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Luton Community Matron Specialist Dementia Care Service

Contact us

You can contact our service Monday to Friday, 8am to 6pm.

Welcome to our service

The Luton Community Matron Specialist Dementia Care Service is provided by a community matron specialising in dementia care. This service is not provided by an admiral nurse.

People living with dementia (PLWD) experience palliative care needs as their dementia progresses and will require both palliative and end of life care.

Our team focuses on:

  • post diagnosis support for PLWD and their families or carers
  • planning for future care
  • palliative and end of life care

We provide:

  • home visits for first contacts, brief interventions and reviews
  • healthy lifestyle and health promotion
  • telephone advice and signposting
  • multi-agency referrals as appropriate
  • person-centred (hospital admission avoidance) care planning
  • advanced care planning including preferences, decisions, advance directives and statements etc.
  • education of professionals involved in caring for people living with dementia and their family members or carers
  • a single named professional who is responsible for coordinating care for people living with dementia

Our goals are to:

  • provide comprehensive and holistic nursing, physical, psychological and social assessments
  • support PLWD, their families and their carers
  • identify carers needs.
  • advise and support in the management of dementia including mood, behavioural and psychological symptoms of dementia (BPSD)
  • undertake medication reviews: anti-dementia, antipsychotic (neuroleptics), antidepressants, anxiolytics and hypnotics
  • promote person-centred care
  • coordinate care between services
  • plan care including hospital admission avoidance and advance care planning

A period of intensive case management includes:

  • holistic nursing assessment including communication, cognitive function, behaviour or mood, level of function with activities of daily living (ADLs): eating and drinking; toileting and continence, transferring/moving/walking, nutrition, hydration and weight management
  • identification of carers needs
  • coordinated care and support between services
  • brief interventions
  • advance care and support planning
  • person centred care
  • hospital admission avoidance care planning with a ‘personalised element’
  • personal care and support planning including 'anticipatory' and 'personalised' elements

Dementia UK Admiral Nurse Service

We host a Dementia UK Admiral Nurse Service who help families face dementia and offer post-diagnosis advice. They support people living with dementia, their carers and their families with complex needs. This includes planning for future, palliative or end-of-life care.

Dementia UK Admiral Nurse Service
Dementia UK logo

Referral

We accept referrals from:

  • GPs
  • Memory Assessment Service (MAS)
  • dementia nurse specialists at the Luton and Dunstable Hospital
  • community nurses
  • social services
  • other healthcare professionals

To refer into the service, call 0333 405 3000 or email CCS-TR.LutonRMSreferrals@nhs.net

Eligibility

To be eligible for our service you must meet the following criteria:

  • Adults 18 years old and over registered with a Luton GP.
  • Diagnosed with dementia and living in the community.
  • Have a cognitive impairment and no formal diagnosis of dementia living in residential care homes.
  • Have a cognitive impairment and no formal diagnosis of dementia under the care of the District Nursing Team.

Self referral

We do not accept self-referrals.

If you are concerned that someone may be showing the signs of dementia but are currently undiagnosed should be referred to their GP for dementia screening. The dementia screening will include:

  • collateral story from the patient, next of kin and carers
  • a blood test
  • pee samples (urine dipstick and mid-stream specimen of urine (MSU))

This is to exclude a reversible condition.

A referral can made for a formal assessment and diagnosis to the East London NHS Foundation Trust (ELFT) Older People’s Community Mental Health Team Memory Assessment Service elft.referrals.lops@nhs.net

Helpful contacts

Bedfordshire and Luton Alzheimer's Society telephone number - 01582 470910

Bedfordshire and Luton Alzheimer's Society email address - bedfordshireandluton@alzheimers.org.uk 

Samaritans telephone number - 116 123

Samaritans email address - jo@samaritans.org

Age UK telephone number - 0800 169 2081

Mind telephone number - 0300 123 3393

Mind text number - 86463

Mind email address - info@mind.org.uk 

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