SCOTS with dementia could be missed in the Covid vaccination rollout if there is no provision for home visits or additional support put in place to ensure parity of access, campaigners have warned.
Alzheimer Scotland said there would be non-compliance because it was “totally impractical” in some cases to expect patients to get a letter or phone call and turn up for appointments.
The charity said this was a particular risk for those living alone who may be cut off from their usual support network due to lockdown restrictions, while carers might also require assistance.
Jim Pearson, Alzheimer Scotland’s director of policy and research, said there was a need for a personalised approach for those with complex healthcare needs that included practical support to attend appointments and home vaccinations where required.
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The Scottish Government said the ability to transport the Oxford-AstraZeneca vaccine made home visits “feasibly possible”, adding it was included in the guidance to health boards.
The Alzheimer Society, which supports people in England with dementia, said it had raised concerns with clinical networks about elderly people missing NHS messages or not phoning to book an appointment after they had received letters.
An estimated 90,000 Scots have dementia, with most living at home, while about one-third are in care homes.
Official figures show deaths from diabetes, dementia and Alzheimer’s disease were about a quarter higher last year than the five-year average, while there is some evidence that the number of women dying with dementia at home has risen by as much as 75 perr cent.
There is growing evidence that patients have experienced more rapid cognitive decline while diagnosis and community supports have also been reduced.
Dementia campaigners say there is a risk the vaccination programme could add to the toll.
Mr Pearson, Alzheimer Scotland’s director of policy & research, said: “The reality is that there are a lot of people with dementia who live on their own and for whom it is just totally impractical to expect them to get a letter or phone call and comply with an appointment at a vaccination centre.
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“For some of those people, they will be seeing less of the people who would normally be part of their circle of support. That’s been completely disrupted.
“There will be non-compliance just because there will be some people who can’t get themselves to a vaccination centre.
“Our plea to those who are rolling out the vaccine would be, to be mindful that there is a group of people for whom if they don’t get practical support to receive the vaccine they won’t get it.
“For those people we have to do something different and that should include a home visit.
“We spoke to someone who was able to get that relatively easily from their GP practice.
“We want to see that option available for people for whom it is not practical to get to one of the vaccination centres.
“And that understandably might delay some of the roll-out and I think that would need to be understood.”
Mr Pearson said the charity had explored the idea of recruiting ‘vaccine buddies’ and added: “We need a personalised approach for those with more complex needs and people with dementia absolutely fall within that category, particularly given that we know they are one of groups most at risk from the virus.”
The asked every Scottish health board what supports had been put in place for people with dementia to receive the vaccine.
NHS Lanarkshire, Highland, Grampian and Tayside said home visits would be offered to those who are house-bound.
A spokesman for NHS Greater Glasgow and Clyde said: “Individuals living with dementia in the community will be invited by age unless they are clinically extremely vulnerable or clinically at risk.
“If they are housebound, they will be contacted by their GP or Health and Social Care Partnership, and vaccinations will be administered by district nursing teams.”
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Dr Andrew Buist, chairman of the British Medical Association’s Scottish GPs group, said patients with dementia were being vaccinated in a number of different ways depending on their circumstances.
He said: “Those who are mobile will, in the main, come to their GP practice particularly if they are in the 80+ group.
“Community teams and district nurses will vaccinate the majority of dementia patients who are absolutely housebound and unable to attend their GP practice.
“Anyone under the age of 80 will be vaccinated as per the JCVI age groups for priority.”
A Scottish Government spokeswoman said: “National and Local Delivery Plans make vaccination at home available for those who require it, and is covered in the guidance to health boards.
“The ability to transport the Oxford-AstraZeneca vaccine makes this operationally feasible with minimal waste.”
The is supporting a campaign by Alzheimer Scotland to reduce the cost burden faced by people with advanced dementia in care homes.