Raising awareness and challenging the stigma surrounding Alzheimer’s

Dementia is a growing challenge that affects millions of people around the world.

This September, we're uniting to raise awareness and challenge the stigma surrounding Alzheimer’s.

Dementia is estimated to affect 24,000 people in Kent and Medway. At KMPT we provide a range of services for people affected by dementia including memory assessment services, specialist support for carers, and support for people in crisis.

We are committed to helping those get a quicker diagnosis for people living with undiagnosed advanced dementia.

A new rapid dementia diagnosis resource for people living with advanced dementia, without a formal diagnosis, is now available for service users of North Kent GPs.

KMPT is working with DGS Health to help diagnose people living in local care homes, and those who are very frail, elderly and housebound, whose nurses, families or carers, have concerns about their significant cognitive impairment.

DiADeM (Diagnosing Advanced Dementia Mandate) is a tool used by primary care providers to empower them to make a diagnosis in the most appropriate and setting, without a formal memory assessment.

The partnership pathway not only removes the stress and inconvenience of a referral for an individual without a formal diagnosis but also frees up capacity in the Memory Assessment Service for more complex cases to be met within the 6-week ambition.

People diagnosed with advanced dementia in this way are then able to access appropriate care to meet their individual needs while avoiding multiple assessments.

“It has avoided scans and unnecessary hospital visits.” (Paramedic practitioner).

“Mum gets very anxious about medical appointments… this system has opened the door for support.” (Carer).

Mark Kitchingham, Advanced Clinical Practitioner, DGS Community Mental Health Service for Older People said: “Sadly, there are a lot of people living with advanced dementia without a diagnosis who may still benefit from this.

“A diagnosis of dementia is usually made in Memory Services but for people living with advanced dementia this is likely to be distressing and is usually unnecessary”.

Dr Kevin Tan, Director of Clinical Services DGS Health, Federation, DGS HCP Clinical Lead GP (Frailty and Dementia) said: “This innovative process provides GPs with insight from those closest to the person being diagnosed, before making a formal diagnosis in a comfortable and convenient environment.

“The result is faster access to multidisciplinary teams and dementia specialists for required care and support, while boosting capacity of the usual memory assessment pathway to mobile service users with mild to moderate cognition impairments.”

Since being rolled-out in Dartford, Gravesham and Swanley in late 2022, DiADeM has already enabled signposting to further support from Dementia Co-ordinators and identified people who would benefit from medication review and medical problems that require follow-up.  The launch of the dementia diagnosis model has also resulted in promoting multi-professional discussions and access to investigations and strengthened relationships across services.

Mark Kitchingham, Advanced Clinical Practitioner (ACP) who regularly works with the DiADeM tool speaks about his role as an ACP and what he does on a day to day:

My current role is as an Advanced Clinical practitioner (ACP) in an older adult community mental health team.

ACPs work as part of multidisciplinary teams (teams consisting of individuals drawn from different disciplines) and are healthcare professionals, educated to Master’s level or equivalent. They harbour skills and knowledge to allow them to expand their scope of practice to better meet the needs of the people they care for.

In my case, I have completed additional training for those with extended roles in dementia care which has enabled me to develop high-level skills in assessment, diagnosis, clinical management and ongoing support for people with dementia and their carers. The NHS Long-Term Plan highlights how advanced clinical practice is central to helping transform service delivery and better meet local health needs by providing enhanced capacity, capability, productivity and efficiency within multi-professional teams.

I first started my career as a student nurse in 2000, before qualifying as a registered mental health nurse in 2003. After completing my A-Levels I deferred going to university as I was not very clear on what I wanted to do at that age. I was working in hotel and pub management so quite a change but I fancied a new career and nursing seemed to provide opportunities to work and study at the same time which attracted me.

I have worked at KMPT since I qualified in 2003 in a variety of roles including inpatient, crisis team and community where I have worked with some fantastic colleagues and have always been supported with further training and development.

I have been working in my current role since August 2022 when I completed my Masters in Advanced Clinical Practice. Before starting my course, I was in a team leader position and the development of the new ACP roles allowed me to progress in my career on a clinical pathway as an alternative to the traditional operational senior management route.

I have always enjoyed the direct clinical care aspect of being a nurse and was keen to keep this aspect. However, an ACP also has responsibilities in leadership, education and research so this brings real variety and there are no set rules for how much of each to do so each ACP role is unique.

My days are very full and varied and include reviewing new referrals, supporting the team with complex patients, seeing new assessments, conducting diagnostic appointments for dementia and starting treatment, liaising with other professionals, and doing medication reviews and follow-ups. This is in addition to supporting patients in care homes, QI projects such as working with the frailty team to develop new pathways so that patients can be diagnosed quicker in the best place for them, service development, audits, memory service accreditation schemes, CPD, providing training and lecturing at the university.

The roles undertaken by advanced clinical practitioners are determined by the needs of the service and the required level of practice to be deployed within their setting. This enables the ACP to meet the needs of a specific population so might be a well-recognised role nationally or can be very be very bespoke.

The benefits of my role are that I get to work with a fantastic team in providing high-quality clinical care to our patient group. I also work across systems with the frailty team to diagnose individuals with advanced dementia using the DiADeM tool when a traditional memory clinic appointment is not necessary and may be distressing for the person.

I really value developing relationships with patients and their carers and supporting them through a complete package of care from assessment to discharge which can include prescribing medication so this role allows me to truly work within a biopsychosocial model (models which look at the interconnection between biology, psychology, and socio-environmental factors) of patient care.

If you are interested in the role of an ACP, visit our vacancies page.