This project aims to commission Admiral Nurses to provide specialist and personalised support to people with dementia and their families and carers in Sussex.

Admiral Nursing has been established since 1990 but there are currently no Admiral Nurses working within Sussex. This project aims to commission three Band 7 Admiral Nurses that will act as Team Leaders covering both a personal caseload and to deliver training to existing community nursing staff.

The Admiral Nurses will provide family-centred assessments, practical advice and liaison with other healthcare professionals. They will work with people with dementia, their relatives and families to ensure they receive the service they need and want based on a  bespoke assessment process.

Through collaborative working with health and social care professionals – as well as voluntary organisations – they will improve the experiences of those affected by dementia.

Through our Proactive Care Programme we are already building multi-disciplinary teams that will provide the circle of support with the patient at the centre, and the Admiral Nurses will provide complementary specialist support, contributing to the wider benefits to the health and social care system through timely expert interventions to prevent crisis.

Objectives

• To improve the overall quality of life for the person with dementia.
• To improve the overall quality of life for the carer or family member.
• To reduce the number of unscheduled admissions for people with dementia.
• To provide appropriate training and education for the carer or family member to enable them to support the person with dementia appropriately in their caring role.
• To raise awareness and reduce the stigma of dementia by training and upskilling current community nursing staff.  All health and social care staff should have access to dementia care training that is consistent with their role and responsibilities as well as access to expert advice.
• To sustain and/or improve the general health of the carer or family member.

Anticipated outcomes

• People with dementia will be able to retain their independence for longer and remain in their preferred place of care (be that their own home or within a residential/nursing home setting).
• The vast majority of care for people with dementia is provided by family carers.  Significant distress, however is a reality for many. Research shows that carers of people with dementia experience greater strain and distress than carers of other older people (Moise, Schwarzinger and Um, 2004).  But when carers are well-supported, they provide better care to the person they care for (Ablitt, Jones and Muers, 2009) and report better well-being outcomes themselves¹. As a result of having access to Admiral Nurses, we would expect family members and carers to be better supported and to fulfill the caring function with a greater degree of confidence and less stress.
• The net result for carers is that they are likely to enjoy better health.  The findings from ‘Support. Stay. Save’ (Alzheimer’s Society, 2011) states that 52% of carers were not getting sufficient support with a negative impact on mental and physical health.
• Whilst quality of life is notoriously hard to quantify, we would expect to be able to demonstrate a reduction in unscheduled admissions and GP visits.
• Upskilling community teams will lead to better outcomes for people with dementia.

Progress update

Due to issues with recruiting to the Admiral Nursing Service (because of the one year fixed term) we have taken the opportunity to re-model and expand the service to include a greater range of professionals. We have also committed to extending the project to 3 years. It will be fully evaluated as we progress.