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‘Essential’ service for dementia patients becomes permanent part of hospital team

A nursing team which provides ‘invaluable support’ for people living with dementia and their loved ones is now a permanent fixture at hospitals in Northumberland and North Tyneside.

Northumbria Healthcare NHS Foundation Trust introduced a team of acute Admiral nurses to work in its hospitals in 2023. Due to the impact the service has had for patients, carers, and staff, the service will now be delivered on an ongoing basis.

Admiral nurses use specialist knowledge to provide emotional and practical support to people living with dementia, their family and their carers. The term comes from the family of Joseph Levy, who founded the national charity Dementia UK. He was known as ‘Admiral Joe’ because of his love of sailing.

Within Northumbria’s hospitals, their role is to provide and offer skilled support, education and advice to staff teams, families, carers and people living with dementia. The team focuses on patients with complex needs. They work with others to coordinate care and advise health and care professionals on best practice in dementia care.

Northumbria Healthcare’s lead Admiral nurse, Judy Mattison, said: “I think fundamentally our role is to inform and support staff to deliver better dementia care. I see it as just making sure that people are aware of what dementia can look like, what that experience might be like for patients and carers, and to look for things to make things a little bit easier.

“We’re advocates for the individuals, for the people living with dementia and their carers, but also, we advocate for the staff to try to make their job a little bit easier to help deliver more seamless care. To make sure that it's a high standard and better quality, and people have a better experience when they're in hospital.”

There are an estimated 8,000 people over the age of 65 living with dementia in Northumberland and North Tyneside.

Neil Wilkinson, whose father Raymond had dementia, said he ‘wholeheartedly recommended’ and urged others to use the Admiral nursing service.

“They facilitate everything, they manage everything, they listen to you personally and take on board your every feasible emotion and they fight your corner,” he said. “They take the mumbo-jumbo out of things, they take the bureaucracy out of things, and they deliver it in a way that is specific to you, so you can make a decision based on what they advise. The most important thing is they have your best interest at heart.”

His mother, Raymond’s wife Shirley, added: “She had to communicate with all the different agencies who were all fighting their own corner with their own priorities, but her priority was us.”

Patricia Sprangle’s husband was diagnosed with vascular dementia and Alzheimer's disease in the spring of 2019, which ‘came completely out of the blue’.

“The support I have received from the team at Cramlington has been invaluable,” she said. “I found this support, even beyond the time my husband was an inpatient and transferred to a care home, was so positive.

“The loss of that support to myself, as I still provide care for my husband in the care home and navigate the living bereavement of being the partner of a dementia sufferer, is significant.”

One of the notable aspects of how the acute Admiral nurses work is their care wraps around the hospital admission to support the patient and their loved ones after discharge for up to 6 weeks. This includes transitions into new care placements, adjusting to being back at home, planning for the future as well as end-of-life support.

June Wilson’s husband Robert was cared for by an acute Admiral nurse following an admission to hospital in late 2022. She described how this extended to attending meetings with social services to support Robert’s transfer to a care home, the application for Continuing Healthcare funding, and continued help and support when he was on the palliative care unit and after his death.

“I can only say that my experience with our Admiral nurse was completely positive, and I don’t know how I would have coped without her help, support, guidance and total professionalism,” she added.

Case studies

Patricia Sprangle

I first came across the Admiral nurses service in 2019 when I approached the British Legion for help and advice. My husband, a veteran of the Royal Navy, has been diagnosed with vascular dementia and Alzheimer's disease in the spring of 2019. It was a diagnosis which came completely out of the blue. I actually realised during our honeymoon at Christmas 2018 that my husband was showing signs of dementia. I had only known him since 2016.

From 2019, as my husband's full-time carer, I had regular telephone contact with the Admiral nurses service via the British Legion. I had never had face-to-face support until I moved to Northumberland and my husband was an inpatient at Cramlington hospital and then in Wansbeck hospital. The support I have received from the team at Cramlington, in particular from Taylor, has been invaluable. I found this support, even beyond the time my husband was an inpatient and transferred to a care home, was so positive.

The loss of that support to myself as I still provide care for my husband in the care home and navigate the living bereavement of being the partner of a dementia sufferer, is significant. I am constantly my husband's advocate in trying to achieve the very best care and quality of life for him. However, I feel that I, myself, need an independent advocate. At times, I am tired, anxious, alone, lonely, fearful of the unknown future - this is why I would welcome Admiral nurse support to be available other than as a hospital-based service.

I believe that, in general, there is so much obvious ignorance and avoidance of addressing the needs of dementia sufferers and their carers. There has got to be more awareness, funding, education and training.

June Wilson

When my husband Robert was admitted to hospital in October 2022, I accidentally met Admiral nurse Kim and her colleague on the ward. I saw they had Dementia UK bags, so approached them to ask about finding an Admiral nurse. They were in the process of setting up the Admiral nurse initiative, funded by Dementia UK, on the wards at the Wansbeck. I think I took them both by surprise, but following this meeting the nurse I met became our Admiral nurse.

I explained to her how hard it was to get any information on Robert’s condition/treatment etc, from nursing staff, doctors and physiotherapists, despite numerous requests. Kim then stepped in arranged for me to have meetings, on a regular basis, and sat in on the meetings with me.

One of the hardest meetings I had to face was the discharge planning meeting, to discuss the way forward, following their decision that Robert’s needs were so complex that he now needed 24-hour nursing care. They felt that I would no longer be able to care for him at home, as I had done since he was first diagnosed with Parkinson’s and a few months later with Lewy body dementia in 2017.

Before the meeting, Kim and I met up and she explained the format of the meeting, and sat with me throughout the meeting, to support me in making one of the hardest decisions I have ever had to make.

I then had to start looking at care homes, providing 24-hour nursing care, again Kim was on hand to offer advice and guidance, and suggesting the right questions to ask when visiting prospective homes. Once I had managed to find a suitable home, I asked Kim to accompany me to ensure it would be suitable to meet Robert’s complex needs.

After he was transferred to the care home, Kim was still there to visit and help sort out any teething issues with the home, also helping me with the Continuing Healthcare funding assessment, by attending meetings with social services and supporting us through it all.

A few weeks later Robert was admitted to hospital again, and Kim contacted me, arranging open visiting for me, as part of ‘John’s campaign’, which the Admiral nurses were in the process of implementing across the wards at the Northumbria hospital.

Robert’s condition deteriorated and the doctors looking after him asked to see me to discuss the way forward. I was due to meet with Kim that afternoon, and contacted her to ask if she could attend the meeting with me, she came in early to be there for me.

At the meeting, the decision had already been made to put Robert on end-of-life care, as he was having swallowing difficulties. He was then transferred to the palliative care ward at North Tyneside General Hospital, the staff offered to put a bed in his room to enable me to stay with him.

Kim suggested contacting Robert’s brothers to arrange for them to come in and say their goodbyes, and offered to contact them on my behalf, for which I was very grateful.

During our time on the palliative care unit, Kim kept in contact with me and the ward staff for updates on Robert’s condition daily and visited us most days (when her workload would allow). She even came in on the Saturday, and was with us when he died.

Following Robert’s death, Kim came to visit me at home, offering her support and making phone calls, notifying social services and the care home, and arranging for both Kim and I to go and clear out his room, a task that I really wasn’t looking forward to doing, but having Kim with me helped me get through it.

I can only say that my experience with Kim was completely positive, and I don’t know how I would have coped without her help, support, guidance and total professionalism.

Media contact

Ben O’Connell, external communications manager, Northumbria Healthcare

Benjamin.O'Connell@northumbria-healthcare.nhs.uk or 07833 046680.