#DementiaAwareness week in #Scotland #Thankyou

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90,000 people in Scotland are living with dementia

A dementia diagnosis changes the lives of not only a person with dementia, but also their family and friends.  Dementia Awareness Week 2018 focused on making sure nobody faces dementia alone. Allied health professionals (AHP) supported the week, spreading the word about dementia, letting people know about dementia, sharing who allied health professionals are & how we CAN help. This week’s blog is a brief overview of our week & an opportunity to say thank you for all your support.

1. A blog a day at alzscot.org/talking_dementia

During the week we posted 7 blog posts every morning at 7am. Here’s the opportunity to have another look at the blogs.

Monday 4th June – Dietitians CAN help with prevention  https://letstalkaboutdementia.wordpress.com/2018/06/04/dietitians-can-help-with-prevention/#respond

Tuesday 5th June – Use of twitter to connect to people living with dementia and their families #DementiaAwareness @AHPDementia https://letstalkaboutdementia.wordpress.com/2018/06/05/use-of-twitter-to-connect-to-people-living-with-dementia-and-their-families-dementiaawareness-ahpdementia/#respond

Wednesday 6th June – How CAN a physiotherapist help you to live with dementia? https://letstalkaboutdementia.wordpress.com/2018/06/06/how-can-a-physiotherapist-help-you-to-live-with-dementia-dementiaawareness/#respond

Thursday 7th June – Getting to Know Me: Supporting a Culture of Person-Centred Care

https://letstalkaboutdementia.wordpress.com/2018/06/07/getting-to-know-me-supporting-a-culture-of-person-centred-care/comment-page-1/#comment-1911

Friday 8th June – With podiatry you CAN

https://letstalkaboutdementia.wordpress.com/2018/06/08/with-podiatry-you-can-dementiaawareness/#respond

Saturday 9th June –  How CAN music therapy impact the hospital environment for people living with dementia?

https://letstalkaboutdementia.wordpress.com/2018/06/09/how-can-music-therapy-impact-the-hospital-environment-for-people-living-with-dementia-dementiaawareness/#respond

Sunday 10th June – Communication – what makes it work?

https://letstalkaboutdementia.wordpress.com/2018/06/10/communication-what-makes-it-work-dementiaawareness/#respond

2. A tweet a day @AHPDementia

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We continued to share our work daily at @AHPDementia where Allied Health Professionals in Scotland are raising awareness about dementia & how they CAN help, sharing practical hints & tips. Retweet, like or comment #AHPConnectingPeople 

3. Hosting an AHP Blether in the community, hospitals & @Alzscot annual conference

During the week allied health professionals, working in partnership, had conversations in shopping centres, hospitals, and at the Alzheimer Scotland annual conference, speaking to people living with dementia, family carers and health and social care practitioners.

It was inspiring to hear about all the times we get it right for people living with dementia and their families. However, we were also hearing stories of where we have still got a lot to do, to share who the allied health professionals are, how you CAN refer to allied health professionals and what we CAN do to assist people to remain active and independent in their local communities.

During the week, we captured some of our blethers on camera, and here is a small selection of photos taken during the week.

Thank you for contributing to #DementiaAwareness week #Scotland and keep following #AHPConnectingPeople to follow the work we are doing in Scotland to transform our contribution to dementia in Scotland.

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Communication – what makes it work? #DementiaAwareness

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I sent an email to colleagues yesterday that read ‘The seminar room is booked for our meeting in October’.  Now, did I mean that I’d made the booking or that someone else had booked it before me and the room was no longer available?  On re-reading, I realised the potential for communication breakdown and repaired the email to ‘I’ve booked the seminar room for our meeting in October’.  A simple change.

As speech and language therapists we deal with the minutiae of communication breakdowns every single day.   Sometimes we repair and sometimes we follow until we find a chink of understanding to latch onto and develop.  Sometimes we fail.  That’s the trouble with communication – it can be a complicated business.

