#DAW2017 meets #AHPDementia: With Occupational Therapy you CAN…..

Alzheimer Scotland has been working with a group of occupational therapists in Scotland and the Royal College of Occupational Therapists to share what and who occupational therapists are and how they CAN help you if you are living with dementia.

Last year we developed a postcard and it is being shared again during #DAW2017. We learnt last year,  you liked the postcard but were looking for information on how to contact an occupational therapist.  So this time we have added a space for an occupational therapist in your area to leave their contact details.

Occupation therapy improves health and wellbeing through participation in occupation

Occupational therapy CAN:

  • Help you to use your strengths and abilities to stay active in your everyday life
  • Help you make small changes to make life easier at home, in the community or at your work
  • Advise family and friends on how to support you to live well with dementia
  • Advise your family and friends on how to look after their own health

What next?

The same group of occupational therapists are building on the ideas shared in the postcard, and developing top tips for you based on the questions you ask us when we meet you.  The three tips we are looking to include are:

  • Staying active in everyday life to help you to keep doing what you enjoy and what’s important to you.
  • Taking care of yourself to help you to look after your own health and stay connected to family and friends
  • What you can do at home to make small changes to make life easier

We hope to have this completed by the end of September and will share this with you in a number of different ways including this blog.

 

Ask an occupational therapist……….

Are you looking for tips on how to manage day to day, to stay active and keep connected with your local community?  Do you have a question on how occupational therapy CAN support you or your family? Leave a question on this blog post and we will do our best to answer or share resources with you that might help.

Allied Health Professionals: Maximising Physical Wellbeing

Dietitians CAN help you tell the facts from fiction during #DAW2017

We are bombarded with messages about food and nutrient on a daily basis in the newspapers, on television and on social media.  Often it is difficult to know what to believe.  So this year during Dietitians week (12-16th June) we are look at how dietitians can help you tell the facts from the fiction.

FACT – no two people are alike!  It is true that every one of us eats and drinks on a daily basis.  However we don’t eat or drink the same things.  Whether you need advice from a dietitian to help you stay well nourished and hydrated will depend on how your dementia is affecting your abilities and if you have any other health conditions.

Often when people hear that someone has Dementia the reaction is to think about what the person can’t do.  But everyone has their own experiences, skills and knowledge, so that is simply not true.  Instead we should focus on what you CAN do.  Dietitians provide information and advice on a wide variety of nutrition topics to help you find the right information to support you.  The British Dietetic Website has a range of fact sheets you can access at https://www.bda.uk.com/foodfacts/home

Let’s bust a few more myths!

  1. If you have dementia you should not cook? FICTION

FACT Try using a step by step cooking guide – this can be as detailed as you need such as how to use  a peeler, opening or boil vegetables.  Laminating these preparation techniques can be useful to maintain independence.  Pictures can also be useful if you find too many words distracting.

FACT Cook together –  It can be more fun!  Ask friends or family to cook with you.  If you forget a step your cooking partner can remind you on what needs to be done.

FACT Bulk cook and freeze  – extra portions of meals can be put away on days when you feel able to cook if you have days where you are not able to cook.  Using clear bags or boxes can make foods easier to see in the freezer.  Label them with what they are and the date they were put away.

FACT Use familiar utensils and equipment – new kitchen items can be more difficult to use.  If using the oven or hob becomes challenging, you could try using a microwave or table top grill.

  1. If you have dementia you can’t have a healthy balanced diet? FICTION

FACT Dietitians recommend you should try to eat a balanced diet.  By this we mean eating in a way that allows you to have all the right nutrients in the right amounts to keep you well.   You will have probably have seen the Eatwell Guide that gives information on the amount of each food you should try to eat.  However sometimes dementia can affect the way you taste food.

FACT Your likes and dislikes may change.  It may be that stronger foods or sweet foods become more appealing.  You may find that you enjoy foods you previously wouldn’t have enjoyed.

FACT Be adventurous – try new foods and drinks from time to time.

FACT Sweet foods can still be healthy.  Let’s look at rice pudding for example.  It does contain calories or energy but it also contains a good source of protein and calcium.  Pairing this with some tinned, fresh or frozen fruit will help to provide vitamins and fiber.  Resulting in a balanced meal!

