Dementia affects one in five people over 80 and the report estimates that around 40,000 people in Wales could have some form of dementia. But from over 700 Welsh GPs surveyed, only 40 per cent feel they've had enough training to diagnose and manage dementia and arrangements to access specialist care are inconsistent.
Specifically, the report says that:
- The quality of mental health services for older people in Wales varies greatly, depending on where people live, and there are severe shortages of specialist practitioners in some areas.
- People in some areas have to move long distances away from their families to get the right kind of support when they can no longer be supported at home.
- Carers are generally well supported but their needs should be assessed more consistently.
- There is a need to ensure that staff in nursing and residential homes are appropriately trained to care for older people with mental health problems.
Losing Time highlights over 30 examples of good practice and acknowledges that staff are committed but says that this good practice isn't being shared widely enough. In particular, the report says that the following areas need to be addressed to help improve services:
- GPs need more support to help them diagnose and manage dementia.
- More needs to be done to support carers.
- Health and social care organisations should improve the way they work together to better plan for the future and review the performance of local services.
- A more strategic approach to developing mental health services for older people should be developed with clearly defined minimum care standards.
The report acknowledges that some important progress is being made:
- Agencies are beginning to use performance reviews to help improve services.
- There are examples of good practice in a range of areas across Wales, including a memory clinic at Cardiff's Llandough Hospital, specialist planning groups in Neath Port Talbot and Bridgend, Denbighshire Social Services' 'Cornerstone scheme' and specialist teams for older people with dementia in Cardiff and the Vale of Glamorgan.
Andrew Wood, lead manager for the Audit Commission in Wales said:
'With an increasingly ageing population, the number of people with dementia is likely to rise and we need to ensure that services can respond to demand. Our report highlights the severe shortages of specialists in some parts of Wales and the long distances some people have to move away from their families for care - these issues should be addressed as a matter of urgency.
'There is clearly much good work in the field of improving mental health services for older people in Wales. But more needs to be done - in particular, agencies need a clearer strategic approach, GPs need more help with diagnosing and managing dementia and carers too need more support.'
* The Losing Time Briefing is available
1. Losing Time is a snapshot of current services, achievements and shortfalls, based on ten multi-agency audits conducted in Wales by auditors appointed by the Audit Commission from District Audit and PricewaterhouseCoopers. It provides a stocktake for the assembly government and local agencies to enable them to prioritise actions and investment.
2. Forget Me Not (January 2000) set out the Audit Commission's analysis of the state of mental health services for older people. Since then, local audits of mental health services for older people across Wales have been carried out using a methodology based on Forget Me Not, adapted to take account of the Welsh policy context.
3. Dementia is a progressive condition that mainly affects people aged 65 or over but can also affect younger people. The most common cause is Alzheimer's Disease which accounts for almost 60 per cent of all people with dementia. Dementia affects an estimated 1 in 1000 people aged between 40 and 65, 1 in 50 people between 65 and 70, 1 in 20 between 70 and 80 and 1 in 5 people aged over 80.
4. Functional illnesses such as depression also affect older people. People over 65, particularly older women are more prone to depression than any other group.