Chapter 7 - Crisis and Assessment of Need in Dementia

Summary

The population is ageing, and dementia is the greatest global challenge for health and social care in the twenty-first century.¹ A recent review estimated that the financial cost of dementia overall to the United Kingdom is £34.7 billion, and this is set to rise sharply over the next two decades to £94.1 billion in 2040.² In the United Kingdom, there are currently around 850,000 people living with dementia, and this is expected to almost triple by 2050.³ While approximately two-thirds of these people with dementia live in the community,⁴ one-third are living alone in their own homes⁵ and are supported mainly by their families.6,7 Dementia symptoms can occur alongside other mental health conditions, including depression and anxiety,⁸ together with an increased risk of physical health co-morbidities.¹ The progressive nature of dementia is often coupled with other health and social needs, and management is complex.⁹ Given the multifaceted nature of dementia, crises can often occur and lead to hospital admissions and care home placements.10,11 Consequently, people with dementia account for 42% of people over the age of 70 who experienced unplanned admissions to hospital, rising to 48% of people aged over 80 years.¹² However, people with dementia have poorer outcomes when admitted to hospital, including increased confusion, risk of infection, longer bed stays and lower quality of life.¹³