  1. Taking a nutritional supplement can help your dementia? FICTION

FACT A range of nutritional supplements such as ginkgo biloba, B vitamins and vitamin E have been linked with improvements for someone with dementia.  Unfortunately there is limited or no evidence to support that they are beneficial, although research is ongoing.

FACT Eat a wide range of foods.  This is the best way to get all the nutrients you need to stay healthy.  However if you miss out a group of foods such as fruit and vegetables, you may benefit from a multi-vitamin and mineral supplement.

 

  1.  Losing weight and eating less is part of the aging process? FICTION

FACT It is not true that losing weight is a natural part of the aging process.

When someone loses weight unintentionally or loses weight quickly they should visit there GP.  A referral can be made to the Dietitian for further assessment and advice if needed.

With Dietitians you CAN….

  • Be assessed, diagnosed and receive personalised treatment for nutrition and dietary problems.
  • Understand how to turn scientific evidence can be turned into practical changes in what you eat and drink.
  • Make dietary changes to help treat a range of physical health conditions.

Ask a Dietitian …….

Thank you for reading my blog during #DAW2017

I welcome any comments on the facts and fiction ideas I have shared with you today

Gillian McMillan

Specialist Dietitian – Mental Health, NHS Lanarkshire

 

Allied Health Professionals supporting #DAW2017: Monday 29 May – Sunday 4 June 2017

Today 90,000 people in Scotland are living with dementia, and that figure is set to rise. Receiving a diagnosis of dementia can be a devastating and frightening time both for the person with dementia and for their families and friends.  Sadly, many people with dementia tell us that friends and even family drift away after their diagnosis. People can find it difficult to know how to react when they hear the news that a friend has dementia. This Dementia Awareness Week, let’s help people understand why friendship and kindness are more important than ever when you have dementia.

Allied health professionals will be supporting Dementia Awareness Week to make sure nobody faces dementia alone. We will be blogging all week, sharing messages on how we CAN help, we are getting involved in local events, ready to answer any of your questions and you will also find us the Alzheimer Scotland presenting national conference on 2nd June, sharing our work in both policy and practice. Follow #AHPDementia #OTHBMR or #ConnectingPeople to find out what we are doing and where we are?

Maybe use this blog to ask us a question if you are worried about falls, good foot care, eating well and keeping active? Perhaps you have questions about communication, looking for tips on how to boost your memory or develop a musical profile? We have Allied Health Professionals who could answer your questions on these topics or direct you to resources.

You can also find out how to contact some of the allied health professional by downloading our allied health professional leaflet http://www.alzscot.org/assets/0002/1191/AHP_Leaflet.pdf.  Join us in sharing information on what we CAN all do to support friends, family and people in our communities who are living with dementia.

Other useful information

For local events you can click here http://daw.dementiascotland.org/events where you can discover all the events taking places across the country during Dementia Awareness Week 2017 and beyond! Simply zoom in to a location near you to find out what’s on!

Dementia can bring many challenges, both for the person with the diagnosis and for those close to them.  If you have any questions about dementia or need to talk to someone, the Alzheimer Scotland Dementia Helpline provides information and emotional support to people with dementia, their families, friends and professionals. It’s a Freephone number and our team is available 24 hours a day, 7 days a week. Call on 0808 808 3000 or email helpline@alzscot.org

Allied health professional Enhancing Daily Living: Home base memory rehabilitation #OTHBMR – An update

On Wednesday there was a workshop with over 40 occupational therapy staff from across Scotland to talking about home based memory rehabilitation. Home based memory rehabilitation was originally developed by Mary McGrath (2013) and is an evidence-based, occupational therapist-led, six week intervention. It takes place in the person’s own home with a family member, where possible and is based on principles of cognitive rehabilitation. It aims to teach the person to compensate for their memory deficits and includes minor adaptations to the home environment to support these strategies. There are also four key principles that Mary shared in Dementia in Scotland (2016:23) that can help all of us cope a bit better with dementia:

