Dementia & Alzheimer’s Care
Dementia is an umbrella term used to describe a range of progressive conditions affecting the brain. There are many different types of dementia, with Alzheimer’s disease being the most common, and some people may have a combination of types of dementia. Dementia is associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities.
The Alzheimer’s Society estimates that there are currently 850,000 people living with dementia in the UK. This is predicted to rise to over 1 million by 2025, with one person receiving a diagnosis every three minutes. 1 in every 14 of the population aged 65 or over is living with dementia (www.alzheimers.org.uk).
At Avery, we aim to continuously meet and exceed the expectations of our residents, their families, visiting professionals and our regulators and in order to do this, we must have a clear and consistent approach to delivering modern dementia care services. We recognise that a person living with dementia can become quickly disconnected from everything that was once familiar without skilled and individualised care. We have therefore named our new comprehensive dementia strategy “ReConnect”.
Avery’s organisation-wide ReConnect programme has been developed using the most up-to-date evidence base and already incorporates much of the guidance that is contained in the updated NICE Dementia Quality standards published recently (28th June 2019).
The Avery Healthcare ReConnect strategy includes a new logo, care model, and manual containing information and guidance for all staff on delivering high-quality evidence-based dementia care in practice. There are also associated training programmes, support for implementation and a bespoke audit tool to measure and evaluate progress.
The logo has been designed to represent how each person is made up of many different elements that interlink and join together to create a whole person. Care must address and reflect each part of a unique individual if it is to be truly person-centred.
The ReConnect Care Model highlights the stages of care which a resident may go through commencing with the process of choosing a care home and moving in. The Avery focus is always on maintaining as much of the person’s normal life, preferences, choices and routines as possible, based on their life story.
The five key elements to support excellent care are: building relationships; supporting families; having skilled staff teams; ensuring evidence-based care and measuring outcomes which fit together to ensure that ReConnect is a comprehensive and effective programme.
1. Building Relationships
Relationships are a key factor in the delivery of high-quality, person-centred dementia care. ReConnect focuses on all staff being able to develop trusting and supportive relationships with residents and their families, as well as with members of the wider Dementia Care Team.
2. Supporting Families
Family relationships remain vitally important and staff must work closely with loved ones who know the resident best. ReConnect ensures that families and friends receive clear information and compassionate support, when and how they need it and as often as required.
3. Skilled Staff Teams
ReConnect ensures that staff working within our homes have the right level of dementia knowledge and training to support residents and their families. The new ReConnect training pathway has been specifically developed with a range of learning approaches for staff teams, including bespoke training materials and a collaborative partnership with Leeds Beckett University.
A resident with cognitive difficulties is inevitably at risk of increased anxiety and distress as they try to make sense of a world that is becoming progressively unclear.
By understanding the previous life story of a resident, we are able to support a resident to continue to engage with familiar routines and preferences rather than working against them. Our Avery Reaction Support Tool has been designed to replace outdated ‘ABC’ charts, to support staff to understand the actions and reactions that may be displayed when a resident is experiencing distress.
All of our staff receive basic dementia awareness training when they join and many undertake additional training in supporting residents who may experience emotional distress. This ensures that wherever possible we avoid the use of powerful mood and behaviour altering medication.
4. Evidence-based care
The ReConnect Programme reflects the most contemporary and robust dementia research and best practice guidance available to ensure that residents are supported to live well and maintain the highest quality of life possible.
5. Measuring Outcomes
A tailored audit system has been developed which complements our existing quality assurance systems. This enables us to monitor and evaluate the effectiveness of the ReConnect Programme in supporting true person-centred and high-quality care. Some principle elements of ReConnect have already been introduced, including Life Story Work and Personalised Musical Playlists.
Life Story Work
Life Story Work is a central part of our ReConnect strategy. It is often used in memory care settings as a useful way of helping others to understand more about a person. Knowing something of the life story of a resident can help members of the team to engage with an individual in a meaningful and interesting way. Understanding the previous interests, hobbies and routines of a resident helps our teams to maintain opportunities for positive engagement.
By understanding the difficulties that an individual with increasing cognitive impairment may experience, our teams can adapt activities to be failure-free reducing the risk of distress to a resident. Examples of activities in our homes; music including Choirs, Playlist for Life and Music Clubs; regular outdoor trips; memory boxes and life story boards to support individual and small group reminiscence.
Life Story Work can also help the care team and family members to make sense of the way a person acts and reacts in situations, allowing the right level of support to be given. The care team can provide more detailed information on how life story work is used and how it helps with planning care for a person with dementia, as well as helping others to connect with the person.
Life story picture boards combine pictures or photographs of places or items that, for whatever reason, may be significant to the person with an explanation of the memories that are attached to these images. It is generally advisable not to include photographs of people in the picture frame, as due to memory difficulties a person can sometimes be unable to recall names which can be distressing. It is often more beneficial if images of places (for example familiar holiday destinations or recognisable workplaces) or significant items associated with hobbies (for example gardening equipment or dance shoes) are used so that care staff can engage the person in more general conversations.