Abstract

Abstract Background In Ireland, approximately 67,744 people live with dementia and 63% reside in Irish communities with increasing care cost estimated at €58,550 per person, which is set to rise alongside increasing longevity (HSE, 2020; Department of Health, DOH 2014). Across the Republic of Ireland, care provision predominantly focuses on middle or later stages of the journey, leaving the newly diagnosed and their care partner as somewhat the invisible. Service provision for post diagnostic dementia services is disjointed, with resource allocation at a low level of provision relative to need, leading to inequity with subsequent disparity resulting in significant geographical variation in the provision of services. Methods Robust interdisciplinary community care pathways developed underpin this ANP Service. The multi-element pathway structure delivers community clinics for Dementia, NCSD and LivDem programmes alongside support networks for family care partners, amongst others. Support and care provision is demonstrated from point of diagnosis and throughout the dementia journey for the patient and family care partners, which is unique in Irish healthcare. ANP service provision through interdisciplinary collaboration has achieved increased QOL outcomes alongside illuminating KPI's and audit outcomes. Capturing dementia services early optimises outcomes for all involved including health service cost reductions, all in one setting. Results Patient satisfaction outcomes range from 71 - 100% with service intervention outcomes favourably indicating the direct impact of the service, which are unmeasurable to the older adult living with dementia, and include increases in: (i) Confidence - 90%; (ii) Mood - 50% and (iii) open to talking through difficulties encountered - 87%. This service contributes to innovations in practice in this complex care area and now achieves 60 attendances each month Conclusion Advanced practice drives collaboration and integration across services delivering on hospital avoidance, early supportive discharge and timely access to services. Facilitating early post diagnostic dementia services optimises interdisciplinary collaboration, crucial to achieve aging in place with timely access to services for all older adults.

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