Response to Wider planning for an ageing population: housing and communities

Consultation body

Scottish Government/COSLA/NHS

Response date

September 2010

Focus of consultation

Workstream Report and its Suggested Actions

Dementia

Around two thirds of people with dementia will live in their own home, often with a family member as their main carer. People with dementia also form the majority of care home residents, who should also be viewed as part of the community.

Dementia is the progressive loss of the powers of the brain, which gradually impairs every aspect of mental and physical functioning.

As age is the key risk factor, a person with dementia may also have a co-morbid health condition which impacts on their physical or mental health functioning. As the majority of care is provided by informal supports, such as family members and friends, there is a significant advantage in taking a personalised approach to in order to make best use of these natural supports.

Outcome 1: Clear strategic leadership

The needs of people with dementia and their carers extend across housing, health and social care; there is a need to bridge the gap that exists between these areas. Benefits can be derived for the individual and the state from taking a joint early intervention approach to enable people with dementia to maintain their normal day to day activities for as long as possible.

This requires the continued strategic direction from the Joint Improvement Team and the coming together of relevant Scottish Government policies including the dementia strategy, self-directed support strategy, reshaping care for older people, long term conditions strategy, and the carer strategy. This will be crucial in continuing a shift in the balance of care, towards a greater focus on outcomes for individuals, empowered citizenship and maximising natural community support and resources.

Outcome 2: Assistance to remain at home

The housing and support needs of people with dementia and their carers will differ between individuals; they will also change and intensify as the illness progresses. What may be useful for one person at a particular stage of the illness may be inappropriate for another.

There are different types of equipment, aids and adaptations that may help people with dementia reduce risks, enhance functionality and remain at home for longer. These include assistive technology, memory aids, safety devices, equipment for personal care and nursing equipment. Early intervention is important; equipment that involves learning should be introduced at an early stage of the illness, as the person may find it difficult to adjust to new ways of doing things as the illness progresses.

People with dementia at the later stages of the illness are likely to have a very sedentary lifestyle; sitting or lying in specialist beds and chairs are an essential part of the health care treatment regardless of whether people are living at home, in a care home or hospital setting.

Outcome 4: Low level and preventative support

Housing support, social networks and community capacity building are essential tools in supporting people with dementia and their carers within the community. Dementia is a degenerative condition with needs increasing over time; there is a need to change to a system that supports people with dementia in a planned preventative way.

Post diagnostic support is essential to providing a low level preventative approach. It offers the opportunity to tap into people’s existing social networks and community links. As the illness progresses people with dementia and their carers become increasingly detached from the fabric that held their life together and the opportunity is lost to build on their natural supports.

Outcome 5: Improve infrastructure to improve outcomes

We support the need to review existing research evidence on the housing needs of people with dementia; as noted in the National Dementia Strategy, there is a need to increase the understanding of the needs of people with dementia and their carers.

Good practice examples: Croftspar Place, Glasgow

Eight specifically designed single storey self-contained flats provide housing support and care for older people with dementia in Springboig, Glasgow. Commissioned by Glasgow City Council Social Work Department and managed by Cube Housing Association; Alzheimer Scotland provides personalised housing support, personal care and social support through a dedicated team from an onsite staff base.

The overall aim of the development is to extend the range and choice of options available to older people with dementia who require support and care on a 24 hour basis. This means that people who require assistance at unusual times of the day and especially at night can be supported in a tenanted property.

This service enables individuals to live in tenancies in the community for as long as possible, so avoiding early admission to care homes.

September 2010

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