Extra care housing and dementia: Ed's blog

This blog is my reflection on the ConnectED evidence briefing on Extra Care Housing (ECH) and Dementia.  I am writing as a member of the ConnectED Project Service User and Carer Advisory Group.  The briefing raised a number of questions for me that I discuss here.

Is getting an early diagnosis of dementia key to unlocking access to Extra Care Housing?

People living with dementia and their carers are not necessarily known to the health and social care system because they are not being identified early on.  By the time a formal diagnosis is made the symptoms might have progressed and become more challenging for staff working in ECH.  The key to early identification is closer collaboration between health and social care agencies in assessing, monitoring and reviewing the suitability of ECH for people living with dementia.  In my experience the risks associated with deciding whether ECH is safe for people living with dementia are not necessarily shared or understood by health and social care professionals.

I believe that knowledge and experience of dementia care is vital when it comes to assessing housing needs, rather than housing availability determining care provision.  A meeting my mother and I had with a social worker after her discharge from hospital for a fall was very informal.  At that stage she showed clear signs of dementia, but it had not been diagnosed.  Although it was proposed that she would benefit from ECH, there was little discussion of a care plan to support her living with dementia.  In fact the shortage of such accommodation meant there would have been an indefinite wait, so she moved into residential care instead. Finding a residential care home that met my mother’s needs was very challenging despite exhaustive visits to lots of care homes.  Had she had allied mental health conditions like paranoia and psychosis I might have understood their concerns about not being able to meet her needs.  I keep asking myself whether a pre-existing diagnosis of dementia may have unlocked access to ECH at an earlier stage for her when her dementia was less advanced and more manageable by staff.

Could training in dementia care be the way to unlock access to ECH for those living with dementia?

Any workforce planning in the social care sector needs to take account of the rising levels of dementia among the frail and elderly and the need to train and equip social care staff with the requisite knowledge and skills.  Greater understanding of dementia and how to support people with dementia might help improve the assessment and delivery of care for both them and their carers.  What surprised me was that my mother's immobility was not assessed even though she had a Zimmer Frame as a mobility aid by her side.  I learnt that some social care workers were not confident enough to make such a risk assessment because they were not trained to do this.  Incorporating falls prevention in the training of Social Workers by Occupational Therapists could help in joining up OT falls prevention plans with Social Work care assessments.

Ed Brooks
Member of ConnectED Service User and Carer Group
August 2024