Call for OTs in A&E departments

RCOT urges OTs to be placed in A&E departments to help cope with the rising number of people with dementia presenting towards the end of their lives

Published on 25th August 2017

Occupational therapists based in A&E departments could help stem the rise of people with dementia contacting emergency departments, the Royal College of Occupational Therapists has warned.

Research published in Alzheimer’s and Dementia found an increase in reliance on emergency care for dementia patients towards the end of their lives.

The research was carried out after a fall in hospital deaths in dementia has been interpreted as indicating an improvement in end-of-life care. However, whether other indicators of quality of end-of-life care, such as emergency department (ED) attendance, show a similar trend is unclear.

The research concluded: “ED attendance among people with dementia in their last year of life is common and is associated with demographic, illness-related and environmental factors.”

The research warned that the strong association between emergency department attendance and environmental factors is of particular importance, “given the potentially modifiable nature of these”.

However the research warns that given the dual pressures of a projected increase in prevalence of dementia and a loss of care home beds in some parts of England, investing in care home capacity is urgently needed to avoid unnecessary pressure on emergency care.

“Although the proportion of people with dementia dying in hospitals has fallen, our data show that ED attendance in the last year of life follows the opposite trend,” said the research. “We recommend that policy makers consider a broader range of indicators of the quality of end-of-life care alongside the place of death.”

Julia Scott CEO of the Royal College of Occupational Therapists said: “Sadly, people with complex and deteriorating needs are sometimes regarded simply as  a set of care needs rather than as a person who need increasing help and support. This can lead to the type of disjointed care highlighted in this report and results in thousands of unnecessary hospital admissions every year, at huge financial cost to the health and care system and emotional cost to the person and their family.

“This is especially true for people who have dementia. The sudden transfer into an unfamiliar environment, with unfamiliar faces and invasive procedures  causes unnecessary distress. That is why we are calling for all A&E departments to have occupational therapists at the front door to prevent unnecessary admissions, and for local authorities to deploy occupational therapy led social care which sees the whole person, encourages advanced planning and address end of life needs,” Ms Scott concluded.

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