An audit of dementia education and training in UK health and social care: a comparison with national benchmark standards.

BACKGROUND: Despite people living with dementia representing a significant proportion of health and social care users, until recently in the United Kingdom (UK) there were no prescribed standards for dementia education and training. This audit sought to review the extent and nature of dementia education and training offered to health and social care staff in the UK against the standards described in the 2015 Dementia Training Standards Framework, which describes the knowledge and skills required of the UK dementia workforce. METHODS: This audit presents national data concerning the design, delivery, target audience, length, level, content, format of training, number of staff trained and frequency of delivery within existing dementia training programmes offered to health and social care staff. The Dementia Training Standards Framework was used as a reference for respondents to describe the subjects and learning outcomes associated with their training. RESULTS: The findings are presented from 614 respondents offering 386 training packages, which indicated variations in the extent and quality of training. Many training packages addressed the subjects of 'person-centred care', 'communication', 'interaction and behaviour in dementia care', and 'dementia awareness'. Few training packages addressed subjects concerning 'pharmacological interventions in dementia care', 'leadership' and 'end of life care'. Fewer than 40% of The Dementia Training Standards Framework learning outcomes targeted to staff with regular contact with people with dementia or in leadership roles were covered by the reported packages. However, for training targeted at increasing dementia awareness more than 70% of the learning outcomes identified in The Dementia Training Standards Framework were addressed. Many training packages are not of sufficient duration to derive impact; although the majority employed delivery methods likely to be effective. CONCLUSIONS: The development of new and existing training and education should take account of subjects that are currently underrepresented and ensure that training reflects the Training Standard Framework and evidence regarding best practice for delivery. Lessons regarding the limitations of training in the UK serve as a useful illustration of the challenge of implementing national dementia training standards; particularly for countries who are developing or have recently implemented national dementia strategies.

Young-onset dementia and the need for specialist care: a national and international perspective.

OBJECTIVES: Receiving a timely and accurate diagnosis and gaining access to age-appropriate support for younger people living with dementia (YPD) remains a challenge both in the UK and internationally because the focus of most dementia services is primarily upon the needs of older people. The political case to improve services for YPD depends upon the establishment of an understanding of the clinical symptoms, an unequivocal evidence base about need and an accurate evaluation of the size of the population affected. This short report assesses the evidence base from international studies regarding service design and delivery. The goal is to raise awareness, advance best practice and galvanise the international community to address the serious underfunding and underprovision of care for this marginalised group. CONCLUSION: The current evidence suggests that there are universal problems, regardless of continent, with delays to diagnosis and poor understanding of optimum models for service provision and long-term care.

Awareness of memory functioning in early Alzheimer's disease: lessons from a comparison with healthy older people and young adults.

To compare awareness of memory in people with early Alzheimer's disease (AD) with older and younger control groups in order to clarify the contributions of disease and ageing. Twenty-one individuals with early AD, 32 older people (OP) and 32 younger people (YP) estimated their performance before and following each of four tests of memory. Those with AD significantly overestimated performance prior to testing, confirming the presence of unawareness for prediction. Their estimates were adjusted for age in a similar way to those of OP, who predicted their performance accurately. Younger people significantly underestimated their performance. Following memory tests, YP and those with AD significantly adjusted their ratings towards greater accuracy but on average those with AD still overestimated. There were variations in post-test ratings from over to under prediction in all three groups. Heightened awareness post-performance may open possibilities of cognitive rehabilitation to consolidate momentary into more long-term awareness, whilst the operation of possible psychosocial influences suggests that emotion oriented interventions to increase acceptance and decrease shame might be helpful.

Cognitive functioning in Parkinson's disease: in relation to prevalence of dementia and psychiatric diagnosis.

Forty-three neurologically and psychiatrically assessed patients with idiopathic Parkinson's disease (PD) underwent detailed cognitive assessment. Cognitive deficits typical of senile dementia of Alzheimer's type (SDAT) were found in 7% but the majority showed definite impairments not typical of SDAT. Cognitive impairment was significantly more likely in those with more severe PD symptoms. There was substantial agreement between psychiatric diagnosis and psychological picture of SDAT and some links were found between other diagnostic categories and nature of cognitive functioning. However, cognitive deficits were also found in two-thirds of patients with no psychiatric diagnosis.