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Dementia is defined by the Diagnostic and Statistical manual of mental health disorders as a deterioration in memory and impairment in cognitive functions such as communication skills, executive and motor functions1. The cognitive deficits must depict a change from a previous state of normal functioning and cannot be accounted for by other psychiatric conditions such as depression and other mood disorders or psychosis1. There are various underlying causes of dementia. The most common is Alzheimer’s disease. The disease is responsible for around 60% of all cases2. Alzheimer’s is characterized by the accumulation of amyloid plaques and neurofibrillary tangles in the brain. The build up of these plaques results in atrophy of neurons in the brain3. In the early stages of Alzheimer’s, the individual usually presents with a loss of memory, especially for learning new information2. As the disease progresses into later stages the individual will start to develop challenging behaviors and neuropsychiatric symptoms. These symptoms include agitation, aggression, wandering, psychosis, sleep disturbance, incontinence and an irregular appetite3. These behavioral and psychological symptoms have a severe impact in the activities of daily living of the affected individual, which may include difficulties in home maintenance, shopping and some aspects of personal care in mild cases. However more severe cases of dementia may lead to difficulties in mobility, toileting and communication skills5.Affected individuals, therefore, have become more increasingly dependent on family members and health and social care services. The challenging behaviors of individuals with dementia often causes a lot of stress to caregivers, with an estimate of 30% of carers having significant psychiatric morbidity7.Individuals affected with dementia and their families have multiple needs. Theses needs can be thoroughly assessed and addressed by more than one agency or sector3. This means that people that suffer from dementia are able to receive support from both or either the health and social care systems. This means that support can be received by the government or through private and voluntary organizations, however most support and care is administered by unpaid family members or unpaid caregivers (informal care)4.The Adult commission (2004) however, has identified numerous problems of informal care. These problems include the failure to refer patients to appropriate social services or the voluntary sector for support and poor early detection and diagnosis3. There are also various studies that suggest that carers associated with supporting older people with cognitive impairment suffer from poor health7.There are many social care services that are available for patients with dementia. The administration of patients into residential care homes is one of them. It has been identified for many decades, however, that the quality of care in residential and nursing homes are a cause of concern. An example of this is the unsuitable physical environments of hospital services for older people with mental health problems in most of residential homes as identified by the Adult Commission (2002). In an attempt to resolve these problems and improve care home standards, several initiatives have been taken. These include thorough performance reviews and inspections, audits and national regulatory standards3. Another social care service is extra care housing. Retirement communities can come within this category. The majority of extra care housing schemes is provided by local authorities or registered social landlords4. In order to implement effective policies to address problems that arise from dementia care, health and policy makers require accurate estimates of the numbers of patients that currently have dementia and those who will develop it in the future. In order to achieve this a group 13 senior academics conducted a systematic review of all relevant studies regarding prevalence and epidemiological studies of dementia, which they used to generate the single consensus estimate of likely prevalence. This is known as The Expert Delphi Consensus3.  Through these studies it was identified that there are over 800, 000 people that suffer from dementia in the UK, with over 770, 000 of them being aged 65 years or over. If the prevalence of dementia remains constant, it is estimated that by 2051 there will be over 2 million people affected with dementia, which shows an increase of 157% over the next 38 years4. This growth can largely be explained by population ageing as life expectancy for older people is increasing. It is therefore expected that the number of people with dementia is to increase at a similar rate to life expectancy as older people possess a higher risk of developing dementia2. This has the potential to majorly overwhelm health and care services due to the large financial burden it presents. The current overall total of costs related to dementia is £26.3 billion and this is only set to rise as more people develop dementia8.Diagnosing a person with dementia early can prove to be very helpful not just to the patients but to caregivers as well, as they are provided with a better understanding disease and therefore know what to expect and prepare appropriately to deal with the disease. Diagnosis rates, however, have always been historically low resulting in large amount of people not receiving appropriate treatment to manage their condition. During 2011 it was estimated that only around 42% of people with dementia in England were being diagnosed6. This prompted the department of health and NHS to implement several policies to improve diagnosis rates. The dementia identification scheme is one of theses policies, which rewarded GP’s £55 for each patient that was diagnosed with dementia and provided a tailored care plan. The NHS also developed a toolkit in July 2014 to aid health professionals to not only help with the diagnosis of dementia but for patient management as well. These policies have resulted in an increases of diagnosis rates from 42% to 67% as reported in march 20166.Improving diagnosis rates is just one of the three focused themes on the government’s first implemented national dementia strategy (Living well with dementia) in order to improve the quality of life for people suffering from dementia as well their caregivers. The other two key themes are; raising awareness of dementia and removing the stigma that surrounds the condition and increasing the range of services for people with dementia and their carers6.The government has since revised these policies and in 2012 the prime minister has implemented the “Dementia 2012: A national challenge”8 scheme which aimed to seek out large improvements in dementia care and research by 2015. This scheme involves attempting to improve public awareness and the establishment of well known dementia- friendly communities led by the Alzheimer’s Society. This scheme also involves and increase in funding for research in dementia involving care, cause and cure to over £66 million by 2015. It also attempts to improve standards of care in hospitals and in care homes as well as more support to caregivers6.There are also several initiatives focuses on Improving support for carers. One of these initiatives is the ‘Care Act 2014’, which forces local authorities to provide information and advice as well as universal preventative services for carers. They’re also required to provide training in order to help them on their supporting role as caregivers.  The NHS England’s commitment to carers action plan was also implemented in May 2014. This action plan includes a series of commitments, among which are raising the profile of carers. £400 million has also been made available to the NHS by the department of health to enable carers to be relieved from their caring responsibilities to sustain them in their caring role6.Although the current quality of dementia care in England is very good, there are still areas that could do with improvement. The department of health are currently analyzing how dementia care has improved since 2009 and will attempt to identify areas in dementia care that could benefit from improving. Areas such as Dementia education and training, data and evidence, end of life care and prevention are highlighted aspects of dementia care that are currently being prioritized and looked into in order improve dementia care in England8. Increasing funding in dementia research is also an urgent priority if treatment of dementia people with dementia is to improve and also may enable us with to find and develop a cure in the future3.

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