Dementia Acute Deterioration Pathway

Author: Dr Sarah Jones, Dementia Clinical Lead & GP , Norwood Medical Centre / SY ICB

Date Published: February 2024

Date to Review: January 2027

Sheffield Dementia Acute Deterioration Pathway

The pathway:

o Clarifies (within existing commissioned and available services) what the best practice is for clinicians and emergency services when attending a dementia patient experiencing an acute deterioration in behavioural presentation (due to delirium or something affecting their dementia).

o Helps to improve the quality of care for dementia patients and reduce unnecessary hospital admissions. For example:

• Supporting patients to continue to be cared for in their usual place of residence where clinically appropriate (e.g. where the GP/OOH GP can – potentially following mental health team or palliative team advice - enable management at usual place of residence; including clinically appropriate use of sedation to allow for safe treatment and assessment).

• Clarity regarding what to do if it is determined that the patient needs to be moved to hospital (including respective YAS/SYP roles)

Further information:

The Sheffield Dementia Acute Deterioration Pathway has been developed and agreed (during 2022/23) by a task and finish group of the cross-organisational Sheffield Dementia Strategy Implementation Group (crisis workstream). 

This was in response to feedback (from GPs, GP Out of Hours service, SHSC older adults mental health services, Yorkshire Ambulance Service, Care Homes and South Yorkshire Police). Feedback was that these difficult to manage dementia acute deterioration incidents are infrequent but when they occur they have a significant negative impact on patient experience and outcomes and may result in an avoidable hospital admission. Some such incidents have also resulted in clinical and care staff being injured due to patients exhibiting insufficiently managed violent behaviour.  This pathway offers guidance to work towards addressing the challenges described above and to support good practice when managing these cases.