Care and Repair-Lochaber colleagues supporting local ‘Tea & Blether’ during #DAW2017

Care and Repair-Lochaber colleagues were involved in supporting and organising local events as part of Alzheimer Scotland #DAW2017 ‘Tea and a Blether’ events.  On Wednesday 31st May at St.Andrews Church Hall, Care and Repair, Dementia Enablement Project colleagues were present at the Alzhemier’s Scotland event to raise awareness about what support they could offer people to continue to live well with Dementia in the local community. Present at the event were members of the community, NHS Highland and Alzheimer’s Scotland staff. Robert and Eleanor had a display of a few of the many interventions that they have used and can use with people in their own homes.

One carer present commented: “it was good to see what was available locally to support her care for her mother”.

 

 

 

 

 

On Thursday 1st June, Care and Repair, Dementia Enablement Project colleagues with support from Lochaber Housing Association held an event for housing and NHS staff to continue to raise awareness about living well with Dementia.  Robert and Eleanor delivered a short presentation about Dementia and had a range of the small pieces of equipment  they use with clients in their own home.

One housing officer commented: ‘it was good to see the various ‘gadgets’ in particular the magic-plug’.

Staff were encouraged to raise awareness about the support that is available within the community in particular the Dementia Enablement Project and Be@home Project along with their in house Occupational Therapist.

The Occupational Therapist role is to maximise an individual’s independence in their daily activities and occupations in their own home, work and community as well as providing advice to family and carers who live with or support an individual. The Occupational Therapist provides housing based focused solutions to people across the community in all tenures including minor, major adaptations and link up with other health and social care support as is necessary.

Learning to date has shown collaboration between professionals is key. Also, timely assessment and intervention is crucial!

Please speak to your local GP, Health and Social Care and Housing colleagues if you are concerned about your memory, or how you or your loved one in managing in their home.

Let’s all sign up today to: https://letstalkaboutdementia.wordpress.com/

Finally, it is important to know we all can make a difference in supporting people in our communities to continue to live well when living with dementia.

Do you know how to access Occupational Therapy, Dementia link worker or housing support in your community?

My pledge from our #DAW2017 is to continue to raise awareness about Dementia in our communities and to ensure people receive timely, effective and efficient collaborative assessments and interventions.

What can you pledge?

Thank you to: Sheila Morris, Occupational Therapist, Eleanor Brown & Robert Drain, Care and Repair Lochaber-Dementia Enablement officer’s

Some useful links to training and support:

Photos from the events

Senior Occupational Therapist-housing solutions – Sheila Morris

Employment, Dementia & Occupational Therapy – Personal Reflections

About Alison

I am a Band 6 Occupational Therapist working in the Older Adults Mental Health Service in North East Fife, covering both the inpatient and community services as part of a small team. Typically, the service sees adults of 65 years and above, but within the last year, we have begun to receive a small number of referrals for younger adults experiencing cognitive difficulties.

Younger vs. Older Adults – what is the difference?

From an Occupational Therapy perspective, some of the most obvious differences between the younger and older adult, particularly at the early stages of their memory difficulties, is that they are less likely to experience the same mobility issues as the older service users we meet; I have not needed to address the issues of equipment assessment and provision that are most often associated with Occupational Therapy and consequently clients have not experienced the same physical barriers to community venues, activities and social opportunities as our older client group often do. In addition and most significantly from the perspective of my own personal development, some of our younger adults remain in employment.

Employment and Occupational Therapy – my experience

The prospect of working with people with employment issues was not new for me as I had had experience working on the Condition Management Programme pilot in conjunction with NHS Fife and Job Centre for two years from 2006, however Norma Clark, Lead Occupational Therapist in Mental Health took a partnering role in Occupational Therapy assessment and employability intervention.

