May 07, 2018

Australian Journal of Dementia Care Vol 7 No 2 April/May 2018

*These resources and articles are available to members of dementia Australia library NSW - if you would like to reserve them please email the Library on nsw.library@dementia.org.au



Cover Story

How to create a dementia-friendly pharmacy

Amanda Bryce explains how her Perth pharmacy is championing dementia-friendly initiatives and why other community pharmacies – the “hidden heroes of the healthcare system”- should do likewise.
Inspired by a client’s needs, attendance at a three-day course offered by in WA, called Dementia Essentials, and a free online course offered by Dementia Australia, which all their staff were asked to complete, it was impossible not to become a champion of dementia.  The article outlines the steps taken to make their pharmacy dementia-friendly.
Approaches included:
Signage and environment
Actively getting to know clients
Education of staff regarding dementia and dementia-specific medications
Inviting clients to share their Advanced Health Directives
Support for Carers

Going beyond ‘tick the box’ training 

In 2016, Dementia Training Australia (DTA) was charged with delivering a three-year, $28 million national Dementia Training Program to the dementia care workforce. DTA’s Directors explain how the consortium’s training and education activities will reach a minimum of 23000 staff and at least 500 care services over the next two years to improve delivery of care for those living with dementia. The focus is on factors that support health and well-being and opportunities for people with dementia to live a full life.
Education and training will be delivered across four streams
CPD training for GPs, nurses, pharmacists and other specialists via courses and workshops.
Vocation level training  (Dementia Essentials)
Online training
Training tailored to the assessed needs of aged care providers willing to work with DTA, implementing and evaluating outcomes (Tailored Training Packages).

Mind the gap: the key to transforming dementia practice
David Sykes discusses how real transformation in dementia practice requires strong leadership in promoting a learning culture within the workplace.



The Virtual Dementia Experience ™ and the Educational Dementia  Immersive Experience (EDIE)  workshop developed by Dementia Australia- provide learning experiences that are more likely to affect participant’s attitude and behaviours.
Sykes discussed the following steps in transferring   learning specific to dementia care into positive outcomes:
Formal education
Tailored training packages
Inclusion of opportunities to apply the learning within practice
Strong leadership in promoting a learning culture within the workplace
Involvement  of staff, consumers and their families in care, by providers


Simple Ideas making an impact 
 pg15-16
NSW aged care provider Anglican Care has recently introduced two complementary programs – The Lifestyle Resource Van, and the Direct Action Response Team (DART) – both with a focus on people living with a cognitive impairment and their carers. Jane Meldrum and Kylie Jacques explain how the projects work and the positive impact they are having.
The aim of the Lifestyle Resource Van (which contains a diverse range of resources such as iPads, indoor golf sets, large print books, games, DVDs board and floor games, knitting, music and art and craft items) is to maximise use of resources across the Anglican Care organisation. The objective is to assist older people to meet their individual needs such as:
Maintaining cognitive ability
Encouraging memory recall
Improving social interaction with others
Increasing physical activity
Promoting and enhancing sensory experience
Evaluation and benefits of the program are discussed.
The DART program aims to treat each person on an individual basis. DART staff  implement an individual therapy-based strategy including, but are not limited to exercise, music, reminiscence, multi-sensory and pet therapy, and the resources in the Lifestyle Resource Van.
The objective of the program is to improve quality of live for residents and clients, improve communication and expand Anglican Care services.
Meldrum and Jacques discuss these objectives in more detail, how the program works and its positive outcomes.



Looking beyond disease  
Pgs 17 - 19
Dr Allen Power, a physician, is the author of two books, Dementia Beyond Drugs and Dementia Beyond Disease, that have contributed to an understanding of the lived experience of Dementia.  Dr Allen Power challenges the medical model paradigm of dementia care and focuses on a holistic lived experience. He is strong advocate for the Domains of Well-being model, an Eden Alternative  mentor, and advocate for people with dementia. Jason Burton interviewed Allen during his recent visit to Australia to present a series of lectures and workshops for Alzheimer’s WA’s Dementia Friendly Communities Project.

Sharing the PIE pgs 20 -22
Positive Interactive Engagement (PIE) is a structured after-hours activity program developed by AnglicareSA to improve the interaction and engagement for residents  with dementia in the evenings and at weekeneds .

An example of some of the PIE activity programming:

Activity category
Range of activities
Goals
Descriptor
Sensory
3.30 5.00 pm
Cooking basket (includes food brochures and catalogues and coookbooks )
Watching cooking shows
Cupcake making
Sensory towels
To:
Enhance a feeling of well-being
Undertake daily living activities
Stimulate discussion and appetite
A range of sensory activities and visual cues to stimulate the senses before evening meal time
Evening meal – 5 pm



High intensity
5.30 – 7.00 pm
Whiteboard/ board games
Bowling
Bean bag toss/ dice games
Bocce
To promote coordination and physical wellbeing and group participation
Group activities that focus on physical activities and gross motor skills – group connection and interaction
Low intensity
7.00 7.45 pm
Reminiscing box
Fun facts
Beauty/tool bags
suitcase Travel
mystery night
To promote engagement and interaction
Stimulate conversation
Trigger remising
Encouraging discussion and interaction with in a clam environment
Relaxation
7.45 – 8.00pm
Reading
Relaxations
Movies
Wind down to enhance rest
Positive triggers that simulate home evening activities and encourage normal  sleep


The lantern Project : shining a light on food in aged care

Aims to improve mealtimes and dining experiences in response to unacceptably high levels of malnutrition particularly those with dementia .
Points of practice include;
  • Asking people regularly about their food references  - past and present
  • Capitalise on sweet foods
  • We eat with our eyes – visually appealing familiar foods –  not blobs of texturally modified food
  • Sharing meals offers many benefits including positive social interactions and mirroring eating habits
  • Food-first approach are recommended before considering supplements as they may not lead to increase in weight which is a factor in people with dementia
  • Dental care is important
  • Themed menus and can trigger memories – particularly in relation to residents’ cultural background
  • Resident involvement in mealtime activities
  • Tapas menus promote independence  and dignity
  • Focus on dining room ambiance – lighting, music, seating arrangements,
  • Engaging the senses

….p  23 – 27

A Village for all

In 2013 NSW aged care provider Scalabrini was presented with an opportunity to build a new residential aged care facility and were determined to do something extraordinary…prioritising residents’ needs in all aspects of the building and care model all based on evidence – the village in Drummoyne includes key features such as
Social model of care – combining person-centred care with a holistic view of wellbeing.
A core principle at the Village is to preserve normalcy in environmental lifestyle – to reduce stress and anxiety, and to reflect the Italian heritage and to protect dignity and promote choice and independence …
The wellbeing manager has helped to rewrite job descriptions for carers reflecting the determination to put residents before clocks and tasks! Staff are encouraged to use their skills, such as painting and meditation and share them with residents and staff turnover is reduced which is in the best interests of residents…p28-30

End of life care: resources to strengthen support

Report on the study and explain how co-designing new resources could help strengthen support at end of life
Key points : end of life planning discussions are hard to have and practical resources are needed
Existing resources don’t draw on all aspects
A care Plan guide (CPG) prototype was developed …includes timely planning, co-ordinated care, effectively working with primary carer, managing hospitalisation, continuing care after death, valuing staff and ongoing learning….p 31 -34

Agitation related to indoor air temperature

Findings – agitation was found to be related to the number of hours that residents were exposed to temperatures higher than 26 degrees C and lower than 20 degrees C…p 35

No comments: