Background It is recognised that people with dementia have been poorly served by hospices and palliative care services, leading to lack of support, inappropriate hospital admissions and poor quality care at end of life. Previously our hospice supported only 50 people a year with dementia and our staff had little understanding or experience of their specific needs.
Aims The aim of the project was to enable more people with dementia to access quality specialist palliative care in the place of their choosing, improving their care at end of life.
Method With the support of a St James’s Place Foundation grant, we employed one of our Clinical Nurse Specialists 2.5 days a week to focus on advanced dementia. In addition to managing a caseload of patients, she provided expert training, advice and support across the hospice. Facilitating improvements in the way we identified and supported people with dementia and ensuring they received appropriate care within our own and other services. We worked in close collaboration with local community Advanced Dementia Service, cross-referring patients and joint visiting. This enabled patients to have the most timely support and referral into all appropriate palliative care services.
Results Patients with dementia, supported by the hospice increased by over 200%. They were able to access all palliative care services and feedback was excellent. Hospital admissions were prevented and 94% of patients that died did so in their preferred place of death. Over 200 hospice and local community staff received education on dementia.
Conclusion Following the project, people with advanced dementia and their families have had greater access to palliative care services. More people have had support to enable them to stay where they wanted to die. The knowledge, skills and therefore confidence of staff and volunteers has increased, which supports better care. Dementia is firmly on our hospice agenda.
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