In 2011 a baseline audit was conducted to better understand and improve the care experienced by patients with a diagnosis of Dementia. From the audit it was found that a large percentage of those patients were living in care homes. It was also apparent that in many cases the hospice had not contacted the next of kin, either as part of the initial assessment process or on-going support. This was identified as something that should be changed as the lack of contact meant that there was a high probability that the needs and concerns of the next of kin were not being addressed.

A further audit was carried out in 2013. The objectives of the audit were:

• To explore the current referral patterns

• To identify which service was used

• To establish the extent to which preferred place of death (PPD) was achieved

• To determine if the team had improved the contact with next of kin

The methodology used was a retrospective audit of patient notes and I-Care documentation.

The second audit clearly demonstrated that the community team had significantly increased the number of contact with relatives of patients who had a diagnosis of Dementia. The second audit also demonstrated that there were other positive changes, notably:

• Improved PPD outcomes

• Improved support to relatives during care

• Improved bereavement support

• Greater voice for and recognition of the wishes of relatives

A further outcome was that it was demonstrated that the majority of patients (and their families and carers) had support delivered via the telephone advice line service, rather than through home visits, although these were carried when necessary.