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The time at which a medical or social crisis occurs for a person with advanced dementia and/or their carer(s) is a pivotal point when, if appropriate services were available, the person with dementia could remain in their familiar place of care until the time of their death.
With timely support in the community, it would be possible to prevent some crises occurring, or in the event of the crisis happening, provide an intervention that would reduce the need for a hospital admission. Our findings indicate that episodes of hospital care negatively affect the health and the quality of life for people with dementia, and that frequently the reason for admission could have been appropriately treated in the community. Evidence is emerging from other cities that where rapid response community teams have been introduced it has led to a substantial reduction in end of life hospital admissions – as these services offer a co-ordinated and proactive, rather than reactive, service model.
Whilst many of the findings reinforce those of the recent National Dementia Strategy and End of Life Care strategy, it also suggests that small changes to local health and social care services could significantly improve end of life care for people with advanced dementia who live in Haringey, as well as provide potential cost efficiencies, and greater value for money. This is particularly important in the context of public sector spending assumptions in the short to medium term.
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