Update on the NSW Update on the NSW Dementia Services Dementia Services

Framework 2010 – 2015 Framework 2010 – 2015

Anne CummingNSW Dementia Policy Team

Wendy NollerAgeing Disability and Home Care

Collaborations and Innovations Symposium

Overview Overview

Background & policy context

The Framework

Draft Implementation Plan

Principles – “I” statements

Progress so far

Key Projects

Dementia prevalence in NSW by LHD by Year

Policy context Policy context Commonwealth Dementia Planning

- National Action Plan on Dementia Care 1992-97

- The Dementia Initiative – 2005

- Living Longer Living Better - 2012

National Dementia Planning- National Framework for Action on Dementia 2006 - 2010

- Dementia as the 9th National Health Priority - 2012

NSW Dementia Planning- NSW Action Plan on Dementia 1996-2001

- Future Directions 2001-2006

- NSW Dementia Action Plan 2007-2009

- NSW Dementia Services Framework 2010 – 2015

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NSW Dementia Services FrameworkNSW Dementia Services Framework

Launched September 2010 in Dementia Awareness Week

Joint publication NSW Health and ADHC

www.health.nsw.gov.au/policies/gl/2011/pdf/GL2011_004.pdf

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Draft implementation plan Draft implementation plan

5. HOSPITAL CARE

WHY DO WE NEED ACTION? WHAT OUTCOME? HOW WILL WE KNOW?

· Poor outcomes, including increased risk of delirium, falls and behavioural symptoms

· Lack of recognition of dementia and delirium

· Dementia unfriendly design· Inappropriate use of chemical and

physical restraint

· Improved detection, assessment, treatment and person-centred care of people with dementia, delirium and behavioural difficulties in hospital

· Increased acute care in place of residence

· Increased access to dementia expertise· Increased identification, hospital record

coding and treatment of dementia and delirium

· Improved physical environments· Reduced adverse events · Increased access to HITH· Increased satisfaction with care

WHAT ELSE IS NSW DOING? WHAT ARE THE PRIORITIES?

· Increase dementia/delirium CNC/NP positions· Further develop acute behavioural units· Conduct a dementia design project· Conduct dementia HITH trial

· Integrated Services Framework for Specialist Health Care of Older People· Orthogeriatric Model of Care – Agency for Clinical Innovation · Partnering in the Hospital Dementia Services Project

WHAT WILL WE DO? WHO WILL DO IT? WHAT WILL WE REPORT ON?Provide clinical support, education and leadership

Local Health Districts Access to dementia expertise in hospitals

Implement Confused Hospitalised Older Person Study (CHOPS)

Agency for Clinical Innovation, Aged Health Network

Evaluation completed and findings promoted

Improve dementia detection, care and intervention

Local Health Districts Adverse events monitored and reduced

Implement the National Delirium Guidelines and Pathway

Local Health Districts Delirium pathways in place and monitored

Increase dementia access to hospital substitution programs

Local Health Districts Dementia patients access to hospital substitution programs

Expand carer consultation and support strategies

Local Health Districts Carer consultation and support strategies in place

Identify and respond to current design constraints in hospitals

Department of Health Outcomes of project reported, environmental audits conducted

Strengthen evidence and support the development of behavioural units

Department of Health Evidence collected, site appraisals undertaken

Version 1

Summary of changes – version 2 Summary of changes – version 2

Changed format

Additional content

– Principles

– Governance structure added

– Self assessment checklist

– State-wide projects table

LHD reporting reduced

Essential actions listed and sequenced

Importance of parallel initiatives emphasised

Setting the direction for dementia care in NSWSetting the direction for dementia care in NSW

My community contributes to

my quality of life

I was given a timely diagnosis and follow up information and support for me and

my carer

We know a professional whom we can trust, who

knows us well who we can contact when

required to resolve issues and provide

advice

I am supported to maintain my quality

of life, based on what I consider to be important and meaningful to me

I am free from pain and

receive best possible end of

life care

My end of life wishes are

discussed and followed

I am valued, respected and treated with

dignityMy family carer/s

are valued, supported and

consulted. They are recognised as experts and as partners in care

The professionals I interact with have the right skills, knowledge and attitude and are

valued for their expertise in dementia

care

When I need to go to hospital my

cognitive difficulties are recognised and I receive the care and

treatment I need

Proposed essential actions for LHDsProposed essential actions for LHDs

1. Local governance structure

2. Dementia Service Networks

3. Local dementia action plans

4. Dementia initiatives with Medical Locals

5. Referral and care pathways

6. Integrated dementia care models

7. Routine cognitive screening over 70 years in hospitals

8. Collaboration between specialist health and mental health services

Implementation Implementation Who? Who?

Ministry of Health and ADHC

4 Pillars

Local Health Districts and ADHC regions

Local Dementia Networks

Partners and contracted projects

How? How?

National reforms

Parallel initiatives

Investment

Planning

Redesign

Policy

Pilots

http://dementiacare@ncahs.health.nsw.gov.au

A life shared ….A life shared ….

Ageing, Disability and Home Care

Home and Community Care (HACC) Program transition

1 July 2012 – NSW Community Care Supports Program for people aged 65/50

Dementia remains a target group of ADHC’s Community Care Supports Program – under review in 2012/13

Approximately 54,000 (was 280,000) people access community supports each year

Dementia

2011/2012 – ADHC funded 65 new dementia projects across NSW

$3.4 million in growth funding

$1.4 million in non-recurrent funds

Announcement of Younger Onset Dementia Person Centred Packages – 3 year pilot ($1m recurrent)

ADHC Dementia projects under DSF

Younger Onset Packages and evaluation

– Person centred packages

– Guidelines finalised

– Considering funding options

YOD mapping and information / advisory service

– Ella Centre

YOD research

– Completed and about to be launched

ADHC DSF projects continued

Increase of funding to Dementia Awareness Week

– Meets goals of awareness and community engagement

Hospital Dementia Services Project

– AANSW and University of Canberra

– Studies people in hospital’s experience of community care services, impact on carer

Transport and Dementia Research Project

– AANSW – looks at community transport, personal transport, public transport

ADHC DSF projects continued

Dementia and Disability Education Program

– 66 workshops over three years

– Intellectual and physical disabilities targeted Carer Coaching Program

– Carer education workers / train-the-trainer model

– Assist carers working with people or families with dementia

CALD Dementia Link Worker (now recurrent)

ADHC DSF projects continued

Aboriginal Dementia Advisory Service expansion (Hunter)

Koori Dementia Care Project

– 5 communities across NSW

State-wide Aboriginal project

– 2 year project

– Develop strategic plan / link into existing strategies

ADHC DSF projects continued

Dementia Services Evaluation Grants Program

– Administered by DCRC

– Funding grants for 11 projects

– Build evidence base through formal evaluation

– Upskill workers Dementia Workforce Competencies Scoping Project

– For managers and health practitioners in HACC and health setting

– Support workforce recruitment, skills development and enhance career opportunities

Dementia Services Evaluation Grant Program Dementia Services Evaluation Grant Program

In conclusion...In conclusion... Implementation of the NSW Dementia Services

Framework is underway at state and local levels.

The implementation plan will provide further momentum, direction and guidance for LHDs and ADHC regions with an emphasis on partnerships, collaboration and co-ordination.

The work in NSW will build on a national agenda for improving the quality of dementia care.

Thank you