My Admiral Nurse Journey - Summer 2017

Jakki Whitehead, an experienced care professional, is training to become one of dementia care’s ‘beacons of excellence’ – an Admiral Nurse. This blog follows her journey and thoughts….

In July, the Riversway Dementia Champions completed their training and gave presentations to Donna, Managing Director, Christine, Associate Director of Communications & Development, Jan, Riversway Operations Director, Sarah, Riversway Service Manager and Faye from the Dementia Wellbeing Service. 

It has been an enjoyable process with a huge amount of work and dedication from all involved. From the Dementia Champions who have put so much work into the course, to the managers who have given us time to develop the role and the residents and relatives who have worked with us to make the presentations.  The sessions have covered what dementia is and the different types, linking them with residents within the home.


The Alzheimer’s Society Brain Tour was useful to lay out the basics of ‘How the brain works’ and the presentations of four of the main types of dementia: Alzheimer’s, vascular, Lewy body and frontal temporal dementia.


We have looked at the legal influences and also national targets such as early diagnosis and how different people react differently to the need for this.

In my experience, a family member was adamant that he did not want to know any diagnosis let alone an early one yet I know that it can help with appropriate medication and treatment and assist in planning for the future.

Medication was discussed, as were the differences between dementia, delirium and depression, however from this point I thought that it would be useful to start to look at the importance of balancing the medical understanding of dementia with the psychological and social care pathways in order to help us to achieve the balance between clinical need and an enabling environment.


Christine Bryden’s quotes from her book Dancing with Dementia (2005), were used to help promote the voices and feelings of people with dementia to the Dementia Champions.

She said,  ‘I operate in a different way to you, and need a different type of interaction, which is slower and more meaningful. People want to be busy, to talk fast, to ask for responses, but I can’t cope with that.’

 


 

Tom Kitwood’s Enriched Model of Dementia was used to present the holistic understanding of good dementia care:

Dementia = Neurological Impairment + Health + Personality + Biography + Social Environment

 


We related this to a new resident who had been expressing his needs through his behaviour. It was powerful to see the Dementia Champions relating his behaviour now to his past experiences during the war years and recognising how this understanding would make sense to other carers so that they could accept his behaviour and not judge him for it.

Residents’ behaviour was discussed in terms of ‘Distressed Reactions”. The main premise being trying to understand what the person with dementia is trying to communicate through their behaviour when they have a reduced verbal ability to do so. For example, they don’t like the food so they spit it out!


Person centred care was at the centre of the course. Dawn Booker’s VIPS framework was used where:

V         = value of all human lives regardless

               of age or cognitive ability

I           = the individualised approach,

               recognising uniqueness

P          = the perspective of the resident

S          = the provision of a social environment that supports psychological need


As was the importance of relatives and friends in the journey of someone with dementia looking at relationship centred care, so that the needs of relatives and paid carers are also recognised within the dementia pathway.

There was one session, Meaningful Activity, which had to been postponed until later in September, in this we will link life stories with meaningful activity in everyday life. Marilisa, the activity coordinator and Faye from Dementia Wellbeing Service will present a meaningful activity to the Dementia Champions to help get the message across, I believe it includes having lots of fun, which has to be at the baseline of most activities!

Then we came to the presentations. Each one was different: there were photo albums, scrap books, a diary written to a granddaughter, poems, family trees, posters with photos showing a resident’s life with dance. What underlined all of them was the life story of the person with dementia and how that person and their relatives had been important people in their own rights with love stories, interests and passions.

All of the presentations were intelligent, sensitive and emotional and at one point there was not a dry eye in the room underlining the empathy and compassion which had been much in evidence.


We then gave out the certificates and ate a fabulous ‘graduation cake” baked by one of the new Riversway Dementia Champions.


Jakki Whitehead, Admiral Nurse, Riversway Nursing Home 

 

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