‘Trainee paramedics must learn about dementia,’ says leading expert.

Trainee paramedics at the University of Bradford taking part in a unique dementia course have reported feeling more knowledgeable and confident in assessing people with dementia.  

Currently, there is no compulsory requirement for undergraduates to study dementia, but Dr Danielle Jones,  Associate Professor in Dementia Studies at the University of Bradford, believes dementia education should be an essential part of the paramedic curriculum.  

Dr Jones said: “Dementia is one of the leading causes of death and disability in the UK and people with dementia often have complex needs meaning they are more likely to require emergency healthcare.  

“Unlike other conditions, like cancer or heart problems, dementia is a cognitive condition which affects how a person communicates and behaves, posing additional considerations for paramedics needing to assess them. We want to see every paramedic student leaving Bradford with the knowledge and skills they need to be able to competently care for people with dementia." 

Around 900,000 people in the UK have dementia, according to latest figures. More than three quarters of people living with dementia - 77 per cent - have one or more illnesses (comorbidities). These commonly include strokes and diabetes, as well as being more likely to be frail and suffer falls.  

Alzheimer’s Society figures show there were 279,265 emergency admissions for people with dementia in England in 2012-2013. This rose by 35 per cent to 379,004 emergency admissions in 2017-2018. 

Dr Jones said: “When an ambulance is called for someone with dementia, research shows they are then more likely to be transferred to hospital, stay in hospital longer, have poorer health outcomes and they are more likely to die in hospital than other patients. 

“A paramedic needs to know how to communicate with someone who has dementia to ensure they receive high-quality, dignified care. Research suggests that paramedics often transfer a patient with dementia to hospital because they don’t know what else to do with them, even though that patient might not need hospital care. 

“I think dementia education should be prioritised in the curriculum for all allied health professionals, not just paramedics, but occupational therapists, physiotherapists and so on.” 

The University of Bradford’s Centre for Applied Dementia Studies is recognised for its outstanding research on dementia as well as providing education and training to improve the perception and treatment of those with the condition. It works closely with people with dementia, who contribute as ‘Experts by Experience.’  

Dr Jones devised a six-hour dementia education course for first year BSc Paramedic Science students, which included some of those experts talking about their conditions as well as case studies based on real-life experiences of how people with dementia found being treated by paramedics. 

Dr Jones said: “We found really mixed experiences: some people had a good experience, while others felt they weren’t listened to or the paramedic only talked to their carer, which is a  particularly common complaint amongst care home residents with dementia.”  

• Prior to the education session, only around a quarter of students - 26.8 per cent - said they felt prepared to care for people living with dementia. Following the course, this rose to 81.3 per cent. 
• Following the course, all students felt their knowledge of dementia had improved and 87.5 per cent reported their confidence and attitudes towards dementia also improved. 
• Before the session, 36.5 per cent of students reported feeling frustrated due to their lack of knowledge in how to care for a person with dementia. This dropped to just 6.25 per cent - two students - after the session. 
• Almost 96 per cent of students felt the dementia education received would improve their practice as a paramedic.  

Students who took part in the training gave the following comments:  

• "The education was well delivered, informative and engaging." 

• "If anything, I would say even more time on it would have been better as dementia patients can, some weeks, be in the vast majority of patients attended." 

The Dementia Training Standards Framework was commissioned and funded by the Department of Health and developed in collaboration by Skills for Health, Health Education England  (HEE) and Skills for Care, and sets targets for every healthcare professional working with someone with dementia to complete Tier 2 level Dementia Education.   

But Dr Jones said: “When you’re working in practice, it’s hard to fit in extra training. You have to get time off which might be difficult, teams are understaffed and existing staff are burnt out. We should be ensuring the workforce is better prepared to care for people with dementia before they start working in practice. 

She added that providing such training would help both patient and paramedic, saying: “People with dementia aren’t inherently aggressive but they may become frustrated if they feel their needs are not met.  

“If a paramedic understands how to meet the needs of a person with dementia and can communicate with them effectively, they will be more likely to be able to provide effective care at home, promoting better health outcomes and a better experience for people with dementia. 

"In six hours, we can not cover every aspect of dementia education. This initial training forms a good basis but ideally, the students need more dementia education, using more ‘hands on’ teaching approaches, going forward to ensure they are fully prepared for the work they will do." 

Joe Frankland, Paramedic lecturer at the University of Bradford, said: "Paramedics are under increasing pressure to manage patients with comorbidities, including people living with dementia. This is a growing public health issue and the level of education required to be competent in this area has been moved towards asynchronous modules. However, there is no quantifiable evidence how patient outcomes are being impacted.  

"In my opinion, there is a pressing need to focus education on urgent care and underrepresented groups in society. As a result, I believe that we need to ensure paramedics receive adequate training and resources to handle these complex cases effectively."