Windows of opportunity: prevention and early intervention in dementia

The journey: Key stages on the journey

The stages that people may pass through on their journey with dementia can be described in various ways. The Integrated Pathway described in the Dementia Services Guide developed by Healthcare for London is particularly useful and has been adapted here to show four stages:

The Integrated Pathway stages

  • Awareness: “Just one of the population”. This is the stage that most of us will remain in. People are aware that dementia exists. They may know someone with dementia. They may be a carer for someone with dementia.
  • Identification: Assessment, diagnosis and initial intervention. This is the stage where an individual or their carers become aware that they have a problem with memory or other aspects of cognitive function, and seek help. At this stage, diagnosis is made and interventions offered.
  • Living well with dementia. This is the stage where dementia has been diagnosed, and the individual and their carers can be offered a range of interventions to support them to live well with dementia. Living well is the key concept that underpins the whole of the National Dementia Strategy, with a focus on continuing to lead a fulfilling life.
  • End of life. Dementia is a terminal illness, and it is important that people with dementia are given the right support to ensure that their needs are met when they are nearing death, and that their carers are well supported beyond their death.

The experience of the journey through dementia moves from a general awareness that dementia exists, to a personal awareness of having problems and the challenges that these present:

Figure 1: The journey through dementia

There are many windows of opportunity for interventions along the journey. The windows offer different types of intervention that are relevant to the person’s need at that point