ABC model: A tiered, integrated pathway approach to peri- and post-diagnostic support for families living with dementia (Innovative Practice)

Aldridge, Zena; Burns, Alistair; Dening, Karen Harrison

doi:10.1177/1471301219838086

Cited by 18 publications

(15 citation statements)

References 7 publications

(6 reference statements)

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“…Although Admiral Nurse services can vary; for example. in their composition, funding, remit and care setting; their core principles and values remain the same, with services that focus on supporting families affected by dementia with complex needs ( Aldridge et al., 2019a ; Gridley et al., 2019 ).…”

Section: Admiral Nursing In Acute Hospitalsmentioning

confidence: 99%

“… The Admiral Nurse ABC Model in Acute Hospitals (Adapted From Integrated Community Model; Aldridge & Findlay, 2015 ; ABC Tiered Model; Aldridge et al., 2019a ). …”

Section: Admiral Nursing In Acute Hospitalsmentioning

confidence: 99%

“…This is achieved by delivering and coordinating specialist clinical care and support during highly challenging times in the hospital for families affected by dementia. If complex needs are identified prior to hospital discharge families are referred to the community Admiral Nurse Service for ongoing support or, to other appropriate services proportionate to the level of need as defined within the ABC tiered model ( Aldridge et al., 2019a ; Figure 4 ). The ABC tiered model ( Aldridge et al., 2019a ) was developed to ensure that families affected by dementia could be directed to the right level of support to meet their needs.…”

Section: Case Studymentioning

confidence: 99%

“…If complex needs are identified prior to hospital discharge families are referred to the community Admiral Nurse Service for ongoing support or, to other appropriate services proportionate to the level of need as defined within the ABC tiered model ( Aldridge et al., 2019a ; Figure 4 ). The ABC tiered model ( Aldridge et al., 2019a ) was developed to ensure that families affected by dementia could be directed to the right level of support to meet their needs. Mapping services to the model ensures efficient use of services, whilst promoting an integrated model of service provision for peri and post diagnostic dementia support.…”

Section: Case Studymentioning

confidence: 99%

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Admiral Nursing—A Model of Specialist Dementia Care in Acute Hospitals

et al. 2020

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Introduction The rising prevalence of dementia has led to increased numbers of people with dementia being admitted to acute hospitals. This demand is set to continue due to an increasingly older population who are likely to have higher levels of dependency, dementia, and comorbidity. If admitted to the hospital, people with dementia are at higher risk of poor outcomes during and following a hospital admission. Yet, there remains a significant lack of specialist support within acute hospitals to support people with dementia, their families and hospital staff. Methods Admiral Nurses are specialists that work with families affected by dementia and provide consultancy and support to health and social care colleagues to improve the delivery of evidenced based dementia care. Historically, Admiral Nurses have predominantly been based in community settings. In response to the increasing fragmentation of services across the dementia trajectory, the Admiral Nurse model is evolving and adapting to meet the complex needs of families impacted upon by dementia inclusive of acute hospital care. Results The Admiral Nurse acute hospital model provides specialist interventions which improve staff confidence and competence and enables positive change by improving skills and knowledge in the provision of person-centred dementia care. The role has the capacity to address some of the barriers to delivering person centred dementia care in the acute hospital and contribute to improvements across the hospital both as a result of direct interventions or influencing the practice of others. Conclusion Improving services for people with dementia and their families requires a whole system approach to enable care coordination and service integration, this must include acute hospital care. The increasing numbers of people with dementia in hospitals, and the detrimental effects of admission, make providing equitable, consistent, safe, quality care and support to people with dementia and their families a national priority requiring immediate investment. The inclusion of Admiral Nursing within acute hospital services supports service and quality improvement which positively impacts upon the experience and outcomes for families affected by dementia.

