Tag Archives: Karim Saad

VIDEO ► Trendsetting Young Dementia Ambassadors

Posted on by karims3d

A Family model for effective intergenerational exchange.

When was the last time someone made a public speech that knocked you off guard and left you with a lump in your throat?

On the 14th of May 2014 I was privileged to attend, as a guest and speaker, the Association for Dementia Studies‘ (ADS) 5th anniversary celebration.

It would be fair to conclude that a highlight for all was a speech made, not by one person, but a family of three!

June Hennell, in memory of her late husband Brian who lived with dementia, announced her generous sponsorship of the Hennell Award for Innovation and Excellence in Dementia Care.

However, when June took to the stage she did so with her two grandchildren.

You could hear a coin drop.

Their eloquent and heartfelt speech was followed by a standing ovation.

Here is a brief extract:

Young people are more likely to want to learn about dementia and shout out for the cause.

The West Midlands has been the birth place for developing dementia intergenerational exchange in England, now part of the Prime Minister’s Challenge on Dementia.

Thanks to an impressive partnership, we now witness a social movement in exponential growth, catching on in hundreds of schools, touching the imagination of thousands of pupils, teachers, people with dementia, carers and citizens across England.

The impact to date has been measurable, positive and truly inspirational.

Young people are proving adept at grasping dementia. They get that it is not a normal part of ageing, and can see how it is possible to live well with it.

They are not fazed by the stigma and yet they can mobilise communities into achieving positive outcomes.

England’s schools, educators, local communities, health and social care planners amongst others must do more to embrace, support and promote our trendsetting young dementia ambassadors.

Sustaining the steady flow of graduating dementia friendly generations must occupy central place in all current and future English dementia strategies.

The Hennell award, set to become an annual event, celebrates the ability to implement positive change for people living with dementia.

For more on the Hennell award and the extraordinary family behind it, including the nomination process, please contact the ADS.

Meanwhile, hats off to the Hennells, and happy birthday to the ADS!

@KarimS3D

Sedating dementia ► a global alert, shocking disparities and a blueprint for action!

Posted on by karims3d

Towards transforming quality and safety in dementia care.

 

What’s the global problem here?

A WHO report (2012) affirms that drugs given for the management of behavioural and psychological symptoms in dementia are being overprescribed globally. Although first-line treatment for behaviour that challenges is non-pharmacological, the prescription of psychotropics remains high and it appears that current systems deliver a largely antipsychotic-based response. Prevalence rates of antipsychotics prescribing range from 20% to 33% and most cases are residing in care homes.

What harms can antipsychotics do to people with dementia?

1,000 people with dementia on an antipsychotic x 12 weeks = 10 extra deaths + 18 extra cerebrovascular events + 58–94 gait disturbances!

Does Europe overprescribe too?

The Alzheimer Cooperative Valuation in Europe (ALCOVE), described in a previous blog, confirms that people living with dementia in Europe are overexposed to antipsychotics.
Whilst the prevalence in over 65s was 10.6% in the general population, and 22% in memory assessment units, prescribing was highest in care homes at 35.6% (25.8 % in Norway and 60% in Italy).
It goes further; overuse of antidepressants, prolonged use of antipsychotics, concomitant use (two antipsychotics or with other psychotropics e.g. hypnotics), or absence of use as second-line after a non-pharmacological approach are also reported. 

These variations are as alarming as they are unacceptable!

Do we have affordable solutions?

There aren’t that many health economic studies. In one cohort of 133,713 individuals with dementia requiring antipsychotic drugs in England, in fact it was estimated that behavioural interventions cost £27.6 million more per year than antipsychotic drugs. 

However, the additional investment was offset by nearly £70.4 million in healthcare savings due to reduced incidence of strokes and falls, and quality of life improvements to the tune of £12.0 million in benefits per annum. Non-pharmacological interventions therefore represented an efficient use of public resources.

Can the ALCOVE toolbox help?  

For an overview find out in this video (French subtitles) 

 

What’s in the box?  ☞

(1)  risk exposure measures in Europe

(2) models of tried and tested risk reduction programmes

  • England’s The Right Prescription; Call to Action, (reduced Antipsychotic prescriptions for people with dementia by 52% in three years) and
  • France’s National Authority for Health  programme (reduced the rate of Antipsychotics exposure in people with Alzheimer’s disease from 16.9% to 15.5% over 3 years). In fact the French ‘mastering indicator’ is used as a proxy Quality of Life indicator, as a measure of national implementation progress and as a quality indicator for care homes. 

(3) links to timely diagnosis

(4) ethical principles underpinning prescribing, and

(5) national programmes to prevent and manage behavioural and psychological symptoms in dementia.

Shaking the tree!

Behaviours that challenge in dementia are almost always a product of complex interactions between care structures and organisations, individual factors, and workforce skills.

ALCOVE contains an up-to-date evidence base for interventions that work and proposes a 3 D model for reference in all settings.

Here then is an opportunity to begin (or continue) conversations to limit the use of antipsychotics and other psychotropics for people with dementia.

This goes deeper! In fact this is a blueprint to help unravel, develop and deliver alternatives to chemical restraints. A seismic culture shift. A transformation in care standards. An end to letting down vulnerable people!

What we have here is a potent yet underused proxy for quality and safety in dementia care globally.

Whether you are a concerned member of the public, a person living with dementia, or clinician, I hope this toolbox might assist you to weave your own priorities, perspectives and partnerships into implementing what’s right for your local community.

Let’s shake this tree and see what happens?

@KarimS3D