The Fife Dementia Strategy: 2010 – 2020 - The Knowledge Network

4.8 Intermediate Care
AIM
People with dementia have access to intermediate care services
provided in a suitable environment and by well trained staff who are
skilled in caring for and rehabilitating people with dementia. Both
generalist and specialist intermediate care services are available for people
with dementia in order to prevent unnecessary admission to hospital and
facilitate discharge.
RECOMMENDATIONS TO ACHIEVE THIS
4.8.1 General intermediate care services are run by well trained staff
and have clear, consistent and well communicated pathways for referral
and criteria for access and use, including for people with dementia.
Intermediate Care refers to any service whose main aim is to prevent
unnecessary admission into, or support discharge from, a hospital setting
back into the community. A recent report on generalist NHS intermediate care
services in Fife found that “people affected by dementia make up a
considerable proportion of the clients seen by teams and services providing
support to prevent unnecessary admission and support discharge from
hospital” 43 . In Fife there are a range of services which provide intermediate
care, although these are not always easily accessible, especially to those who
work with patients with mental health or cognitive issues such as dementia.
In the aforementioned report, some inquiries were made into the eligibility
criteria for people affected by dementia. The researchers reported an
overwhelming response that there were no separate criteria for people with
confusion or memory loss such as is experienced in dementia, and that if it
was thought the service user would benefit from that team’s input, they would
be accepted to that service 44 . However, as the main aim of intermediate care
services is to assist people to get back to the level of independence they
previously had, and in some instances this is not possible with people with
progressed dementia due to the progressive nature of their condition,
generalist intermediate care services may not always be appropriate.
Consultation work done during the preparation of this Strategy demonstrated
that there was some confusion over referral criteria for service use by people
with dementia as clients were not being accepted for reasons not understood
by the referring provider. And, whilst it is understandable that each decision
must be made individually based on a number of factors, it is necessary that
an individual who is denied a service understands why this was the case and
43 Gilmour M, Valentine J & McLaren G (2008). Provision of Intermediate Care for Older
People in Fife: A Needs Assessment. NHS Fife & Fife Council, Scotland.
44 Ibid.
59