Case study:

02 August 2007

Hope for Home care of dementia in Bexley and Greenwich

Key points

A home visiting service in London for people with advanced dementia and their families has shown it is possible to maintain people with such conditions in their home to the end of their lives as an alternative to nursing home care.

A study of the Hope for Home service in Bexley and Greenwich using qualitative semi structured interviews, suggests it can save substantial amounts of money compared to nursing home care and will probably lead to fewer hospital admissions.

It was also extremely popular with the families.

All the 14 carers studied said they were glad they had been able to do what they did and felt the service had played a big role in making this possible.

The service, which is in many ways comparable to the hospice at home service for those dying with cancer, aims to visit patients at home on a regular basis.

By doing this it has been possible to support a number of patients through till death.

This model of regular visiting, with the opportunity to be seen for any or no reason, is important, as is access to all the right equipment, medication and so on.

As well as giving advice on things like medication, the Hope for Home staff can help with appliances, mobility, feeding, carers, carer support and funding structures, as well as linking with social services, the PCT, district nurses and GPs.

An evaluation found that without this holistic approach, patients were hardly ever visited and were often left to struggle at home with little support.

There have been a few problems along the way, not least the reluctance of the PCT to invest and the time constraints faced by staff in working outside their contracted remit.

It is now hoped to set up a funded pilot model. More information about the service is available from the NCPC website