We are regularly
bombarded with news stories about the aging population and inevitable increase
in people with dementia (44%
predicted increase by 2021 in Powys), and I wondered what services were
available in North Powys. Just a short walk from where I am based, here at
Ponthafren in Newtown, is the Fan Gorau older people’s assessment unit, a
modern compact building based in Newtown hospital grounds. The unit allows a
short term admission of people over 65 who need an assessment in order to
provide future care, be it at home or a suitable home that is able to meet the
individual’s needs. The focus is on people with dementia and related illnesses whilst
those experiencing mental distress because of depression or schizophrenia, for
example, are cared for through The Redwoods Centre at Shrewsbury Hospital.
A few days
ago I met two of the staff at the unit – Nicki Sayce, Memory Clinic Nurse and
Julie Jones, Ward Manager. I wanted to find out more about what is actually
provided at Fan Gorau, and I had heard there were some changes in the way
Memory Clinic services were being delivered. (You can find out more about Memory Clinics here).
Julie and
Nicki are clearly passionate about the work they do, providing support not only
to the people staying at Fan Gorau but their families. “Husbands and wives of
those at the unit are often left at home without their partner for the first
time in many years which can make it very difficult.” There are support mechanisms in place, be that
The Alzheimer’s Society locally, or the Dementia Advisor
Heather Lewis (based at Welshpool), but it can still be tough.
People are
assessed and diagnosed initially by doctors when referred, and all efforts are
made to admit them to Fan Gorau. However, occasionally people may have to be
admitted elsewhere, such as Wrexham, or even further afield. The staff
explained that “Fan Gorau is a small assessment unit and relatives need to be
aware that once the assessment process is completed, then the unit does not
provide long term care. If the individual is not able to return home then care
placements need to be made, potentially in a home which is not the first choice
whilst a place is awaited in that first choice home.”
The new
initiative I had heard about was the creation of a Memory Clinic nurse post. Whilst
the move to provide these services in North Powys is excellent news, and in line with
the Welsh Government's dementia
action plan, it is just one
post. In South Powys there is apparently a whole team providing this service.
I gave an
update recently on the new Home Treatment Team in North Powys (again, a case of catching up with
the South), and both Nicki and Julie spoke enthusiastically about the need for
an equivalent service for older people with dementia. (The new HTT will provide crisis support for older people with mental health conditions but not dementia). They believe that many people with dementia should
continue to live at home with their families if a strong support network is in
place, including crisis support as required. However, resources for the service are focused on the inpatient service with
nothing spare to resource a community service.
The irony is
that in 2009 the local community fought to keep Fan Gorau open when
it was threatened with closure. The Accident and Emergency Unit in the main hospital
building at Newtown had already been lost… and instinct seems to keep people
fighting for buildings… but listening to Julie and Nicki I had to wonder - perhaps the best outcome for people with dementia
and their families lies in developing more community based services…?
Increasingly mental health and dementia services in North Powys are focussing on community rather than inpatient services - including a Young Onset
Dementia post and a new Senior Practitioner post. And then there’s the new Home
Treatment Team. Should this trend continue? What do you think?
