Identifying Dementia in Care Homes using DeAR-GP
The Alzheimer’s Society estimates that up to 80% of residents in care homes have dementia or severe memory problems (Alzheimer’s Society, 2013). The disparity between the number of those who are likely to have dementia and those with an actual diagnosis means that many people are not being given the opportunity to make informed choices, receive care informed by a thorough understanding of their care needs or access appropriate treatments, interventions or services.
In 2014/15 The Health Innovation Network Healthy Ageing Programme (previously Dementia Programme) team conducted a feasibility study to ensure appropriate diagnosis in residential and nursing homes in South London by co-designing and testing a dementia case-finding tool ‘DeAR-GP’ (Dementia Assessment Referral to GP) with care workers, to be used by care workers.
The DeAR-GP Tool
The DeAR-GP tool was tested in three care homes in South London. The tool is used by care workers in care homes to identify residents who may be showing signs of dementia.
Care workers are asked to identify signs such as confusion or memory problems which have lasted over 3 months, and if they have concerns to report these to the GP or another clinician by completing the DeAR-GP tool. In testing, a total of 23 case-finding tools were completed by care workers. It was found that 20 of the residents who care workers had concerns about were subsequently diagnosed with dementia or referred to memory services when reviewed by a clinician, or it was found that the care home were unaware of an existing dementia diagnosis beforehand.
Ensuring that residents in care homes have an appropriate diagnosis will lead to a better understanding of the resident by care workers, relatives and friends; provide access to support services such as care home intervention teams; allow more accurate care planning in care homes, and; depending on the type of dementia and stage of dementia, specific interventions may be available.
The feasibility study informed the development of the Dementia assessment and referral to GP DeAR- GP user guide. The user guide provides a step-by-step process of how to implement DeAR-GP in care homes in your local area. Drawing on experience gained in the small-scale pilot, the guide includes a number of step-by-step training and resources.
DeAR-GP is now being actively implemented in many CCGs across the UK and has received support from – amongst others – the National Clinical Director for Dementia, the London Strategic Clinical Network for Dementia and the Alzheimer’s Society.