GPs delivering late-stage dementia care denied specialist support

GPs are being forced to play the main role in caring for patients with late-stage dementia with too little specialist support, researchers have warned.

Home visit: report warns GPs need more support with dementia care (Photo: iStock)
Home visit: report warns GPs need more support with dementia care (Photo: iStock)

Despite having complex needs, most of the healthcare received by people in the later stages of dementia is provided by GPs, with little support from specialist healthcare professionals, according to research published in the journal Palliative Medicine.

It found that GPs are the main providers of medical care for these patients, with 96% of patients seeing a GP in their last month of life.

Around one in five (19%) were seen by a paramedic in the month prior to their death, suggesting a reactive rather than planned response to patients’ needs.

Just 1% of people with advanced dementia were seen by a geriatrician or an older person’s psychiatrist during the study’s follow-up period.

The researchers, from the Marie Curie Palliative Care Research Department at University College London, warned that healthcare services are ‘not currently tailored to the complex needs and symptoms of people with advanced dementia’.

Dementia care

GPs carrying out home visits were ‘not supported by specialist services’, they added, and care homes were ‘poorly served by secondary healthcare services’.

Marie Curie’s Dr Liz Sampson - lead author of the study - said: ‘Complex symptoms require active specialist intervention, multidisciplinary working and effective care co-ordination but many GPs are not supported by these services and feel that they do not have the time or knowledge to do this themselves.

‘The system isn’t currently fit for purpose. We need to see more resources provided in the community and nursing home staff receiving more support from external healthcare services.’

RCGP chair Professor Helen Stokes-Lampard said: ‘We will always do what we can in the best interests of the patient in front of us, but patients at or nearing the end of their lives, particularly those with advanced dementia, have very complex health and social care needs.

‘GPs are generalists – by definition we are not specialists in geriatric medicine, or psychiatry – so when our patients need input from specialist services, it is essential that they have access to them and that we have the technology to enable effective communication.

‘We need to be supported at both a national and local level by commissioners, so that we have adequate support to deliver the care that our patients at or nearing the end of their lives – whatever their unique circumstances – need and deserve, at a time when they are incredibly vulnerable.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Viewpoint: PCNs can be at the forefront of tackling health inequlities

Viewpoint: PCNs can be at the forefront of tackling health inequlities

Dr Mark Spencer explains how the COVID-19 pandemic helped his primary care network...

GPs expected to exceed 75% flu jab uptake as NHS England reveals campaign details

GPs expected to exceed 75% flu jab uptake as NHS England reveals campaign details

The government has said it expects practices to hit a minimum 75% uptake of flu vaccination...

Red flag symptoms: Heavy menstrual bleeding

Red flag symptoms: Heavy menstrual bleeding

Possible causes of heavy menstrual bleeding (menorrhagia) include uterine and ovarian...

Details on how practices can claim COVID-19 support funding announced

Details on how practices can claim COVID-19 support funding announced

NHS England has released details on how practices can claim back additional costs...

Most GPs say scrapping revalidation and CQC checks would not affect patient safety

Most GPs say scrapping revalidation and CQC checks would not affect patient safety

Around two thirds of GPs say scrapping revalidation and CQC inspections would make...

PCNs offered funding to accelerate recruitment of social prescribers

PCNs offered funding to accelerate recruitment of social prescribers

Primary care networks (PCNs) have been offered funding in a bid to accelerate the...