Windows of opportunity: prevention and early intervention in dementia

Transition points

What are transition points?

There are many potential transition points along someone’s journey with dementia. The first point is usually when someone’s cognitive functioning is worrying enough for them to consider seeking help. Research (Chrisp & Thomas, 2009) suggests that the gap between someone beginning to notice problems with their memory and actually mentioning this to someone close to them may be as long as a year.

Transition points occur where there is an intensification of perceived or actual risk to a person’s independence, health or wellbeing, or that of their carers.

A transition point need not be an inexorable shift to a greater level of dependence. It is an opportunity to reassert an individual’s overall independence. It is true that once a person’s needs for support become substantial or critical it is likely to represent increased care costs to them or to the social care community.

If the right kind of support is offered at the right time, shifts to substantial levels of need may be delayed or prevented. This needs to be underpinned by a fundamental person-centred approach that offers individual choice and control.

As well as offering the right support at the right time, it needs to be offered in a way that encourages people to seek help when they need it, and to plan for their future needs.

Where transitions occur in relation to a sudden change in a person’s health or their carer’s situation, perhaps through a fall or through physical illness, this should be regarded as a temporary state of affairs and efforts should focus on helping the person to return to their desired situation as soon as possible.

Questions for transition points