 Occupational Therapy assessment

Our service routinely uses a standardised assessment toolkit including:

  • Claudia Allen Assessment – functional cognitive assessment
  • Evaluation of Social Interaction (ESI)
  • Assessment of Motor and Process Skills (AMPS)

In addition, other non OT specific assessments:

  • ARCS – audio recorded cognitive screen

These same assessments were utilised with our clients remaining in work and completion of the AMPS assessment with this client group allows us to specifically pinpoint areas of strength within their motor and processing skills that have the potential to support that patient in the work environment, and then those areas that present a challenge. We then use our Occupational Therapy knowledge of assessment and activity analysis to understand the impact of our findings upon peoples  work demands and routines, potentially identifying adaptive and compensatory strategies and how these can be translated into the work place.

 

Examples of assessment findings have included challenges with:

  • Heeds – ability to carry out and fulfil specific tasks set
  • Searches – locating items in a logical manner
  • Inquires – asking for information a person should know
  • Turn taking in conversation
  • Noticing and responding to task related issues

Job Retention issues

The typical skill challenges listed above can then be understood by the Occupational Therapist in the work context. Examples might include:

  • A person may not be reasonably expected to complete a range of work-related tasks repeatedly based upon initial explanation only.
  • A person may require additional cues and support to consistently locate required items within the work place.
  • May require additional compensatory strategies and arrangements to support completion of a task e.g. planner, tick-off list, verbal discussion.
  • Other staff may need to clarify that task related direction has been understood if the individual does not immediately demonstrate understanding
  • Individual may benefit from working alongside others to provide additional support and assistance should additional or unexpected demands arise.

Where do we go with this information?

We, as Occupational Therapists, are able to use our assessments to support completion of the Allied Health Professional Advisory Fitness for Work Report, which allows us to provide the individual, employer and GP with advice regarding strategies to support them to remain in employment. I have also had the opportunity to meet and liaise with employers to identify whether these ‘reasonable adjustments’ can be put in place to support the individual. In addition, this work has allowed me to work jointly alongside other agencies including the Individual Placement Service (IPS) in Fife, who offer vocational rehabilitation support to people with long term mental health needs.

What have I learned from this experience?

On reflection, I do not feel that I have specifically learned any new or additional skills. What this work has demonstrated and validated however, is how prepared Occupational Therapists are, with their assessment skills and understanding of occupation and activity analysis to work in this area. Assessment of our employed service users utilises the same Occupational Therapy skills as we use with any other people we see and our partner agencies with greater experience in work placement are able to work jointly alongside us to create the best outcome for our service users. It also highlights the important role that work-focused Occupational Therapy plays in Alzheimer’s Scotland 5 Pillars and 8 Pillars of Community Support for dementia; we are contributing to the person centred support that promotes participation and independence.

On reflection

Do my other Occupational Therapy colleagues agree with me? What has been your experience?

What should and could our role be as occupational therapist to help people living with dementia be to stay at work?

Alison Long

I am a Band 6 Occupational Therapist in the Older Adults Mental Health Service, based at Stratheden Hospital in Cupar, Fife. I work as part of a small team with two other Occupational Therapists and two Support Workers. Together we provide Occupational Therapy assessment and intervention to three inpatient wards at Stratheden Hospital  and also provide community input to North East Fife, from Falkland to Newport-on-Tay.

 

 

Dementia Friendly Prestwick – We’re one year old!

Dementia Friendly Prestwick celebrated its first birthday on 4 June 2017 so it’s an ideal opportunity to reflect on the last year and the progress which has been made in such a short time.

Dementia Friendly Prestwick aims to support people with dementia, and their families/carers, in Prestwick to be included and remain part of their community for as long as possible.  Since launching Dementia Friendly Prestwick in June 2016 we’ve already made great progress including:

Dementia Friendly Community Garden: Biggart Hospital: With the support of Biggart Hospital, Dobbies Garden Centre and GE Caledonian, we developed a Dementia Friendly Garden in the grounds of Biggart Hospital.  This is in the main entrance area to the hospital and open to any member of the public to enjoy.  Our raised beds, comfortable seating, wide paths and bright colours means that this space is attractive and safe for everyone to use. The environment is so inviting, that even before we’d finished building it, people were sitting with us and chatting. We’re expanding the garden this summer 2017 with a bespoke summer house with big windows and patio doors beside the garden: giving shelter and beautiful views throughout the year.

