Health Inequalities in Dementia Patients and Intervention Plan

Practice Based Public Health
and Health Promotion Project

TABLE OF CONTENT
Title: ................................................................................................................................................1
CHPATER 1: INTRODUCTION....................................................................................................1
Background .................................................................................................................................1
Aim .............................................................................................................................................1
Objective .....................................................................................................................................1
Target group.................................................................................................................................1
Rationale .....................................................................................................................................2
Public health area and scope .......................................................................................................2
CHAPTER 2: IDENTIFICATION OF NEEDS .............................................................................3
Epidemiology of dementia ..........................................................................................................3
Needs of target group...................................................................................................................4
Professional needs for addressing health inequalities..................................................................5
Health inequalities and social determinants affecting public health ...........................................6
CHAPTER 3: EVIDENCES ..........................................................................................................8
Local services and strategies for treatment and prevention of dementia ....................................8
Dementia services in local region of Westminster ..................................................................11
Measurement and effectiveness of health interventions ...........................................................12
CHAPTER 4: INTERVENTION...................................................................................................13
Data collection ..........................................................................................................................13
Resources and analysis of stakeholders ....................................................................................14
Time frame for the intervention ................................................................................................14
Public health ethics ...................................................................................................................15
Method for developing intervention .........................................................................................15
Health intervention settings and key activities for service delivery .........................................16
CHAPTER 5: CONCLUSION AND RECOMMENDATIONS ..................................................16
REFERENCES .............................................................................................................................19

Title:
Health inequalities in dementia patients and to prepare an intervention plan for treatment
and prevention of dementia in City of Westminster which is one of the most densely populated
borough of London, UK.
CHPATER 1: INTRODUCTION
Background
Dementia is known as the progressive and chronic dysfunctionality of functional and
cognitive disabilities as a result of pathology of brain structures (Surr and et.al., 2018). The
impairment is also accompanied by disturbances and critical changes in behaviour, mood and
personality changes. Mainly elder people of the age group 60 years and above are vulnerable to
the disorder. The progressive and significant decline in the cognitive ability and domain such as
learning, memory, executive function, language, social cognition and perceptual motor also
interfere with the independence of elder people in their everyday tasks. Decline in memory make
it challenging for the elder people to memorise something or to plan or organise information
making it impossible for them to live alone without care. The patients also lack emotional control
or social behaviour changes and may demonstrate irritability and apathy (Yumoto and et.al.,
2018). The timely diagnosis, education and training, care homes and community engagement
plays equal role in addressing the public health issue.
Aim
To analyse the health and social inequalities in dementia care services and to prepare an
intervention plan for prevention and treatment of dementia among elder people in Westminster
borough, UK.
Objective
The key objectives of this report are as follows:
 To analyse the existing health inequalities in dementia treatment and services in LBHF.
 To identify various factors responsible for health inequalities in dementia care services.
 To develop an intervention plan for the treatment and prevention of public health issue.
Target group
The project is intended to wide range of audience group such as individuals vulnerable to
disease, research communities, local health care authorities, government, care givers and public
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sector partners. The project aims at providing necessary support through intervention plan and its
justification.
Rationale
The number of people suffering from dementia is increasing day by day. With ageing the
number of dementia patients is also rising and as per the the report of Dementia UK, 2007 , there
will be nearly one million dementia patients in UK by 2025 and it will also increase by 40% over
next 12 years. Thus it is important to evaluate the public health issues and related vulnerabilities.
The factors such as service availability, quality of care services, early onset of the disease and
care home services along with the medications is vital for controlling the progression and
worsening of disease (Regan, 2016). The lack of information and effective public health services
influences the mortality and quality of life of elder people as well as care givers. The dementia
patients needs extensive care and support from the family members and care givers (Jones and
et.al., 2016). Thus intervention plan must be developed effectively with aim to fill the health
inequalities and service gaps for the dementia patients.
Public health area and scope
Dementia is known to be the major cause of dependency and disability among older
people. It has social, physical,psychological and economic impact on patients as well as their
family members. Despite being critical public health issue there is very limited awareness and
knowledge regarding the same (Kupeli and et.al., 2018). It result in various barriers in diagnosis
and providing care to communities. Thus the proposed dementia services and interventions will
not only assist individuals to provide effective care to their family members suffering from
dementia but also for the health care service providers which aims at controlling the worsening
of dementia symptoms. At present there are no effective treatments are available for dementia
and thus available interventions are based upon altering and lowering its progression by means of
early diagnosis and effective care services.
Thus the study outcomes can also be used by other researchers and health service
providers to enhance their studies for improving dementia care (Griffiths and et.al., 2015). For
efficiently addressing the public health issue gaps service providers must conduct in-depth
analysis of various socio-economic factors and epidemiology affecting the prevalence of disease.
Westminster borough has high number of dementia patients among elder people. In addition to
this unhealthy life style is also promoting the onset of disease in younger age whose symptoms
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get worsen with with time (Gibson and et.al., 2016). Thus the project will assess the various
factors influencing dementia interventions so that quality life can be promoted and individuals
can live a sustainable and healthy life.
CHAPTER 2: IDENTIFICATION OF NEEDS
Epidemiology of dementia
In Westminster the number of ageing population is increasing and thus the population
vulnerable to the onset and progression of dementia is also increasing. The borough regions of
Westminster, Royal borough of Kensington and Chelsea (RBKC) and London borough of
Hammersmith and Fulham (LBHF). According to the statistics presented in Dementia: A Joint
Strategic Needs Assessment (JSNA) Report for Hammersmith and Fulham, Kensington and
Chelsea Westminster, 2015 in the next 15 year there will be an estimated increase of 60% in the
elderly population of Westminster. The reason for this growth is that large proportion of people
were born in generation of baby boomers which are now converting into elders (Robinson, Tang
and Taylor, 2015).
(Source: Dementia: A Joint Strategic Needs Assessment (JSNA) Report for Hammersmith and
Fulham, Kensington and Chelsea Westminster, 2015)
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Illustration 1: Expected number of dementia cases in borough's
of LBHF, RBKC and Westminster

(Source: JSNA Report , 2015)
For the elder people of age group more than 65 years there will be a rise of 7000
dementia patients in 2030 as compare to the 4500 people in 2015. Westminster is among three
boroughs (along with RBKC and LBHF) which are at the highest risk of increased number of
dementia patients. Thus there is need that diagnosis and treatment services must also develop
accordingly in the same proportion so that health inequalities can be addressed.
Needs of target group
The dementia patients and their family members have multiple and diverse needs which
must be satisfied by bringing key policy changes. The foremost primary needs for patients
include informal care which is provided by friends or family members of the patients without
any pay (Livingston and et.al., 2017). Since dementia patients witness significant memory loss
and emotional changes they become highly dependent upon informal family care and support. In
addition to this there is also need of dementia assessment and care services. The health
professionals must analyse and diagnose the progression or onset of dementia so that patients can
be referred to specialist care services.
Westminster also have specialist health service providers such as old age psychiatry,
nutritional expert and home care service providers. The patients are required to have access to
memory service care, general medical and residential care as well as community care services to
ensure the integrated care facilities for the patient (Mullan and Sullivan, 2016). Though
medications can also be used to treat the symptoms of cognitive and behavioural aspect but they
does not have much impact on the progression of the disease.
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Illustration 2: National incidence rate of dementia in population
incidence