  1. Don’t multi-task. Focus on one thing at a time. Whether that’s what you’d planned to make for dinner or trying to recall the name of a school friend from a photograph, putting all of your attention on the task at hand puts less strain on your memory.
  2. Don’t guess. If you don’t know, you don’t know and that’s fine. For a person with dementia, the process of making a guess can store that information in their mind, whether that information is right or wrong. For example, if somebody asks what day it is, don’t urge them to work it out for themselves, tell them and then reinforce the answer by encouraging them to repeat it and write it down.
  3. Dementia doesn’t define you. It’s very easy to start defining someone (or yourself) by their dementia. However, you must remember that there is more to someone than their dementia. Loss of self-confidence can have a big impact on a person with dementia’s trust in their own ability to remember things or carry out tasks. 
  1. Don’t over care. For many family members and carers it is a natural instinct to want to support the person with dementia as much as they can. This over caring can mean that even tasks and responsibilities that the person in still capable of achieving are taken away and that can contribute to further decline. Where it is safe to do so, people should be encouraged to continue being involved in familiar activities.

Home based memory rehabilitation has been successfully implemented in Scotland by the occupational therapy team in NHS Dumfries and Galloway. You can hear from four people who have been involved on the positive impact of the approach to their daily lives in the video below.

We are now collaborating in Scotland to test home based rehabilitation in 12 areas of Scotland and you can see from our photo album below who is involved.

National team supporting the work

NHS Dumfries and Galloway, Queen Margaret University & Alzheimer Scotland.

Keep in touch:

We will continue to share with you our progress on home based memory rehabilitation through this blog and on our community of practice http://www.knowledge.scot.nhs.uk/ahpcommunity/ailip-priority-workstreams/dementia.aspx

You can also follow #OTHBMR to find our more or post us a question on this blog

Thank you

McGrath M P 2013 Promoting safety in the home: The home-based Memory Rehabilitation Programme for persons with mild Alzheimer’s disease and other dementias.

Techniques and strategies for improving memory 2016 Dementia in Scotland issue 90 page 23

5 things I learned in Japan

Alzheimer Disease International holds a conference every year and it is a unique opportunity to bring together everyone with an interest in dementia – staff and volunteers of Alzheimer’s Associations, people living with dementia, family members, clinicians, researchers, care professionals and scientists – to share and learn from one another.

I was lucky enough to represent Alzheimer Scotland at the Alzheimer Disease International Conference in Kyoto, Japan in April, sharing our work in post diagnostic support. As I was going all that way for a conference I wanted to see the best of dementia care and support Japan has to offer so set up some visits to services that I’d heard were well respected. Here’s some of the headlines:

  1. Scotland is seen by the dementia community in Japan as world leading and way ahead of anywhere else. Our Human Rights approach; 5 and 8 Pillar models; our activism on dementia such as the Scottish Dementia Working Group. The few people from Scotland who were at the conference felt like minor celebrities-it was very humbling.
  2. In Japan dementia care is funded through a long term care state run insurance that everyone over 40 pays for. It has created a mixed market so, whilst the quality is mixed, there is a wide range of support available and lots of innovation is evident.
  3. Group homes of up to 9 people are a popular option for people with dementia who can no longer live at home. Daily life centres around an open plan kitchen and living space and people with dementia are supported to maintain their skills and abilities, including shopping for food and contributing to cooking meals, from chopping vegetables to stirring pots or laying out the chopsticks.
  4. Cognercise, used in some primary schools here, is growing as a therapeutic intervention in Japan. At a day centre in Tokyo, I joined in the body & brain exercise that energised everyone mid-afternoon.
  5. Dementia care, like everything, sits in a cultural context. Dementia care in Japan is thoughtful, kind, intricate and considered, with Hokkoi, roughly translated as a deep sense of wellbeing and contentment, the ultimate goal of dementia care.

Kyoto preparing lunch

Making a friend in the park

Room sign, Katerei no ie

On Reflection

How much do cultural values and norms influence our dementia care in Scotland? And how aware are we of this?

Occupational Therapy Lead Memory Management Group: a practice example

For over ten years occupational therapists in Lanarkshire have been running memory management groups. These groups are for people who have a problem with their memory and wish to do something themselves to improve this. It aims to enable people to be as independent as possible in their daily lives.