So, what makes communication work?  Teepa Snow, an American dementia expert says ‘It’s the relationship that is MOST critical not the outcome of any one encounter’.  If the relationship is most important, our priority is getting to know the person we’re communicating with.  In a work setting, this might mean gathering life history information with family help.  We often discuss likes and dislikes around a specific topic using simple choices –

‘Do you prefer Coronation St or Eastenders?’                                   ‘Sweet or savoury’

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It’s difficult when someone can no longer find the words to say exactly what they mean.  It becomes the communication partner’s job to look for the meaning behind the lost words.

  • What is the person’s tone of voice telling us? Do they sound angry or frightened or excited?
  • Are they looking at or pointing to something that might help to understand meaning? A calendar or a photograph or a letter?
  • Are there words that sound a bit like the target? Maybe a changed first letter or even a word in the same category – e.g. bed for blanket.  I worked with a man who served in the Navy but used Army every time we talked about his past.
  • If we know the topic, it can help us to offer appropriate choices. It can help to write words where choices can be underlined or circled.  By whittling down the choices, we can reach a shared understanding.  Pictures or images can also be helpful here.

What did you do at the weekend?

Football                           Cricket                       Something else

On TV                              At Dens Park            Somewhere else

Win                                  Lose                            Draw

I’m sure we’ve all had the experience of talking and not being heard.  Perhaps the person we’re talking to is looking away or is distracted by something else or is even texting on their phone!  How do you feel when this happens?  It feels better when we have someone’s undivided attention, doesn’t it?  When the person is looking at you, actively listening and giving their full attention the conversation is more likely to work.  At least it’s off to a good start.  Listening is easy in a quiet environment with no distractions.  You might take a moment to consider

your environment before embarking on a conversation.  It’s easy to turn off a blaring TV or move closer to someone to ensure good eye contact and listening.  Little changes add up to successful connections.

When my daughter comes home and excitedly offers masses of information in a constant flow, it’s easy to lose key points.   That’s the reason I might miss the dress-down day at school or sign the wrong lunch form.   Sometimes there’s so much to process that I need to hear it again.  I tell her to take her time and give me one chunk of information at a time.  I might write it on the calendar.  Following her lead directs me to make sure she has the right things at the right time.  We can both feel satisfied by implementing strategies to:

  • Slow down
  • One point at a time
  • Make a note
  • Ask for repetition to clarify
  • Follow the person’s lead without interrupting

With the best will in the world, sometimes conversations break down.  That’s life living with or without a dementia diagnosis.  We might need a refresh and come back to the opportunity later.  As Lisa Genova, the author of Still Alice and eminent neuroscientist says in her TED talk:

‘There are three lessons I’ve learned from my grandmother and the dozens of people I’ve come to know living with this disease. Diagnosis doesn’t mean you’re dying tomorrow. Keep living. You won’t lose your emotional memory. You’ll still be able to understand love and joy. You might not remember what I said five minutes ago, but you’ll remember how I made you feel. And you are more than what you can remember.’

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References:

https://www.slideshare.net/HISCSonoma/teepa-snow-dementia-expert-on-understanding-alzheimers-patient-behaviors?qid=94a41289-6906-4f9f-9fb0-b1e6995974be&v=&b=&from_search=1

https://www.ted.com/…/lisa_genova_what_you_can_do_to_prevent_

Contributor

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Jenny Keir Speech & Language Therapist NHS Tayside

 

 

 

 

 

 

 

 

 

I’m sure we’ve all had the experience of talking and not being heard.  Perhaps the person we’re talking to is looking away or is distracted by something else or is even texting on their phone!  How do you feel when this happens?  It feels better when we have someone’s undivided

How CAN music therapy impact the hospital environment for people living with dementia? #DementiaAwareness

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In a previous blog post a fellow AHP addressed the high percentage of people with dementia living in hospital. Hospital care can be incredibly complex for people with dementia, whose circumstances can often result in longer hospital stays. Because of this it is imperative to gain a holistic understanding of the people with dementia we are working within this environment.

As a music therapist working in NHS Lothian, I have piloted two music therapy projects over the past eight months on dementia-specific hospital wards. These pilots took place on three assessment and continuing care wards at Midlothian Community Hospital and the Royal Edinburgh Hospital. Reflecting on these experiences, I have distinguished the following as how music therapy can offer something unique in this environment.

