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Staff caring for dementia patients must be trained in understanding their identity, NICE says

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Staff caring for people with dementia should be trained in understanding a person’s identity as an individual, and their life story, according to the first major update of the National Institute for Health and Care Excellence’s dementia guidance.

The document – Dementia: Assessment, Management and Support for People Living with Dementia and their Carers – is the first comprehensive update of NICE guidance published in November 2006.

It states that every patient diagnosed with dementia should have a care plan that is reviewed annually.

The recommendations focus on person-centred support, putting particular emphasis on involving people with dementia in every decision about the care they receive.

Care providers should train staff in understanding the signs and symptoms of dementia and what behavioural changes to expect at different stages, the guideline states.

Staff should also be trained in understanding the person’s individual identity, sexuality and culture, and that of their family members and carers, it says.

Providers should also give face-to-face training to staff on subjects including how to react to people with dementia who are agitated or aggressive.

The guidance says that carers should be offered training about dementia and its symptoms as well as how to adapt their communication to a person living with dementia.

There was still a lot of work to do on making care plans the norm, said Professor Gillian Leng, deputy chief executive at NICE. While everyone with dementia should have one, she noted that Age UK reported earlier this year that one in three people with the condition do not have a care plan.

And data from more than 7,000 GP practices in England has shown that, out of 450,000 people diagnosed with dementia in November 2017, under 300,000 had a care review in the preceding year.

“As dementia is a progressive condition, regular review is essential to ensure care needs continue to be met,” she said.

The updated guidance was a “step in the right direction” said Dr Karen Harrison-Dening, Head of Research and Publications at Dementia UK.

‘The current social and healthcare landscape can be challenging for people with dementia and their families to navigate. They should be seen as individuals with specific rights, needs and wishes rather than someone who is living or diagnosed with dementia.”

She said that NICE’s updated guideline complemented the post diagnostic support that Dementia UK provides through its Admiral Nurses.

Alzheimer’s Society welcomed the updated guidance but warned that more needed to be done. “What we need now is support to implement these recommendations,” said Sally Copley, Director of Policy, Campaigns and Partnerships at Alzheimer’s Society. “Take training as example - a third of homecare workers currently have no dementia training, resulting in inadequate care for many people with dementia. The guideline alone can’t change this, we’ll need to see significant investment to improve care quality when the Government announces its plans for social care reform in the autumn.” 

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