Led by the Yorkshire and Humber Strategic Clinical Network (SCN) the Code4Health Dementia Community are very keen to develop a diagnosis protocol for advanced dementia in the form of an app to support health care professionals in care home settings. The team have undertaken ‘App in a Day’ training and have produced a prototype app based on the DIADEM tool using LiveCode.
Detection and diagnosis of people with dementia living in care homes
It is estimated that around 80 % of care home residents have dementia but that less than two-thirds of these people have a confirmed diagnosis. (Alzheimer’s society, Low expectations – attitudes on choice, care and community for people with dementia in care homes, April 2013, www.alzheimers.org.uk/lowexpectations)
For residents living with undiagnosed dementia, receiving a diagnosis will enable access to appropriate support, care planning and in some cases, treatment. A diagnosis prompts staff to consider Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) issues. It also enables the resident, staff and family carers to consider advance wishes for End of Life Care, and having advance knowledge of what the person wants helps staff to deal with crisis situations and hospital admissions in a calm and considered way. Once a diagnosis is made, care home staff are more likely to consider 'Prevention of Delirium Care Plans' and seek support from Care Home Liaison Services for support to understand and address behaviours that challenge.
Despite all these benefits, some care home residents with advanced dementia and/or frailty, may currently be denied a diagnosis due to difficulty attending a memory service clinic. This protocol will give GPs a ‘mandate’ to diagnose those with advanced dementia (DiADeM) living in a care home setting.
We want to be able to expand upon the initial prototype by attending OpenEHR training to produce an architype for Dementia care that can be reviewed and approved by our peers and would welcome comments via our Code4Health forum.
We are keen to work with anyone interested in using this approach for other areas of dementia care, and other programme areas within the Strategic Clinical Network, such as neurological conditions. Sign up for our community above and join the discussions taking place on our forum.
As a Strategic Clinical Network we work with clinical commissioning groups, local authority commissioners and service providers across the Yorkshire and Humber region to improve the quality of care and services for people living with dementia and their carers. We are keen to work collaboratively with other stakeholders and ensure that our approach can be shared via the SCN and AHSN National networks. Further information and a list of the Yorkshire and Humber Dementia SCN work priorities can be found on our website.
Jan 18, 2017
In 2016 we made great progress with the development of the DiADeM App including the first round of testing on a variety of devices using 'test patient scenarios'. Feedback from the testing was excellent and very constructive and we have been able to incorporate most of the suggestions made by our testers.
Feedback included the need to add in extra identification fields and the App now records patients name, date of birth and name of care home where they reside as a 3 way identification model.
The launch of DiADeM is planned for the end of March 2017 so we are now working towards realising that date. Development work on the 2 servers, Operon (Open EHR) and Azure is well underway and as soon as we have them up and running we plan to do a final testing prior to launch and roll out of the finished App.
The final testing will involve GP's and Practices and if there are any community members who would like to get involved or can recomend any GP's and their practices please contact firstname.lastname@example.org
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Community Lead: Colin Sloane