Dementia Rapid Response Teams
The Dementia Rapid Response Teams (DRRT) provide a community-based service that is an alternative to hospital care during times of crisis. There are three separate teams providing a comprehensive service to all areas within Derbyshire.
The primary aim of both DRRTs is to improve the well-being of people with dementia at times of crisis, by delivering rapid assessment and intensive support. In the process, the team aims to reduce the need for admission into specialist dementia hospital beds. Evidence suggests that people with dementia are best supported within their home environment where possible. Admission to hospital can be confusing and have a detrimental effect.
The service is delivered in an individual’s home, wherever that home may be. The team is flexible and highly responsive, providing a same-day response. The service is available Monday to Friday between the hours of 8am - 8pm and also between 9am - 5pm on Saturday and Sunday.
The service starts with a specialist assessment. From there, an individual person-centred plan of care is developed, in collaboration with the service user and their carers. Where home treatment is part of the plan, intensive support will be provided. This can be up to four times a day and for seven days a week. Although the majority of service users receive two intervention calls per day for six weeks, this is very much led by the individual's needs.
The assessments, interventions and treatments offered by the team are informed by evidence-based best practice (from research and guidance including that provided by the National Institute for Clinical Excellence – NICE).
Individuals requiring the service will be experiencing a breakdown to the point of crisis as a result of their having dementia, or suspected dementia. Other community services will be unable to support them safely at home and hospital admission is a likely pathway for their care.
Others who will benefit from the service include individuals who are in hospital but who could be discharged sooner with a short period of intensive support. The team will help to ensure a rapid discharge back home.
Specific interventions, or actions, the team may offer include:
- Focusing on the immediate crisis, identifying the source and treating it – for example through behavior mapping, psychotherapeutic intervention and medication review
- Identifying and intervening to meet an individual's needs in challenging situations – for example by ensuring daily activities are maintained
- Building on the steps above to enable carers to meet these needs through modelling (learning through observation and imitation), support and education
- Collaborating to develop a care plan including the use of advance statements (written statements setting down an individual's preferences, wishes, beliefs and values regarding their future care)
- Working with caring relationships to build resilience – such as through cognitive reframing (looking at your thoughts from a different point of view)
- Offering education, advice and support to enable resilience and reablement
- Exploring factors which might cause stress and ways to prevent and manage relapse
- Encouraging individuals to develop a range of coping strategies and ways to keep safe
- Enabling individuals and carers to access other support services which may be of help.
The team is a key part of the dementia care pathway, working closely with community mental health teams (the triage and access point), and in an integrated way with key partners – including adult social care, integrated care services, GPs and primary care, and the voluntary sector.
The team also has a strong role in enabling people who are admitted to hospital to return home as soon as possible, to reduce the impact of negative outcomes that can result from being in hospital. Consequently the team works closely with inpatient services.
Referrals into the service are through the community mental health teams and old age consultant psychiatrists. The service is for people with a diagnosis of dementia or symptoms consistent with a diagnosis of dementia.
If you are concerned about someone with dementia, please speak to your GP. Your GP will then be able to contact the relevant neighbourhood mental health team, where the duty triage system will determine the best pathway of care for an individual.