Author Description

Dementia is a term for a range of progressive, terminal organic brain diseases, including Alzheimer's. Some 560,000 people in England are estimated to have dementia, with a steeply rising trend over the coming years. Some 476,000 people are unpaid carers of people with dementia. Direct costs to the NHS and social care are currently at least £3.3 billion a year, but the overall annual economic burden is estimated at £14.3 billion. This report examines what health and social care services are available for people with dementia and their unpaid carers in England and whether they are providing effective and good quality support. Until 2005 the Department of Health attached little priority to dementia, and progress was hampered by a lack of good quality data, by stigma, and by the low level of political and national focus on older people's mental health. The NAO conclude that services are not currently delivering value for money to taxpayers or people with dementia and their families. Whilst health and social care services are spending significantly on dementia, spending is late - too few people are being diagnosed or being diagnosed early enough. Early interventions that are known to be cost-effective, and which would improve quality of life, are not being made widely available. Services in the community, care homes and at the end of life are not delivering consistently or cost-effectively against the objective of supporting people to live independently as long as possible in the place of their choosing. The rapid ageing of the population means costs will rise and services are likely to become increasingly inconsistent and unsustainable without redesign. Recommendations cover: improving diagnosis and early intervention; improving management of services; gearing the system to respond to the major challenges of dementia in the future.