NHS Lanarkshire Occupational Therapy and Connecting People, Connecting Support

National AHP Dementia Webex Series

The Allied Health Professionals (AHPs) in Dementia webex series was launched in December 2018.  It had been identified that the AHPs would like the opportunity to hear more from their AHP colleagues about areas of good practice and quality improvement in dementia.  It was agreed to trial the use of webex in order to make this as accessible as possible.  We also wanted to support the delivery of Connecting People, Connecting Support (Alzheimer Scotland, 2017) Ambition 3: AHP workforce skilled in dementia care where an action for change included:

“The Alzheimer Scotland AHP dementia forum will work collaboratively to ensure a national approach to…..sharing best practice…..”(2017:42)

Wendy Chambers @wendyAHPDem facilitates the bi-monthly webex on behalf of the AHP Dementia Forum and the presentation in June 2019 was on the topic:

NHS Lanarkshire Occupational Therapy and Connecting People, Connecting Support      

An overview of work around self-supported memory management, Home Based Memory Rehabilitation, Tailored Activity Programme, What do you want for Tea?, Lanarkshire AHP Dementia Forum, Link work with Emergency Service partners and Primary Care developments.

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The Webex was hosted by:

Lesley Bodin (Locality Lead Occupational Therapist), Gillian Gowran @MHOTGill (Advanced Specialist Occupational Therapy Practitioner), Lynsey Dow (Specialist Occupational Therapist) and Sarah Jane Donald (Specialist Occupational Therapist), NHS Lanarkshire.

The presentation can be found here:  bit.ly/2Zmy8sX

Following the webex, the participants are asked to complete a short evaluation with the following 3 questions, which will guide future webex sessions:

  • Something you liked about the Webex?
  • Something that would have made the Webex even better?
  • Future topics?

A large number of people joined the webex, linking in from across 13 Board Areas as well as national organisations.  Participants fed back that it was beneficial being sent the presentation prior to the webex.  It was highlighted that it was useful to hear about the various projects the team are involved in, with lots of interest in finding out more.  This was evident from the many questions posed, which were answered by the team with the offer for people to get in touch for more information.

We will continue to Blog about the AHP Dementia Webex and will share information from these – look out for this throughout 2019.  Further information and previous presentations can be found on the AHP Dementia Community of Practice (National AHP Dementia Webex): bit.ly/2XoMlYY

A big Thank You to Lesley, Gill, Lynsey, Sarah Jane and Wendy!

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Supporting post diagnostic support in NHS Lanarkshire

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NHS Lanarkshire were keen to make post diagnostic support (PDS) information more accessible to people living with dementia and their families and carers.

It was agreed an online resource, that was primarily for use by the person with dementia, but open to everyone would be designed.  Maureen Cossar who had worked as a community psychiatric nurse (CPN) in the East Kilbride and has an MSc in dementia studies was seconded into the post of Project Manager to collate the relevant information, create the resource design and write in an easy reading format.

Maureen sought the views of what should be contained in the resource from people with dementia and carers across Lanarkshire by attending various dementia and carer groups. She also formed a working party including staff from Nursing, the carers sector, Occupational Therapy, Medics, Alzheimer Scotland as well as a person with dementia and their carer; who all assisted in collating the relevant information. In addition she regularly liaised with Amanda Minns, Head of Evidence regarding the computer software package to be used and how it could be adapted to include the relevant material.

It was agreed to follow the principles of the 5 pillar model with the information being added that was relevant, including links where possible.  It was agreed duplication between some sections was inevitable and that it was better to repeat information than for it to only sit under one pillar.

Prior to its launch the package was trialled with people with dementia and their carers, with their feedback being used to inform the final package.

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The online resource has been positively received by people with dementia, their carers and those delivering PDS since it’s launch in March 2019.  It can be accessed via the Clinical Knowledge portal:

http://www.clinicalknowledgepublisher.scot.nhs.uk/Published/PathwayViewer.aspx?fileId=2598

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The plan is for the resource to be the responsibility of the Practice Improvement and Development Team with Maureen reviewing it 6 monthly and the working party reviewing yearly to ensure information is relevant and up to date.

Contributors

Gill Gowran

Advanced Practioner Occupational Therapist

@MHOTGill

 

Maureen Cossar

Practice Improvement and Development nurse

@CossarMaureen

Allied Health Professionals #Scotland Supported #DementiaAwareness Week

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With over 90,000 people living with dementia in Scotland, Dementia Awareness Week was our annual opportunity to generate maximum exposure around dementia and change how Scotland talks about and sees dementia. The week ran from Monday 3 to Sunday 9 June and Alzheimer Scotland highlighted the support our localities currently provide, as well the importance of dementia research, the impact it can have and the vital need for new research volunteers.

