The coronavirus pandemic and the response to it, has had an impact on the health and wellbeing of people in Wales. This has often been felt most acutely by the most vulnerable members of society, including those people living with dementia and their families.
This statement updates Members about the work the Welsh Government has undertaken to understand the challenges faced by people with dementia and ensure we respond to them.
Since the beginning of the pandemic, the Dementia Care COVID-19 partnership forum, led by Improvement Cymru, has offered a regular opportunity to identify challenges and develop solutions. The Dementia Oversight of Implementation and Impact Group (DOIIG) has also been re-established to provide further support to shaping the approach to recovery.
We have supported health boards, local authorities and the third sector to continue to provide support to all those receiving dementia services. This includes the release of the Integrated Care Fund monies allocated to Regional Partnership Board (RPBs) to support the implementation of the 2018-22 Dementia Action Plan for Wales. Where individuals are struggling, support is also available through their local voluntary organisation.
Social Care Wales has worked with partners, including people living with dementia, to develop a range of online resources to support health and social care workers and families of people living with dementia. These online resources are available at: https://socialcare.wales/service-improvement/dementia-and-covid-19.
The pandemic has meant many services have had to make changes to reduce the risk of spreading the virus, which has inevitably meant a reduction in face-to-face contact. We have seen a lot of innovative practice emerge over the last seven months, which must not be lost. But we also know that not everyone has adapted to telephone and digital services.
Mental health services were classed as essential NHS services and while some clinics were not able to operate during lockdown, we sought assurances that urgent dementia assessments have been undertaken and remained operational. As more routine services have become available over the summer months, additional staff have been deployed and remote assessments used, where appropriate, to manage waiting times.
This has been a very difficult period for people living with dementia and their families. Sadly, we know many people with dementia have died during the pandemic. There has been an increase in the proportion of deaths where the leading cause of death is dementia or Alzheimer’s disease, particularly in care homes. Further research will be needed to fully explore the reasons for this increase.
A National Bereavement Steering Group has been set up and a national framework for bereavement care in Wales is being developed to support clear referral pathways, risk and needs assessments, training for staff and volunteers and a directory of available bereavement provision. There is also ongoing work to develop a more individualised risk stratification tool, which will take account of the published data of the impact of COVID-19 on specific conditions.
We know these challenges have been felt particularly acutely in the care home sector and care homes have needed to make significant adjustments to provide appropriate care, and will need to continue to do so.
Where restrictions to control the pandemic have impacted on care home visits, this will have had an impact on the wellbeing of all residents especially those with dementia. We know these are difficult decisions to make and are not taken lightly. People living in care homes are particularly vulnerable to coronavirus and have a particularly poor prognosis if they become unwell due to the virus.
Significant efforts have been focused on supporting care homes in Wales, and those who live and work in them, during the pandemic. The Deputy Minister for Health and Social Services has recently published an update about the Care Homes Action Plan, which has the wellbeing of people living in care homes at its heart.
We are funding two projects which will support carers of people living with dementia in care homes.
The Dementia and Integration Links project is led by Platfform and delivers one-to-one and group sessions to improve the lives of people living with dementia and their carers in the Cardiff and Vale and Cwm Taf Morgannwg university health board areas. Age Cymru is leading a project which aims to improve access to information, advice and support for older carers and to create opportunities for carers to influence and shape services. It will also work with the carers of people living in care homes.
This has also been a challenging time for care home staff. Improvement Cymru, with support from Social Care Wales, has set up a digital support network for care homes across Wales in response. The Cwtch Project has offered a platform for care homes to share best practice and self-manage some of the challenges of providing care at this time, as well as offer peer support.
The “Ask Us About Dementia” service provides timely access to advice and signposting to dementia care using telehealth. This is a partnership between Social Care Wales and health professionals, including an allied health professional consultant, whose role was developed through the implementation of the Dementia Action Plan and who has provided advice and guidance on dementia policy throughout the pandemic.
Carers are able to book a virtual appointment with experienced dementia practitioners who provide a range of knowledge and skills; physiotherapy, speech and language therapy, occupational therapy, nursing, dietetics, pharmacy, dementia training are represented in the project. The pilot has been co-produced with input from people living with dementia, care providers, third sector organisations and statutory bodies. The service is currently being offered as a localised pilot, and will be used to test processes and outcomes to inform a long term national project.
The Welsh Government’s rehabilitation task and finish group has also ensured the needs of people living with dementia and their families is included in the consideration of increased need for rehabilitation, reablement and recovery.
We want to support people to recover and live as independently as possible for as long as possible.
It is clear coronavirus will be with us for some time yet. I am hugely grateful for the efforts of health, social care and the third sector in supporting people living with dementia, their carers and their families.