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

There are few specialist intermediate care services for people with dementia
operating in Fife (e.g. EAST, CAST, Old Age Psychiatry Liaison Service), and
due to historical and financial barriers, access is geographically restricted and,
unlike generalist intermediate care, they have not been subject to a
comprehensive review. At the time of evaluation of generalist intermediate
care services it was felt that this topic merited a dedicated piece of work on its
own which has yet to be completed. Service providers feel that a lack of
appropriate services available throughout Fife is likely contributing to
inappropriate admissions into hospital, delays in discharge from hospital, and
unnecessary moves into care homes.
In order to develop a comprehensive understanding of current specialist
intermediate care services in Fife for people with confusion/memory problems,
and to identify gaps in services and modes for future development, a review is
necessary. This review should include an evaluation of how/if these are
accessed by people with confusion or memory problems such as those
present in people with dementia, in an effort to differentiate rhetorical criteria
from actual use.
In the short term it is necessary to develop referral criteria for specialist
intermediate care services which are explicit and clear in regards to access
and referral pathways to alternate services which meet the needs of people
with confusion or memory loss. This work will also be used to inform the
development of the patient pathway described in section 4.2.1.
In the longer term, the information collected during the review of specialist
services will be used to identify and develop alternate models of care which
will be accessible throughout Fife. Particular attention should be given to the
role of intermediate care services in admission prevention which provides the
greatest impact on quality of life 47 , and improving joint working between
hospitals, intermediate care services and care at home providers.
Central Assessment & Support Team
CAST is a specialist mental health nursing assessment team and is part of
the Mental Health Service for Older People. The team currently takes
referrals from the Levenmouth area and a limited number of Kirkcaldy
practices. It provides short-term, home-based assessment, treatment and
support for patients over the age of 65 with mental health difficulties
including dementia who have related problems of a complex nature and
for younger patients with an established diagnosis of dementia.
Assessment is carried out promptly and flexibly with visits planned
according to the needs of the individual patient. The team works closely
with catchment area psychiatrists and other members of the multidisciplinary
mental health team. Support is transferred as soon as
possible to longer term care providers.
47 Scottish Executive (2005) Better Outcomes for Older People: Framework for Joint Services
http://www.scotland.gov.uk/Resource/Doc/1095/0013875.pdf
61