During the week allied health professionals were talking about dementia in Wick, sharing films on facebook in Dumfries, celebrating with dementia champions in Glasgow, hosting information stalls in Lanarkshire and sharing posters of their innovative work at the Alzheimer Scotland conference in Edinburgh. However, there are many other examples of events hosted or supported by allied health professionals and we will post further blogs to share & celebrate where we were, who we spoke to and what has changed in how we think about dementia as a result.

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Today’s blog is to say thank you for supporting the week & let’s keep talking about dementia: at home, at work, in the street and on the bus, in cities, towns and villages across Scotland. By talking about dementia, it can help us make sure that nobody faces dementia alone.

Allied health professionals in Scotland will continue to talk about dementia, sharing their ideas and innovations on twitter and facebook at @AHPDementia where we share practical hints and tips to living well with #dementia.

You could read what our contributors have to say on our weekly Thursday blog at www.alzscot.org/talking_dementia. You can enter your email address in the right side menu and we’ll let you know when a new post has been published.

We also share our AHP dementia policy and how we are implementing policy to local practice at www.alzscot.org/ahp and http://www.knowledge.scot.nhs.uk/ahpcommunity/ailp-priority workstreams/dementia.aspx.

Thank you for supporting the week

Contributor

Elaine Hunter, National AHP consultant, Alzheimer Scotland @elainahpmh

A selection of photographs & you will find more at #AHPConnectingPeople & #DementiaAwareness

A day in the life of a Physiotherapist

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Hi, I’m Claire and I am a specialist mental health Physiotherapist in Inverclyde HSCP inpatient mental health services, with a focus on dementia care.  I have worked in mental health for almost 12 years, and it is true that every day is different.  There is no such thing as a standard day for me. Every person I meet brings new challenges and I am always learning from the people around me – something I plan to never stop doing!

For me, getting to work involves a drive down the coast.  This gives me time to prepare for the day ahead.  Often I practice mindfulness en-route – a skill that people use to reduce stress and anxiety. Why don’t you give it a try?

https://www.nhs.uk/conditions/stress-anxiety-depression/mindfulness/

On arrival at work, I check my diary, answerphone and emails – this can often take some time! E-mails may include referrals, requests for information or presenting, advice, policy comments, or day to day activities, and many of these require a quick response.

Once the admin has been dealt with, I go and see patients.  Working in mental health services, I treat people with complex presentations of mental ill-health, who may also have physical health concerns.  This can include (but is not limited to) people with anxiety, depression, personality disorder, schizophrenia, huntingtons disease, parkinsons disease and dementia (all types).

Many of the people with dementia we see in our wards are admitted due to complex concerns related to aggression, agitation, mobility, falls and communication, and they cannot currently be cared for at home / in a care home as a result.  Our teams’ role is to find ways of managing these risks and to provide any required rehabilitation. Our goal is to support people to return to a home environment when and if they are able to do so.

My first patient has advanced dementia, and is recovering from a hip fracture.Physiotherapy is core to their rehabilitation to get out of bed, walk, identify and manage pain (using observational pain measures e.g PAIN-AD and Abbey), and provide­­­­­­­­ information to other staff on safe moving and handling.

Recovery will vary, but people with dementia CAN participate in rehabilitation. They may however present differently to those without cognitive impairment and require more personalised approaches with varied timescales.

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My next patient has anxiety and has developed a fear of falling.  Fear of falling can be debilitating, impacting on how people live, affecting social lives, and ultimately resulting in people becoming less mobile.  Using physiotherapy rehab techniques and exercises, in conjunction with anxiety management techniques, and graded activity, people can overcome these fears and lead more active lives.

Next up is a patient with severe depression, who has been receiving ECT (electro-convulsive therapy).  This is a last resort treatment, but to those who receive it, it is essential.  People with depression tend to be more inactive, and at worst, can become immobile.  Physiotherapy can promote specific exercises and activities to help people become more active again and improve strength and balance after a period of immobility.  It is also great to get carers involved in doing these exercises with patients to ensure they are part of the team – its always more fun to be active with someone else!

My final planned patient involved completing a car transfer assessment for a person with dementia with my occupational therapy colleague.  We support risk enablement, and encourage open discussions with carers to set appropriate goals that often include encouraging mobility and social interaction.  Having completed the assessment, this person is now looking forward to a day off the ward with their family as part of their pre-discharge plan.

One of the things that working in mental health requires is flexibility.  In planning my working day, I have to be ready to alter my plans if I receive an urgent referral or request for review.

Today I received an urgent call to see a patient with advanced dementia with a chest infection as a result of aspiration (inhaling food into the airways).  Chest physiotherapy uses varied methods to help people clear secretions from their chests. This can improve peoples’ ability to breathe more easily, recover from infections and manage long term respiratory conditions.   It can be challenging if people have a cognitive impairment and with this patient, I had to think outside the box. As a result I completed a singing chest assessment! – while I was singing they settled and I was able to listen to their chest so we could plan effective positioning and treatment, including specialist seating. My speech and language therapy colleagues also assessed this patients swallowing ability to reduce the risk of further aspiration.

