At Birch Green, Gill, Sharon, Emma and Sian recently attended four days of level 2 Dementia Care training, two in January and two in March 2018.
The role of the Dementia Champion is to: ‘Reflect and question; to refuse to accept that the person’s dementia is inevitably the reason for every difficulty that they experience.’ (B. Loveday, 2013).
Day 1. Was all about numbers and statistics - the amount of people diagnosed and the present costs, estimated at:
£26.3 billion – NHS- £4.3 bill, Social care- £10.3 bill, families- £11.6 bill. Informal carers save £119 bill/year. This is without ethnic minority numbers being included.
The different types of dementia were discussed and how they present (Alz. Soc website Dementia Brain Tour). This training is based on the bio-psycho-social model so we looked at the importance of a proper diagnosis and the reasons for ruling out any physical problems. Such as determining the difference between delirium, dementia and depression. The place of pain and medications. Then looked at current legislation: Care Act, MCA, DoLs, National Dementia Strategy and the Prime Ministers Challenge.
Good News was discussed:
- Coffee in older women can have benefits
- Brain training can halve the risk
- Learning something new: a language, instrument or a sport
- Nutrition and good health maintenance are key in prevention
Day 2. We looked at acknowledging complex care within dementia care and useful strategies.
The importance of Carers’ input and the roles of such groups as Dementia Action Alliance ‘Nothing About Us Without Us.’ and Tide.
Of course, Christine Bryden had a mention:
‘How you relate to us has a big impact on the course of the disease. You can restore our personhood, and give us a sense of being needed and valued. There is a Zulu saying that is very true. “A person is a person through others.” Give us reassurance, hugs, support, a meaning in life. Value us for what we can still do and be, and make sure we retain social networks. It is very hard for us to be who we once were, so let us be who we are now and realise the effort we are making to function.’
We started to develop the psycho social element more according to Tom Kitwood and the Enriched Model of Dementia where Dementia= Neurological Impairment+ Health+ Personality+ Biography+ Social Environment. We have used this throughout the course for case discussions.
The next session, Day 3 was all about communication and Kitwood’s 5 great needs of Inclusion, Comfort, Occupation, Identity and Attachment. How these relate to good care and poor care and how to recognise it. This obviously then moves us on to the ‘Distressed Reaction.’ The more appropriate term for the old ‘challenging behaviour.’
What is the person is trying to communicate through their behaviour?
Why might people with dementia act in a way that shows distressed behaviours?
To Lie or Not to Lie was a heading of one discussion, this ties in with the recent Mental Health Foundation paper ‘What is Truth?’
Good communication skills were highlighted as being of vital importance to providing good dementia care for residents and their families as well as recognition of good communication strategies in the end of life stages of dementia care.
We recognised the importance of staff and family as well as residents in person-centred and relationship-centred care. We looked at Brooker’s VIPS framework and Nolan’s Senses framework of security, continuity, belonging, purpose, achievement and significance being equally important to people with dementia, relatives and paid carers. We spent time looking at ways to support couples including sexuality and intimacy needs.
Day 4. Was all about Meaningful Activity. Together with life history and the importance of maintaining physical activity.
The importance of life history was illustrated in the presentations which followed and was linked with the This Is Me. We spoke of Meaningful Activity and then Gill facilitated a session reading emotive dementia poetry and exploring the importance of smells in reminiscence work.
As you can see this has been an intense training programme. Emma, Sharon, Gill and Sian have been very involved; never flagging and working hard. Doing even more homework than given! They obviously know and already work in a person-centred fashion. The theoretical framework now given should help to support this. Their job is to cascade the learning throughout the service through modelling and, of course, good communication.
After this we had four excellent presentations of resident and their relatives’ life stories and we'd like to thank Donna, Christine, Virginia, Vicky and Bernadette for coming to the project presentation.
There were some exceptionally emotional accounts which showed just how much empathy and compassion there is in the care at Birch Green.
I then presented certificates to four very deserving new Springhill Dementia Champions.
By Jakki Whitehead, Admiral Nurse, Riversway Nursing Home