Opportunities for non-verbal or post-verbal interaction

As with all other individuals living with mental health needs, people with dementia deserve access to psychological therapies. Because language capabilities may have changed as a result of the persons’ dementia, it may be difficult to access traditional counselling or psychotherapy services. Music therapy is one of the arts therapies that offer a non-verbal way of addressing the persons’ psychological, emotional, social, communicative and physical needs. Even more apt to working with people with dementia is the term ‘post-verbal’, which acknowledges the persons’ earlier ability to communicate verbally, thereby taking into account their previous ways of using language and how this may have changed during their dementia journey. As music, language and communication are so closely intertwined, viewing these abilities from a musical angle may open up new ways of engaging.  By interacting with the person musically and non-verbally, the music therapist may be able to gain a greater understanding of the person’s individual communication abilities and how this understanding can improve the person’s support in hospital.

A safe space for emotional expression and validation of these experiences

It can be hard to be upset, angry or sad and to show these and other emotions. It can be even harder to see others experiencing this, especially when it is difficult to know why the person is feeling this way. Music can have a great impact on our emotions, due to the large number of associations and memories we each have as a result of our individual experiences, preferences and cultures. In a music therapy space, once a trusting relationship has been developed, the person with dementia can safely experience a range of emotional states, putting these into music where words are too difficult or not possible. The music therapist can respond to these expressions empathetically in the music and thereby allow for a contained emotional experience. It is important that the person knows their experiences have been acknowledged, so that the reaction is not to silence emotions but rather let them be heard.

A can-do approach

Though by no means exclusive to the music therapy profession, acceptance of each person as they are and a focus on what they can do is at the core of the arts therapies. This stems from the belief that creativity is an innate human characteristic and therefore that everyone has the capacity to respond to music. This capacity offers a range of possibilities for the person. Using music may give the person the feeling of being in control, where otherwise a lack of control may play dominate for the person with dementia, especially in hospital care. Working with music can also offer a sense of motivation, and in creating something, accomplishment. Every person may use their innate musicality in a different way, and it is important that we enable these spontaneous, creative processes to happen.

Being alongside, being with

Finally, music therapy can bring a new perspective to the way we are and engage with others. A huge part of the music therapeutic experience is simply being with another person in a musical space. When playing music with others, it is a way of creating something together. Rather than instructing, or doing something to the person, you exist alongside them in a shared musical space. Creating this atmosphere is imperative to all therapeutic processes, and sharing this way of being with is a crucial part of working with open groups, where patients, families and staff can all come together in the music making to be with one another.

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Contributor

Nina Wollersberger, music therapist

With podiatry you CAN…….. #DementiaAwareness

Podiatrists are highly skilled health professionals trained to prevent, diagnose, treat and rehabilitate abnormal conditions of the foot and lower limb, aiming to keep people mobile and active.

The College of Podiatry and NHS Fife podiatry department have been working in partnership with Alzheimer’s Scotland to create a postcard to raise awareness of the benefits podiatry can bring to dementia care. The postcard will be launched in conjunction with Dementia Awareness Week and Foot Health Month.

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Podiatrists can help people remain independent and mobile through good foot health.

Podiatrists can:

  • Promote an active and healthy lifestyle by helping you to maintain your mobility
  • Devise an agreed treatment plan tailored to your needs
  • Reduce your risk of falling by identifying concerns and helping you to act upon them
  • Support and advise you, your families and carers on delivering personal care

Good foot health is an important part of our overall wellbeing. When we develop problems with our feet this can have an impact on our mental and physical health. Many health conditions can increase our risk of lower limb problems. By promoting good foot health and a healthy lifestyle this can significantly decrease the risk to your wellbeing.

When issues arise we work with the person/family/carers to reduce the impact of the condition. This can be done through physical treatments such as wound management, corn/callous reduction, management of infection, management of ingrown toenail and falls prevention to name a few. We always put the person at the centre of their care and work to achieve the best possible outcomes.

