Improving the safety of care for older adults who have dementia and other comorbidities

Project summary

Background and methods

We know that the rate of dementia in older adults (65 years or older) is rising, and that caring for people with dementia is becoming an ever bigger challenge for families and for health and social care services. Only a small proportion (12%) of patients who have dementia, have dementia alone without any other health problems. Many more people (88%) who have dementia, have at least one other long term condition (such as diabetes, cancer or heart disease).  

People with dementia are at greater risk than those without dementia of potentially harmful events, such as medication errors and falls, whilst living at home. They are particularly vulnerable if admitted to hospital, where an acute illness, together with unfamiliar carers and a strange environment can exacerbate pre-existing confusion and compromise their treatment and care. Frail older people are also at increased risk of hospital acquired infections (such as MRSA), of longer hospital stays with a delayed discharge, and of institutionalisation. 

Little research has been done to understand how having dementia in combination with other long term conditions affects patient safety and the prevention of harm to patients. Research with a group of older patients without dementia, but who had two or more long term conditions, suggests that they were more likely to be unsafe during their care, because they experience harm from the drugs they take or the care they receive, fail to take their medication, fail to be diagnosed, or have mistakes on their prescriptions. Based on this, we expect that having dementia as well as another co-morbidity will make patients even more vulnerable and at risk.

Aim

• To improve the safety of care of older adults who have dementia and another long term condition in North West London.