Community Cinema with relaxed screenings: Our monthly pop-up community cinema, has so far been attended by over 250 local residents including all care homes in the town. Initially funded by Ayrshire Council and Place Partnership, we secured further funding through a recent participatory budgeting event. Our screenings of classic films are “relaxed”, which means the room we’re in isn’t as dark as traditional cinema, the volume isn’t as loud, we show subtitles on all of our films, people can get up or make a bit of noise without fear of shushing, and cups of tea, coffee, cake and ice cream are provided free of charge. It’s more than a cinema, it’s a social hub!

Cinema attendees commented:

“It’s so relaxing to go somewhere, and know that even if we make a bit of noise, no one is going to stare, judge or not understand us”. “My husband was diagnosed with dementia five years ago, and this is the first time in a couple of years we’ve gone out socially to something. Thank you.”

Intergenerational Activities: In February 2017, we worked with Alzheimer Scotland to organise an engagement event in the style of the Dragon’s Den, for Prestwick Academy pupils and primary 7 pupils from local primary schools.  The pupils were supported to develop design ideas for new innovations to support people living with dementia and then to pitch their ideas to our ‘friendly dragons’. Many drew on their own family experience of dementia in order to inform their thinking.  The winning team won the ‘Dementia Friendly Prestwick Innovation Award’. The winning idea ‘snappy reminder by mail’ will be followed up by Alzheimer Scotland to identify opportunities to test this in practice.

Dementia Friends Training and other activities: We have engaged with some of the local business community to promote dementia friends training.   We will be developing this work further in the year ahead. Other initiatives have included running Lingo Flamingo language classes to include people with dementia  in the local community and running a range of fundraising events including a ‘purple party’, Christmas card and twiddle mitt sales.

On reflection 

What one thing could you do to support your local community to become dementia friendly?

Thank you to all who have supported our work so far. Keep up-to-date with our developments via:@Dementiapwick, Facebook: Dementia Friendly Prestwick, website: http://www.dementiaprestwick.co.uk/

C

 

“A blog a day” for #DAW2017 by #AHPDementia #ThankYou

If you follow #DAW2017 you can see, last week was a busy week for everyone in Scotland. To support the week we shared  a blog a day from a few of the professions who wanted to share who they are and how they CAN help if living with dementia.  If you missed any of the blogs, you can review the blogs here and let’s keep talking about dementia in 2017. 

On reflection

What was your favourite bit of Dementia Awareness Week?

Share a photo of your best bit to share on in our photo album?

Thank you to all our bloggers this week:

Gillian (who is not a tweeter but happy to share her expertise on social media)

Caroline @radcaca1

Rebecca @rmakellett

Claire @ClaireCraig_PT

@Karin & @RCOT  for supporting occupational therapists in Scotland in partnership with @Alzscot

@musictherapyUK for supporting music therapists in Scotland in partnership with @Alzscot

@AHPScot for supporting and posting our blogs in partnership throughout the week

 Thank you to ALL our readers, followers, supporters and blog contributors.

We launched this blog during Dementia Awareness Week in 2014 and we said then, “Dementia is frightening. Talking about it helps us make sure that nobody faces dementia alone and through this blog we want to keep the country talking about it.”

So let’s keep talking about dementia!

 

With Physiotherapy you CAN #DAW17

Over the last few years I have been spending increasing amounts of time working with people with advanced dementia and their carers and I am surprised at how often I hear people say they can’t do something because of Dementia.  Physiotherapists as AHPs actively promote what people CAN do – and it is exciting to be part of a community that helps people with Dementia to live well.

With Physiotherapy you CAN……….Stay mobile for longer.

