Acute care of people living with dementia

PROJECT STATUS: Proposal
Summary

We are developing a programme of work around the acute care of people living with dementia. Existing strands include: expertise in delirium epidemiology, interface geriatrics services (step-up/step-down pathways between acute and community care), established acute frailty improvement platforms (with ICS, pan-London, national and international reach). Expanding these in the context of a capacity-building post-doctoral training programme will enable transformative dementia care in the acute setting.

Delirium and dementia care in acute hospitals have consistently been highlighted as under-researched areas (e.g. James Lind Alliance, Cochrane Dementia and Cognitive Improvement Group). Our PPI work with the Alzheimer’s Society specifically prioritised research into cognitive recovery after delirium. Though we adopt a whole-system approach for health services research across ARC-NT, we will build on our partnership with Care City in the London Borough of Barking and Dagenham - an area facing particular urban health inequality challenges. All of our work is underpinned by established stakeholder engagement, and we have a history of innovative and inclusive PPI.

We will address cognitive and functional recovery after delirium, one of the commonest complications of dementia. Delirium is distressing for patients and their families, and associated with multiple poor outcomes, including increased length of stay, higher rates of institutionalisation, and cognitive and functional decline. Despite this great need, there has been little research to date on how best to maximise delirium recovery. Our aim is to develop an evidence-based integrated inpatient / outpatient delirium recovery programme. This could have high impact for people living with dementia.

We will synthesise evidence from systematic review, theoretical models (choosing or adapting one most suitable) and qualitative processes in co-design bringing together older people, families and carers, practitioners, and commissioners using the updated NIHR/MRC framework for developing and evaluating complex interventions. This process will define the scope of the intervention and its delivery.

Without pre-empting the final intervention to be developed, a possible output could take the form of a nurse-led educational intervention for families and carers to recognise early delirium and seek timely medical assessment, and delivery of cognitive stimulation activities and neurorehabilitation after delirium. 

Return to the overview page.

Partners & Collaborators

University College London

St Pancras Rehabilitation Unit 

Back to top