Dementia care for social care self-funders now and in the future::Insights from the DETERMIND study

With the UK population of people with dementia predicted to increase to almost 2 million by 2030 the question of how we meet the needs of people with dementia and their carers, now and in the future, has never been more pertinent. A significant (and growing) proportion of homecare hours and care home places are paid for by self-funders. The evidence base about the experiences of self-funders is increasing but little is known about the outcomes for this group, and even less about self-funders with dementia. In England, care policy has been driven by a desire to increase choice and control for people in receipt of council-funded support, underpinned by an assumption that self-funders have more options available to them. But self-funders can feel disadvantaged within the social care system, often reporting care arrangements arrived at by chance rather than through active choice. DETERMIND (https://determind.org.uk/) is a longitudinal study exploring inequalities in dementia care, costs and outcomes. Data are being collected from 900 people with dementia and their carers from shortly after diagnosis for up to 3 years. In this presentation we report early insights from Workstream 4 focussing on experiences of, and outcomes for, self-funders. This is a mixed methods workstream combining analysis from in-depth interviews of a sub-sample of people with dementia and their carers, with quantitative data from the full cohort. Early themes include choice and control, access to care coordination and the role of social capital.