For further information on the role of podiatry please refer to: https://www.scpod.org/

As a service we are delighted to be working alongside our fellow AHP colleagues to help people live well with dementia and access the services they require.

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Contributor

Karen Mellon

Lead Podiatrist for Learning Disabilities/Care Homes

Getting to Know Me: Supporting a Culture of Person-Centred Care

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Improving outcomes for people with dementia within acute care settings has long been recognised as a commitment by the Scottish Government. Yet, with the recent launch of Scotland’s National Dementia Strategy (2017-2020) (Scottish Government, 2017), there is recognition that although significant progress has been made over the last ten years, wide variations in dementia care and treatment remain evident across Scotland.

People with dementia are estimated to occupy approximately 25% of acute hospital beds (Alzheimer Research UK, 2018) and are known to have longer lengths of stay and poorer outcomes than people who do not have dementia. With a growing ageing population and incidence of dementia, there is no doubt that acute hospital settings require ongoing support to meet current and future dementia care needs.

Person-centredness is at the heart of high-quality dementia care provision. This involves knowing the person and tailoring care to meet their personal abilities, needs, likes and dislikes. There is a plethora of different forms, passports, life story work and personal profile tools which support person-centred care planning by enabling the person with dementia, with support as required, to inform staff about who they are and what is important to them.

The ‘Getting to Know Me’ (GTKM) personal profile tool was created by the National Dementia Consultant network, consisting of Alzheimer Scotland Dementia Nurse Consultants and AHP Dementia Consultants in Scotland, in conjunction with the Scottish Government and people with dementia. It is a nationally available and recognised tool which can aid staff working in acute care settings across Scotland to support person-centred care, through helping them to understand the person beyond their diagnosis of dementia.

By knowing people’s strengths and what activities they like to do, staff can support the person with dementia to retain existing skills whist they are in hospital. Likewise, by knowing who and what is important to individuals, can help to alleviate/respond to episodes of stress and distress and support family/carer involvement. However, even though planning for the future is a key part of the process of post-diagnostic support (PDS) within Scotland, people with dementia do not routinely present at hospital with a completed person profile tool and even when documents such as these are in place, there is often no information on how people likes things done or what to say for example when the person with dementia asks for someone who is no longer there.

As a group of Alzheimer Scotland Dementia Nurse (ASDNC) and AHP Consultants, we recognise that embedding new practices, such as the use of the GTKM document, takes time, support and commitment. Nevertheless, the wider value of the GTKM as a tool to provide transferable, individualised information to support and embed person-centred care practices across acute care services cannot be underestimated. We believe that there is scope to build on the existing work which has been undertaken to introduce tools such as the GTKM document as a routine part of dementia care within acute services by undertaking further work to:

  • Promote completion of GTKM as part of the process of PDS.
  • Support acute hospital staff to develop confidence and competence in completing a GTKM document on/during admission if this has not been completed prior to admission.
  • Support acute hospital staff in applying information obtained to practice.
  • Develop pathways to support the transfer of the document on, during and following admission.

Please let me know if you have come across the GTKM document and if you have any further suggestions as to how its use may further be supported in practice.

Also, please watch out for daily tweets from the ASDNC network on how to complete the GTKM, during Dementia Awareness Week. You are also most welcome to come and “Get to Know Me” and my dementia consultant colleagues by visiting our stall at the Alzheimer Scotland Annual Conference on the 8th June 2018.

References:

Alzheimer Research UK (2018). Dementia Statistics Hub [Online].

Available: https://www.dementiastatistics.org/statistics/hospitals/

Scottish Government (2017). Scotland’s National Dementia Strategy (2017-2020) [Online].

Available: http://www.gov.scot/Publications/2017/06/7735

Contributor

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Profile: Susan Holland @Susan_hol1

Alzheimer Scotland Dementia Nurse Consultant

Throughout my career as a registered mental health nurse, I have retained a passion for working with older people and a specialist interest in Dementia. I am passionate about improving the care experience of people with dementia, their carer’s and families and of staff involved in providing dementia care. I am extremely proud to work with NHS Ayrshire and Arran and Alzheimer Scotland in the role of Alzheimer Scotland Dementia Nurse Consultant.