Integrated Care Pathway for Dementia

Breaking Down the Walls of Silence

An Integrated Care Pathway for Dementia

Best Practice For Dementia Care

Marian Naidoo & Roger Bullock
(Harcourt. February 2001)

The publication of this book was the culmination of a year of very exciting work that the team at Kingshill and their colleagues from the wider local health care community, carers and patients have been involved in.

Care pathways have been developed in a number of areas and in many different ways.  A care pathway is a pre-determined plan designed for patients who have a specific diagnosis.  In this instance it has been the intention of the team to develop an agreed route, based on research evidence where it is available and consensus where it was not, from early diagnosis of dementia up to and including continuing care.

Work on the pathway began in the autumn of 1999 and the team identified the following objectives. The pathway should:

·        be evidence based where possible.

·        involve representation of all stakeholders

·        include wider consultation

·        have the patient and carer at the centre of any change.

·        imply a commitment to implement.

The pathway is divided into the following five stages: -

1. Recognition
   
   
2. Assessment
   
   
3. Management
   
   
4. Review
   
   
5. Coping with change

Each stage includes the evidence available for that part of the care process and a flow chart identifying best practice.  Each stage also includes examples of essential paperwork, audit and education.

This pathway was submitted to the team who worked on the National Service Framework for Older People as an example of best practice and will lead to positive improvement for people suffering from dementia nationally.

The multi-disciplinary and integrated approach to the development of the pathway is a key feature, as is the use of evidence based research and patient inclusiveness. Given that all stakeholders were consulted the care pathway can boast a thorough approach to its development and a significant contribution to the development of care pathways as part of the NHS drive to improve patient care overall.

A pilot implementation of the care pathway within a Primary Care Group across two counties  (Berkshire and Wiltshire) is underway.  A team from Kingshill is facilitating this process through a series of developmental workshops involving all stakeholders.

For further information on the integrated care pathway for the diagnosis and treatment of dementia, please contact:

Marion Naidoo or Roger Bullock

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