As Dementia progresses, it can affect a persons ability to move in many ways.  Take for example a task such as standing up from sitting – A day to day activity many of us take for granted, which includes several processes including:

  • hearing, understanding and processing the task
  • deciding to stand up
  • sending a message from the brain to the muscles and joints to move and carry out the task.

Dementia can interrupt any one of these processes making the task difficult to complete.  But we want to keep people mobile – and the following tips can help.

  • Instead of asking someone to stand up, show them – through gestures such as sweeping a hand up their back
  • Keep requests short and positive – “stand up” or “come with me”
  • Ask someone to do something – or go somewhere – they may stand up automatically.

A Physiotherapist can help by determining whether the person is unable to stand up due to physical or cognitive reasons and can then develop a plan to make the task easier which could include communication hints and tips, exercises, or advice on moving and handling.

With Physiotherapy you CAN……….Improve your posture.

As dementia progresses, people may begin to find it difficult to stand or sit up straight.  This can be caused by pain, fatigue, lack of muscle control or mood. Some things you can try to help someone maintain a good posture include:

  • Making sure that chairs are not too deep or saggy – they may look comfy, but they will not provide any back support and can be difficult to get out of.
  • Doing some simple exercises every day – try rolling your shoulders in a circle backwards and stretching your hands up over your head.

Physiotherapy can help by assessing for specialist supportive seating, providing stretches, exercises and massage to reduce muscle tension and improve posture, and linking with orthotics services to provide any splints required. As they have a strong understanding of the physical causes of postural changes, they can help to ensure people are able to sit and lie comfortably.

With Physiotherapy you CAN……….Remain physically active for longer.

Physical activity is an important part of keeping well.  Whatever you enjoy be that walking, dancing, swimming or football, finding a way to continue to take part can be a good way to maintain health.

  • Check out your local area for activities such as walking football, tea dances and walking groups.
  • If these are no longer possible, consider dementia specific groups such as sporting memories and groups run by Alzheimer Scotland for more tailored activities.

A Physiotherapist can assist you to find exercises or activities that you enjoy, and find ways of adapting activities to make taking part possible. They may run specific classes you can attend as well!

With Physiotherapy you CAN………..Manage your pain.

People with dementia can show signs of distressed behaviour due to pain, yet be unable to tell others where it is coming from.  So if you are concerned that a person with dementia may be in pain, consider trying the following.

  • touch an area you think may be causing a person pain and ask if it hurts.
  • Watch for changes in facial expression throughout the day – this can indicate what is making them sore.
  • Consider ways of easing pain without pills– heat packs, movement or rest can be helpful.

A Physiotherapist can assess a persons pain using movement, special tests and pain scales to determine the cause of pain and then help reduce it using techniques that may include electrotherapy, heat, acupuncture, stretching, treatment specific injuries techniques or advice.

With Physiotherapy you CAN………..Reduce your falls risk.

“Older people with Dementia experience 8 times more falls than those without Dementia”  – This was highlighted by Lynn on her previous blog on Dementia and Falls https://letstalkaboutdementia.wordpress.com/2014/07/11/dementia-and-falls/    – where you will also find some top tips to reduce those risks.  A Physiotherapist can help identify personal risk factors, and will aim to reduce these with strength and balance exercises, adapted physical activity and motivational support, all of which can affect mood. They can also provide walking aids and link with other AHPs who can provide additional support.

With Physiotherapy you CAN……….Continue to do the things you enjoy.

So if a persons physical health is changing, consider a Physiotherapy assessment- Dementia can and does affect peoples physical abilities but for many people it does not mean that they need to stop moving – risks may be present, but sometimes they are worth taking and even little changes can have a big impact.

My questions 

  • When a task becomes difficult, do you stop doing it completely or try to find an alternative way to do it?
  • What are you top tips to keep physically active?

Contributors: Claire Craig

I am a Specialist Mental Health Physiotherapist in Greenock.  I am passionate about promoting living well with Dementia and other Mental Health conditions and want to celebrate the role Physiotherapists can play in this.  Oh and I also love to dance so I share this skill widely and promote the value of dancing anytime I can!

