There are only 200 Admiral nurses in the UK, and some counties have none at all. That is a stark fact.
Admiral nurses, trained and supported by the charity Dementia UK, can make a real difference to families struggling to care for loved ones with dementia. New research shows that they not only improve the lives of those with the condition and their families, they also save cash-strapped NHS and local authorities money because they reduce the numbers going into care homes and hospitals, as well as cutting referrals to GPs. So why aren’t there more?
Kate and Jon Henderson, whose mother, Sally, has dementia, have seen the benefits of an Admiral nurse at first hand. They have devoted the past 10 years to looking after their mother, and until February this year they shared a bungalow in Rottingdean, near Brighton, with her. They were managing to cope: just.
But Sally’s condition began to worsen: she developed balance problems, and needed a wheelchair. Her speech deteriorated so much that the only way that Kate and Jon could understand her needs was to read her body language. They installed a wet room, a disabled access door and a hospital bed with rails.
But last year, constant urinary tract infections had left their mother even more confused and a bad cold had led to acute illness because Sally could not clear her throat. Kate was so worried she took to sleeping on an air bed in her mother’s room.
“We were running on empty,” says Kate, 36. “We didn’t have a life and we got to the point where we thought, we can’t do this alone – we need help.”
Which was where Admiral nurse Helen McBryer came in. Referred to them by Lucy Frost, the dementia lead at Sussex Community NHS Trust, she has proved to be a lifeline. She helped them secure state funding so that their mother could stay at home, and provided much-needed emotional and practical support. And when they decided that it would be best for Sally to move into a care home, Helen helped them to find one.
“I don’t think we would have got to this place without Helen,” says Jon, 41. “She is our rock.”
The practical and emotional benefits for the Hendersons are clear to see: and where Clinical Commissioning Groups (CCG’s) employ Admiral nurses, the cost benefits appear to stack up, too. The London Borough of Sutton CCG, for example, estimate that hiring one Admiral nurse saved them £296,466, through avoiding or delaying care home, nursing home and acute hospital admissions. Other CCG’s report similar cost savings.
Alistair Burns, NHS England’s national clinical director for dementia, describes Admiral nurses as invaluable. “They may delay, or even avoid, hospital and care home admissions for people with the condition,” he says.
Given this, and the fact that cases of dementia and Alzheimers have been rising so rapidly that they are now the leading cause of death for both sexes amongst women 80 and over and men 85+, placing the NHS and social care services under ever-increasing strain, why aren’t Admiral nurses being used more extensively throughout the UK?
The problem may be funding, as it so often is. CCG’s are cash-strapped, and are reluctant to spend £40,000 to £50,000 per Admiral nurse, regardless of the financial benefits.
Hilda Hayo, chief Admiral nurse and Dementia UK’s chief executive, said, “The CCGs’ response is that we have an ever-shrinking pot of money allocated and the local community’s needs have to be prioritised.”