Of course not all days look like this – after all, I have other roles as well as that of a clinician! Amongst other things I am a Dementia specialist improvement lead (DSIL), and as such I may attend meetings, provide training to other staff, develop resources, respond to policies……the list goes on.  But that’s just how I like it  – challenging and varied!

And then I head home! I look after my own health and wellbeing in the evening by participating in hobbies including dance classes, running and yoga.

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After work, I often find myself looking at twitter.  Social media is an excellent way to keep up to date with advances in Physiotherapy, mental health and dementia practice.

People post up to date research, examples of good practice, top tips, upcoming events and even tweetchats  – @physiotalk provide a discussion topic on Monday evenings.

We have a team of tweeters @ahpdementia tweeting daily top tips about living with dementia – follow us for more information and follow the hashtag #withPHYSIOyouCAN for physiotherapy specific information.

So there you have it.  A day in the life of a mental health physiotherapist.

I hope you have had a lovely day!

Alzheimer Scotland Dementia Nurse Consultants Supporting #DementiaAwareness week

The Alzheimer Scotland Dementia Nurse Consultant (ASDNC) Group are excited to have launched two new documents at the Alzheimer Scotland Dementia Awareness Week conference on the 3rd June and then sharing this work in our first ever blog post.

The first document is the ‘Leadership and Innovation in Hospital Care: Alzheimer Scotland Dementia Nurse Consultant Report: 2015-2108’. This report outlines an evidence-based picture of hospital care for people with dementia and their families in Scotland. It also highlights the impact of ASDNCs since our last report in 2015, and sets out our key national priorities and actions for ASDNCs over the next two years.

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The key areas that we will be focusing on during 2019 and 2020 are:

  1. Engaging with key stakeholders to lead the development of an action plan and monitoring process for Commitment 7 of Scotland’s National Dementia Strategy 2017-2020[1] , ensuring the delivery of the best possible care for people with dementia in hospital.
  2. Developing evidence-based position statements on key topic issues to help inform practice. The first will be on the use of ‘identifiers’ for people with dementia in hospital.
  3. Mapping training and education in place across Health Boards in line with Promoting Excellence[2], assessing the impact of this, and identifying priorities for future learning so that all healthcare staff have the right knowledge and skills to care for people with dementia.
  4. Looking at the use of the Getting To Know Me[3] document, with a view to re-developing and re-launching this, along with best practice guidelines for its use, promoting person centred care for people with dementia.
  5. Examining best practice across Health Boards in preventing inappropriate admission to hospital and facilitating timely discharge, learning from this and sharing across NHS Scotland.
  6. Working with Focus on Dementia[4] to explore and set out how the Improving Observational Practice Framework[5] can cross over into general hospital settings so that people with dementia who need an enhanced level of support are provided with this in a person centred and therapeutic way.

To see the full report please click here and let us know what you think at @AlzScotDNC

The second document we are pleased to launch and share is the Coming into Hospital 5 Key Things. We know that going into hospital can be a worrying time for anyone. If you have dementia, you may be particularly worried and anxious about staying in an unfamiliar place. You may also be unsure about what will happen during your hospital stay.

The information in the Coming into Hospital 5 Key Things is designed to help answer some of the questions you may have about preparing to come into hospital and about what to expect during your stay. It provides information in response to the following questions:

  1. What do I need to bring into hospital with me?
  2. How will I know who people are and how to find my way around?
  3. Will staff know I have dementia and how to help support my individual needs?
  4. Will my family and friends be able to visit?
  5. What should I do if I have any concerns about my care? 

We hope that by reading this document you will feel better prepared and reassured about coming into hospital if you ever need to do so. We would love to know what you think about the resource so please add a comment in this blog post or link with us at @AlzScotDNC

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To see the full document please click here.

Contributor

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For more information please contact Helen or Lyn

Helen Skinner – Alzheimer Scotland Dementia Nurse Consultant NHS Fife @helenskinner99        helen.skinner@nhs.net

Lyn Irvine – Alzheimer Scotland Dementia Nurse Consultant NHS Grampian @irvine_lyn        lyn.irvine1@nhs.net

[1] https://www.gov.scot/publications/scotlands-national-dementia-strategy-2017-2020/

[2] https://www.gov.scot/publications/promoting-excellence-framework-health-social-services-staff-working-people-dementia-families-carers/pages/0/

[3] https://www.alzscot.org/assets/0001/9836/Getting_to_know_me_form_single_pages.pdf

[4] https://ihub.scot/improvement-programmes/focus-on-dementia/

[5] https://ihub.scot/media/5508/spsp-iop-from-observation-to-intervention.pdf