriatric Psychiatry 2016; 31(6):638–47.Google Scholar
Fink, A, Kosecoff, J, Chassin, M, Brook, RH. Consensus methods: Characteristics and guidelines for use. American Journal of Public Health 1984; 74(9):979–83.Google Scholar
Murphy, MK, Black, NA, Lamping, DL, et al. Consensus development methods, and their use in clinical guideline development. Health Technology Assessment (Winchester, England) 1998; 2(3):i88.Google Scholar
Ven, AH, Delbecq, AL. The effectiveness of nominal, Delphi, and interacting group decision making processes. Academy of Management Journal 1974; 17(4):605–21.Google Scholar
Jones, J, Hunter, D. Qualitative research: Consensus methods for medical and health services research. British Medical Journal 1995; 311(7001):376–80.CrossRefGoogle Scholar
Hoffmann, TC, Glasziou, PP, Boutron, I, et al. Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide. British Medical Journal 2014; 348(g1687):1–12.Google Scholar
Dalkey, N, Helmer, O. An experiential study of group opinion prepared for United States Air Force Project Rand. Santa Monica; 1963.Google Scholar
Reynolds, T, Thornicroft, G, Abas, M, et al. Camberwell Assessment of Need for the Elderly (CANE): Development, validity and reliability. British Journal of Psychiatry 2000; 176(5):444–52.Google Scholar
Slade, M, Powell, R, Rosen, A, Strathdee, G. Threshold Assessment Grid (TAG): The development of a valid and brief scale to assess the severity of mental illness. Social Psychiatry & Psychiatric Epidemiology 2000; 35(2):7885.Google Scholar
Perry, S, Kalberer, Jr JT. The NIH consensus-development program and the assessment of health-care technologies: The first two years. New England Journal of Medicine 1980; 303(3):169–72.Google Scholar
Parker, J, Bradley, G. Transforming Social Work Practice in Assessment, Planning Intervention and Review. Exeter, UK: Learning Matters; 2003.Google Scholar
Knox, K, Roberts, A. The crisis intervention model. In Coady, N, Lehmann, P (eds.), Theoretical Perspectives for Direct Social Work Practice: A Generalist-Eclectic Approach, 3rd ed. New York: Springer; 2007:183202.Google Scholar
Imison, C, Castle-Clarke, S, Watson, R, Edwards, N. Delivering the Benefits of Digital Health Care. London: Nuffield Trust; 2016. Available at www.atmedics.com/wp-content/uploads/2016/02/nuffield-trust-delivering-the-benefits-of-digital-care-17–02-2016.pdf.Google Scholar
Michon, A. Crisis intervention in dementia. Psychologie & NeuroPsychiatrie du vieillissement 2006; 4(2):121–5.Google Scholar
Stanyon, M, Streater, A, Coleston-Shields, D, et al. Protocol for the development of an evidence-based ‘best practice model’ for teams managing crisis in dementia. Journal of Medical Internet Research Research Protocols; 2019. Available at https://preprints.jmir.org/preprint/14781.Google Scholar

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