Nurses need more in-depth training on dementia in order to deliver the aspirations set out in an updated government strategy for dementia nursing, according to an expert charity.
The Making a Difference in Dementia strategy, published by the Department of Health, sets out a vision for the care delivered by all nurses to people with dementia and their families in different settings and at different phases of the condition.
“We need more resources to make sure people can access the next level of education”
While dementia nursing experts have applauded the vision and its aims, they warned that the strategy was short on detail on “how to ensure it actually happens”.
The document replaces the 2013 dementia nursing strategy, the first to be published, and follows the launch last year of the government’s 2020 Dementia Challenge, which set the goal of making England “the best country in the world for dementia care and support”.
Rachel Thompson, Admiral nurse professional lead at Dementia UK, welcomed the holistic approach outlined in the new strategy, including a stronger emphasis on working “in partnership” with patients and their loved ones.
She also welcomed its focus on an “interpersonal and psycho-social” model of care, such as understanding a person’s life story, cultural background and interests, building relationships with the person and their family and helping them access alternative sources of support.
“There has been a shift in focus to thinking about how nurses support people across the pathway and that now includes the health prevention side of things, which is a positive move,” she said.
“It also recognises the need to acknowledge co-morbid conditions – that wasn’t in there before – and the role of nurses in co-ordinating care,” she added.
“If you have people with expertise to give support you are much more likely to see a change”
However, Ms Thompson, who was involved in drawing up the 2013 strategy, said there was a gap in the revised version when it came to people with atypical symptoms who may not present with memory loss. But the biggest question mark was around implementation, she said.
“It is a positive vision, but there is not much in there to help us understand how we’re going to ensure nurses have the right knowledge and skill and capacity in the system to support them to deliver this,” she said.
While there has been a “massive improvement” in dementia awareness among nurses, she said there was a need for more high-level training backed up with practical support from specialist dementia nurses.
At the moment there were huge variations in the training available to nurses, she added.
“You could work in one hospital and be given something called a dementia awareness session delivered by someone they’ve got in who knows a little bit about dementia and it might be an hour-long session whereas dementia awareness in another hospital might be a whole day of training,” she said.
“There is a difference between awareness and having the skills and ability to deliver the care they are asking for in this vision,” she said. “We need more resources to make sure people can access the next level of education.”
A Dementia Skills, Training and Education Framework was launched a year ago with three different levels or “tiers” of training.
Nursing dementia strategy ‘light on implementation detail’
The goal is for all NHS staff – including registered nurses and healthcare assistants – to have had basic Tier 1 dementia awareness training by the end of 2018.
“There has been a lot of emphasis on Tier 1 but what we would like to see is more emphasis on good quality education at Tier 2 and Tier 3 and the availability of specialist nurses to support other people in practice,” said Ms Thompson.
“Education and training doesn’t necessarily change the way people deliver care – we know that if you have people with expertise to give support you are much more likely to see a change,” she said.
The strategy states that all nurses have “a critical leadership role in supporting and promoting dementia-friendly communities” whether in primary, community, acute or learning disability services.
However, Ms Thompson said it was hard for every nurse to be a leader and it was important to have specialist nursing roles “to offer leadership and direction”.