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The Interface between Old Age Psychiatry & Learning Disability

The Interface between Old Age Psychiatry & Learning Disability. Susan M Benbow Wolverhampton City PCT & Staffordshire University Norwich November 13 th 2008. Acknowledgements. Dr S. Bhaumik Dr S. Black Dr K. Dodds Members of the Interface Group. Context. Key policy documents.

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The Interface between Old Age Psychiatry & Learning Disability

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  1. The Interface between Old Age Psychiatry & Learning Disability Susan M Benbow Wolverhampton City PCT & Staffordshire University Norwich November 13th 2008

  2. Acknowledgements • Dr S. Bhaumik • Dr S. Black • Dr K. Dodds • Members of the Interface Group

  3. Context

  4. Key policy documents • Valuing people • NSF for Mental Health • NSF for Older People • Apply to ALL people

  5. Older People’s Mental Health • Standard 2 NSF-OP:Person-centred care • NHS and social care services treat older people as individuals and enable them to make choices about their own care

  6. Valuing People • Based on people having • Their rights as citizens • Inclusion in local communities • Choice in daily life • Real chances to be independent

  7. Everybody’s Business • 1.2m people with mild/ moderate LD • 210,000 People with severe LD in England • 25,000 aged 60+

  8. EB cont. • Most psychiatric disorders more common in people with LD • High risk of dementia in people with Down’s • 55% at age 60-69 • Life expectancy increasing

  9. Key elements 1 • Cognitive assessments in adulthood for people with Down’s • Better information & signposting of services • Support for family carers & others • Involve people in planning, monitoring & delivery of services • Special consideration for people from BME groups • Joined up working • Joint training

  10. Key elements 2 • Consider joint teams • Joint protocols • Better collaboration between • Primary Care • OPMH • LD services • Consider in • Transport • Aids & adaptations • Access to routine medical investigations

  11. ‘Nothing about us without us’ • DH Strategy User Group • ‘All services should include people with learning difficulties properly in everything they do … not just one person as a token but several people who can support each other’.

  12. National Dementia Strategy • Consultation doc • 2008

  13. College work

  14. 4 main areas of work: • Joint protocol for people with Downs syndrome + dementia in partnership with BPS & others • Training Days/ CPD events • Psychiatrists • Other staff working in both specialist areas • College publication • Survey of LD & OA psychiatrists

  15. DRAFT 7 – 22nd September 2008 • Dementia and People with Learning Disabilities: •  Guidance on the assessment, treatment and support of people with learning disabilities who develop dementia

  16. Aims of joint protocol • To collate evidence-based practice, clinical opinion & experience • to provide a framework for good practice • to promote assessment, treatment and support for PWD, their staff & carers • guidance for service developers & commissioners • to provide a set of standards of good practice • to promote service development • to provide a training framework • to guide future service development

  17. Comparative Rates of Dementia - Down’s syndrome, Learning disabilities, General Population LD DS Cooper, personal communication GP

  18. Key points: • assess every adult with Down’s syndrome at age 30 to establish a baseline against which to compare future suspected changes in functioning. • consider screening all adults with Down’s syndrome over 40 regularly because of • increased risk of dementia • prevalence of undetected treatable illnesses.

  19. Sharing the information with the person with learning disabilities: • Steps should be taken to share the information with the person with learning disabilities at all stages ……. This process should be undertaken as good practice irrespective of the mental capacity of the person concerned.

  20. consider the person’s happiness, comfort and security. The focus of care should move away from targets to quality of life.

  21. Key Points: • Wherever possible, people with learning disabilities and dementia should remain in familiar environments. • Environments can be adapted to make them dementia friendly and enable the person with dementia to make sense of where they are living.

  22. ‘Dying in place’ where the person can stay where they are currently living with appropriate supports adapted and provided. This means that the person stays with what is familiar in their long term memory.

  23. 4 main areas of work: • Joint protocol for people with Downs syndrome + dementia in partnership with BPS & others • Training Days/ CPD events • Psychiatrists • Other staff working in both specialist areas • College publication • Survey of LD & OA psychiatrists

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