Claire_CraigPT

5 things you should know about: Speech & Language Therapy for people living with dementia

  1. The title “Speech and Language Therapist” can be misleading.

Although lots of our training is about spoken language, we cover all aspects of human communication. Everybody uses non-verbal communication in all  interactions, whether it is in the way we use eye contact, what facial expressions we have, laughter, yawning, sighing, whistling, crying out, shrugging,  what position we are sitting in. Things we do, objects we fetch, what we wear, all convey a message too. If I put the kettle on, my colleagues expect a brew up, even if I don’t say anything. If I put on my walking boots, everybody knows I am going for a walk.  All of these things are forms of communication, and if the use of words is limited, as can happen with dementia, how we use non-verbal communication becomes all the more important.

  1. It follows that Speech and Language Therapy doesn’t always focus on speech.

Even if spoken language is good, when a person has dementia they often need more time to process a message or plan a response. Thinking about the way non-verbal communication can support speech can really help us to give the person that little bit of extra time they need to take part in a conversation successfully. A spoken word is gone in a flash, whereas a picture, object, newspaper headline or even a gesture can last much longer, helping the person to hold on to what has been said.

  1. Speech and Language Therapy is not just about working with the person with dementia.

The changes and adaptations have to be made by their communication partners. As well as thinking about what non-verbal communication we use and how we can adapt it for the person with dementia, it is important for us to learn their ways of using behaviour to communicate. Each of us has a repertoire of habitual behaviours, and they all mean something. If we are good at reading what is behind the behaviour, we can respond appropriately and are helping the person communicate their feelings and wishes effectively.

  1. The people closest to the person with dementia are the best therapists.

Recognising a person’s attempts to communicate is all about valuing them as an individual. When communication is limited, for whatever reason, it is very easy for a person to become isolated, withdrawn and unhappy or distressed. The more we know about a person, the things in their life which make them feel proud or happy, the people, places, music, other things they are fond of and why, the more we can support them to be themselves and feel valued.

  1. Speech and Language Therapists often help people with dementia who have difficulty eating and drinking.

Sometimes this involves avoiding certain foods or modifying the texture. If a person is coughing or choking, or having frequent chest infections, a Speech and Language swallowing assessment may be needed. But perhaps surprisingly, thinking about the communication techniques already described can sometimes solve less severe problems. Knowing the person well, knowing their preferences and routines, thinking about the environment and how they respond to it, being sensitive to what their behaviour is communicating and making sure they have all the time they need, can all make a huge difference.

Thank you for reading my post.

  • What questions or comments would you like to leave for me to answer?
  • What resources could we share to make sure we all have good conversations?

Rebecca Kellett, specialist Speech and Language Therapist, NHS Lothian

Maximising Psychological Wellbeing: with music therapy you CAN

Alzheimer Scotland has been working with music therapists in Scotland and the British Association of Music Therapists to share what and who music therapists are and how they CAN help you if you are living with dementia.  To begin this work a postcard has been designed and is being shared during #DAW2017

Music therapy supports communication, relationships and psychological wellbeing through engagement in music

Music Therapy can…

  • Help keep connections alive – music is a channel for communication and engagement with others, helping maintain relationships with loved ones and carers.
  • Helps you to look after your psychological wellbeing – helping you to share emotions and feelings with others without the needs for words.
  • Enable self-expression and creativity – supporting you to engage your mind, enabling you to maintain skills and abilities
  • Stimulate – playing music and singing with others can stimulate your brain and energise you, supporting both mental and physical health

Ask a Music Therapist……

Thank you for reading our blog.  Please leave a comment or a question to enable us to talk about dementia and music therapy.

You will find useful resources at this website including information on Music Therapy and dementia – bringing back the feeling of life.

*Music therapy is an established clinical intervention, which is delivered by HCPC registered music therapists to help people whose lives have been affected by injury, illness or disability through supporting their psychological, emotional, cognitive, physical, communicative and social needs.