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Section: Admiral Nursing In Acute Hospitalsmentioning

confidence: 99%

“… The Admiral Nurse ABC Model in Acute Hospitals (Adapted From Integrated Community Model; Aldridge & Findlay, 2015 ; ABC Tiered Model; Aldridge et al., 2019a ). …”

Section: Admiral Nursing In Acute Hospitalsmentioning

confidence: 99%

Section: Case Studymentioning

confidence: 99%

Section: Case Studymentioning

confidence: 99%

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Admiral Nursing—A Model of Specialist Dementia Care in Acute Hospitals

et al. 2020

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“…16 A variety of innovative postdiagnostic support projects have been piloted in the UK to address this shortfall, some of which have strong connections with primary care. [17][18][19][20][21] The aim of this UK study was to explore the views and experiences of key professionals, including commissioners and managers of dementia services, on the concept of a task-shifted and task-shared approach.…”

Section: Introductionmentioning

confidence: 99%

Task-shifted approaches to postdiagnostic dementia support: a qualitative study exploring professional views and experiences

et al. 2020

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ObjectivesTo explore the views of commissioners, service development leads, service managers and senior staff in selected dementia services on increasing the role of primary care in postdiagnostic support for people with dementia.DesignQualitative semi-structured telephone interviews and a focus group.SettingParticipants were drawn from National Health Service (NHS) Clinical Commissioning Groups, social care commissioning and a range of dementia services across primary care, secondary mental healthcare, social care and the third sector. All participants were based in England or Wales.Participants61 professionals, comprising 25 commissioners or service development leads; 25 service managers; and 11 team leads or senior staff.ResultsParticipants had varied views on whether a primary care-based approach for postdiagnostic support for people with dementia and their families was appropriate, achievable and/or desirable. Potential benefits of a task-shifted approach were continuity and a more holistic approach to care; familiarity for both patients and staff; and reduction of stigma. Key challenges included the capacity, ability and inclination of primary care to deliver postdiagnostic support for people with dementia and their families. We discovered a number of conceptual challenges to implementing a task-shifted and task-shared approach, including uncertainties around the nature of postdiagnostic support, the definition of primary care and identification of tasks that could be shifted to primary care.ConclusionsOur data highlight the concerns of key professional staff around greater involvement of primary care in postdiagnostic support for dementia. Further research is needed to achieve a shared understanding and consensus over what postdiagnostic support means in the context of dementia. We will be undertaking such research in the next phase of our programme.

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Further development needed: models of post-diagnostic support for people with dementia

Low

Gresham

Phillipson

2022

Current Opinion in Psychiatry

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Purpose of reviewThere is increasing recognition of a service gap immediately after diagnosis for people with dementia and carers. This narrative review of models of post-diagnostic support focuses on recent developments and offers suggestions for future development. We present the current evidence for these models and consider the service components they provide against the recommendations of clinical guidelines and principles underpinning ideal post-diagnostic support. Recent findingsModels of post-diagnostic support include a short-term support worker, ongoing support worker, centre-based support, primary care management, and specialist dementia clinics. Of these, specialist dementia clinics that include ongoing support workers provide most components of an ideal and timely post-diagnostic support framework, but may be more costly to implement universally. The greatest research evidence is for the benefits of long-term support models, specifically case management, though this does not necessarily include medical care or nonpharmacological interventions. There is sparce evidence for the benefits of short-term support worker models such as dementia advisers for people with dementia and carers. SummaryFurther development is needed to create whole-system models of dementia support which meet the needs of people with dementia and their carers, are timely, accessible and equitable, and can be implemented universally.

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ABC model: A tiered, integrated pathway approach to peri- and post-diagnostic support for families living with dementia (Innovative Practice)

Cited by 18 publications

References 7 publications

Admiral Nursing—A Model of Specialist Dementia Care in Acute Hospitals

Admiral Nursing—A Model of Specialist Dementia Care in Acute Hospitals

Task-shifted approaches to postdiagnostic dementia support: a qualitative study exploring professional views and experiences

Further development needed: models of post-diagnostic support for people with dementia

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