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Improving the quality of care for mild to moderate dementia: an evaluation of the Croydon memory service model

Improving the quality of care for mild to moderate dementia: an evaluation of the Croydon memory service model
Improving the quality of care for mild to moderate dementia: an evaluation of the Croydon memory service model
Background: The large majority of people with dementia receive nothing in the way of specialist assessment and care at any stage of their illness. There is a particular lack of services focussed on early identification and intervention in dementia where there is the possibility of long-term harm reduction for people with dementia and their family carers. We have developed a model of care that is complementary to local systems of health and social care (The Croydon Memory Service Model [CMSM]). This is a low-cost, high-throughput, generic service to enable early identification and intervention in dementia. It is a multi-agency approach with joint ownership by health services, social services and the voluntary sector with embedded specifically-tailored approaches to primary care and minority ethnic communities.

Method: We completed a service evaluation of the introduction of the CMSM in a single borough in South London. Six predefined service goals were set: high acceptability; high appropriate referral rate; successful engagement with people from minority ethnic groups; successful engagement with people with young onset dementia; focus on engagement with mild cases to enable early intervention; and an increase in the overall number of new cases of dementia seen. Mixed qualitative and quantitative methodologies were used including a description and 6-month follow-up of a cohort of 290 consecutive referrals.

Results: All key predefined service goals were met: 95% acceptability; 94% appropriate referrals; successful engagement with minority ethnic groups (two-fold greater number compared with that expected from general population demographic data); 17% of referrals under 65 years of age; 68% referrals with mild or minimal dementia severity; and an estimated 63% increase in the number of new cases of dementia seen in Croydon. At 6-month follow up, those referred to the service had decreased behavioural disturbance and increased quality of life compared with baseline.

Conclusions: Specific services for early dementia, which deliver diagnosis and care, can be established. These services can increase the numbers of people with early dementia identified and provided with care. Those receiving such services appear to improve in terms of quality of life and behavioural and psychological symptoms of dementia. Next steps should include the establishment of such services in other representative areas and evaluation of their effectiveness in comparison with other models of care.
dementia, alzheimer's disease, early intervention, quality of life, quality improvement, service evaluation, health services research
782-788
Banerjee, Sube
c89df0e0-46cf-482b-ac93-6c39333c93b5
Willis, Rosalind
dd2e5e10-58bf-44ca-9c04-f355f3af26ba
Matthews, David
f8699e10-6109-4fae-945c-0b76ef43fd3c
Contell, Faith
a681d3eb-5dee-45a0-ba2f-921fa64a32c4
Chan, Jeni
698d9db4-6a05-4951-93e4-15f4d9d9e904
Murray, Joanna
e4c89a6e-d81c-4378-8786-0e82eeed6b58
Banerjee, Sube
c89df0e0-46cf-482b-ac93-6c39333c93b5
Willis, Rosalind
dd2e5e10-58bf-44ca-9c04-f355f3af26ba
Matthews, David
f8699e10-6109-4fae-945c-0b76ef43fd3c
Contell, Faith
a681d3eb-5dee-45a0-ba2f-921fa64a32c4
Chan, Jeni
698d9db4-6a05-4951-93e4-15f4d9d9e904
Murray, Joanna
e4c89a6e-d81c-4378-8786-0e82eeed6b58

Banerjee, Sube, Willis, Rosalind, Matthews, David, Contell, Faith, Chan, Jeni and Murray, Joanna (2007) Improving the quality of care for mild to moderate dementia: an evaluation of the Croydon memory service model. International Journal of Geriatric Psychiatry, 22 (8), 782-788. (doi:10.1002/gps.1741). (PMID:17243196)

Record type: Article

Abstract

Background: The large majority of people with dementia receive nothing in the way of specialist assessment and care at any stage of their illness. There is a particular lack of services focussed on early identification and intervention in dementia where there is the possibility of long-term harm reduction for people with dementia and their family carers. We have developed a model of care that is complementary to local systems of health and social care (The Croydon Memory Service Model [CMSM]). This is a low-cost, high-throughput, generic service to enable early identification and intervention in dementia. It is a multi-agency approach with joint ownership by health services, social services and the voluntary sector with embedded specifically-tailored approaches to primary care and minority ethnic communities.

Method: We completed a service evaluation of the introduction of the CMSM in a single borough in South London. Six predefined service goals were set: high acceptability; high appropriate referral rate; successful engagement with people from minority ethnic groups; successful engagement with people with young onset dementia; focus on engagement with mild cases to enable early intervention; and an increase in the overall number of new cases of dementia seen. Mixed qualitative and quantitative methodologies were used including a description and 6-month follow-up of a cohort of 290 consecutive referrals.

Results: All key predefined service goals were met: 95% acceptability; 94% appropriate referrals; successful engagement with minority ethnic groups (two-fold greater number compared with that expected from general population demographic data); 17% of referrals under 65 years of age; 68% referrals with mild or minimal dementia severity; and an estimated 63% increase in the number of new cases of dementia seen in Croydon. At 6-month follow up, those referred to the service had decreased behavioural disturbance and increased quality of life compared with baseline.

Conclusions: Specific services for early dementia, which deliver diagnosis and care, can be established. These services can increase the numbers of people with early dementia identified and provided with care. Those receiving such services appear to improve in terms of quality of life and behavioural and psychological symptoms of dementia. Next steps should include the establishment of such services in other representative areas and evaluation of their effectiveness in comparison with other models of care.

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More information

Published date: 2007
Keywords: dementia, alzheimer's disease, early intervention, quality of life, quality improvement, service evaluation, health services research

Identifiers

Local EPrints ID: 178179
URI: http://eprints.soton.ac.uk/id/eprint/178179
PURE UUID: beb8a891-8104-402f-9c42-324ae3a2669c
ORCID for Rosalind Willis: ORCID iD orcid.org/0000-0001-6687-5799

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Date deposited: 08 Apr 2011 13:21
Last modified: 14 Mar 2024 02:56

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Contributors

Author: Sube Banerjee
Author: Rosalind Willis ORCID iD
Author: David Matthews
Author: Faith Contell
Author: Jeni Chan
Author: Joanna Murray

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