This short paper attempts to summarise some of the key issues around people with dementia and their carers in relation to COVID 19 (Coronavirus). While there is ample general advice about COVID-19 and its management the following ten key points have been devised which reflect clinical advice and specific information about dementia. It may be helpful to clinicians and planners.
Covid-19 and Dementia in England
There are an estimated 675,000 people with dementia in England, the majority of whom are over 65 and have comorbid health conditions. This makes them particularly vulnerable to developing the severe symptoms of Covid-19 and develop complications.
The majority of these people are supported by a similar number of carers who are frequently of a similar age. Twenty-five per cent of people in acute hospitals and seventy-five percent of care home residents have dementia.
- People with dementia are much more prone to develop a confusional state if they develop an infection – being aware that a person may have dementia will alert staff to the additional risk.
- People with dementia in their own homes may already feel isolated and if they need to further self-isolate, additional assistance and support may be needed to mitigate the emotional impact of separation – care plans reflecting this are important, including updated Lasting Power of Attorney documentation and advance directives.
- Support in the community is key – Dementia Connect and Dementia UK are examples of where bespoke advice is available.
- Volunteer community groups could be encouraged to prioritise support for people with dementia, particularly those living alone.
- There will be an additional burden on carers, many of whom are in high risk group themselves, which could lead to more emergency calls on the NHS and social care – early testing for the virus would allow them to continue in their role.
- Some people with dementia may have difficulty in following complex instructions about self-isolation or handwashing regimes – keeping the information accessible and repeatable is key.
- People with dementia may lack awareness of and be less able to report symptoms because of communication difficulties – people should be alert to the presence of signs as well as symptoms of the virus (“look beyond words”).
- People with dementia may have swallowing difficulties which could put them at increased risk of developing chest infections.
- A blanket ban on visitors to care home could have a detrimental effect on residents – use of technology may help improve communication between families both at home and in care homes.
- Going into hospital is frightening enough and particularly so for someone with dementia – staff involved in their screening and treatment should be aware and be prepared to take extra time while examining a person with dementia.