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Mapping existing care pathways for people with dementia with fall-related injuries

Lookup NU author(s): Dr Alison Wheatley, Claire Bamford, Dr Miriam Boyles, Dr Caroline Shaw, Dr Louise Allan

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Abstract

BackgroundPeople with dementia living in their own home experience ten times as many incident falls than people without dementia (Allan et al., 2009). They are less likely to recover well after a fall, more likely to be hospitalised and for longer, and are more likely to require increased care. Multifactorial falls services, while effective in preventing further falls in cognitively-intact older people, are not usually tailored to meet the needs of people with dementia. This study aimed to understand the range of services used by this patient group following an injurious fall.MethodsWe conducted qualitative semi-structured interviews and focus groups with 81 professionals, including staff from NHS trusts, social services and third-sector organisations. Participants were recruited via snowball sampling; recruitment continued until data saturation was reached. A topic guide was developed to help structure the interviews and create consistency to aid thematic analyses. We also observed 21 professionals delivering care to 86 patients, and conducted interviews with 9 patients and carers.ResultsNone of the areas studied had a clear existing care pathway for people with dementia with fall-related injuries. We also did not identify any individual services designed specifically for people with dementia with fall-related injuries. Several services explicitly excluded people with dementia. Specialist dementia services, such as day hospitals or in-patient wards, could provide support to people with dementia following a fall but were typically available only to a limited range of patients. Drawing on our data, we have produced a diagram illustrating the range of potential services that could be accessed by this patient group (fig 1). The majority of participants were unaware of the range of services available locally, and some thought there was unnecessary duplication and division, particularly when crossing health, community care and third-sector boundaries.ConclusionsCare pathways for people with dementia who fall are often fragmented and unclear. This may result in patients not being referred to all appropriate services, leading to poorer rehabilitation and reablement outcomes.


Publication metadata

Author(s): Wheatley A, Bamford C, Boyles M, Shaw C, Allan LM

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: Alzheimer's Association International Conference (AAIC)

Year of Conference: 2017

Pages: P1173-P1174

Online publication date: 20/10/2017

Acceptance date: 23/03/2017

ISSN: 1552-5260

Publisher: Elsevier

URL: https://doi.org/10.1016/j.jalz.2017.06.1731

DOI: 10.1016/j.jalz.2017.06.1731

Library holdings: Search Newcastle University Library for this item

Series Title: Alzheimer's & Dementia

ISBN: 15525279


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