Minimising long-term effect of COVID-19 in dementia care.

We thank Huali Wang and colleagues for highlighting that dementia is also a pandemic in an ageing society, albeit the word pandemic generates a negative perspective of dementia.

The UK is now dealing with the issues that China has already dealt with. People with dementia in the UK, both those living with families and alone, have lost the invaluable support offered by art, music, and exercise groups. Family carers have lost precious respite opportunities, such as those offered by day centres, because of COVID-19, causing them to feel they are alone and abandoned. The burden of care was increased by the lockdown enforced in March, 2020, with government advice being that all people older than 70 years should self-isolate, denying them the informal support of family and friends. We, along with other professionals, are deeply concerned regarding the effect of COVID-19 on the wellbeing and on the physical and cognitive function of those with dementia. We are also concerned that increased family carer burden and stress will diminish family carers' ability to cope long term, meaning that more people with dementia will enter full-time care prematurely.

COVID-19 has brought death and dying to the forefront, yet dementia is the most common cause of death in men and women older than 80 years. Etkind and colleagues predict that deaths from dementia will increase from around 59 000 per year in 2014 to around 220 000 per year by 2040.

Wang and colleagues reflect that a vital organisational response in their management of COVID-19 for families affected by dementia would provide better support for family carers to help maintain resilience and psychological and mental wellbeing. The UK is arguably in a good position by having existing services to provide such support. Admiral Nurses are specialists in dementia care who use a case management approach to support the whole family unit affected by dementia, from the point of diagnosis to end-of-life care, and provide continued support of family carers in bereavement. It is more important than ever that the commissioners of health and social care for dementia do not break the care trajectory into an ever-increasing fragmented pathway for those affected and adhere to National Institute for Health and Care Excellence guidance to minimise the effect of COVID-19 on one of the most vulnerable groups in our society.