The groups are suitable for those with mild memory difficulties who feel it is impacting on their daily life. It is essential that the person is aware of their memory problem and actively wants to manage this effectively. People are referred to our groups via their consultant psychiatrist or GP. Everyone is visited at home by the occupational therapists prior to the group starting to talk through how the group could help and if they would like to take part.

The informal structure of the group allows people to gain support from others in a similar situation as themselves. Occupational therapist staff facilitate discussion, whilst working through a programme and offer practical advice related to their concerns regarding their memory.

Through discussion we assist people to work out solutions to the difficulties they are experiencing with memory problems. This is done by suggesting techniques and strategies to assist their memory in order to manage their day to day lives more effectively. The groups are generally small for approximately 4-6 people, taking place over four to five with each session lasting 90 minutes.

Some of the topics included in the group are:

  • Remembering names
  • Staying safe at home
  • Getting out and about
  • Tips and strategies
  • Enhancing well-being
  • Keeping the brain active
  • Leisure

We have practical materials we demonstrate in the group and provide what we can after each session as from experience individuals are more likely to use the strategies suggested if they have the required material rather than having to go and get the item themselves.

 

To evaluate the group we use “Emotional Touchpoints” which has been an effective way for those attending to share how they have found their group experience. For those unfamiliar with this method, ‘Emotional Touchpoints is a powerful means of helping people to share the aspects of experiences that are important to them – rather than the things service providers think are important.’ (Scottish Health Council, 2016). Below are a few examples of what people have said about this group.

“I now feel hopeful but I didn’t before I came here. I used to isolate myself and do things alone as I was embarrassed if I got things wrong. I now willingly go out with others and say yes to invites. I feel I’ve changed. I feel more positive and see a difference in myself since coming to this group. I’m relieved as I used to think about my memory all the time but I’m now at the stage I go with the flow and I’m enjoying myself.”

“I’m happy I’ve been involved with others with the same problem and feel I can now handle stuff I couldn’t have before. I’ve valued the hints and tips shared in the group and hopeful that what I’ve learned will stay with me and allow me to enjoy myself.”

“I’ve felt welcome here right from the start and quickly felt involved. I’m relieved to know I’m not the only one going through this. I’m hopeful; by using what I’ve got from here that I will be able to manage what is ahead of me.”

“I was really anxious about my memory at the start but now feel inspired and more hopeful and confident in myself and about my memory. I’m using techniques eg in the pub yesterday I was listening for someone’s name being said as I knew him from years ago and was talking to him but couldn’t remember his name. Being supported here has made this a great group and I will miss coming.”

Thank you for reading our blog post. we would love to hear what you think and if you have experience of working with occupational therapy

 

Gill Gowran, Specialist Occupational Therapist, NHSL

@MHOTGill (Twitter)

#valueofOT

 

 

 

Maximising Psychological Wellbeing – Music Therapy Reflections: On a positive note…

 

In my last Blog post, I asked our Art Psychotherapy Student, Shirelle Young about the best of her Alzheimer Scotland placement experience. Here, the conversation is with Ed Muirhead who has just finished his Music Therapy placement, asking him about what worked well during his time spent in one of our Dementia Resource Centres.

Environment

Question: Reflecting on the therapeutic environment, what really mattered?

Answer: “The room was very important as part of the secure space, and maintaining this space was a key building block of the therapeutic process.

Music

Question: Concentrating on the process of music making, what worked well?

Answer: “Singing was the most frequent form of music-making, people seemed most familiar and comfortable with this. We would sing known songs according to peoples’ preference – everyone has their own particular songs they like to sing. These would be accompanied with piano or guitar, and we would occasionally improvise words in the moment to known tunes. Other instruments such as glockenspiel, shakers, drums and tambourines were also used, though not so often as singing.”

 

Relationships

Question: Focussing on the therapeutic relationships that developed, what made a difference?

Answer: “There was evidence of developing relationships with people throughout the 22 weeks of the music therapy practice placement. Particularly after the Christmas break, I noticed a deepening of relationship, a closer proximity, both physically and emotionally, and heightened eye-contact and engagement. At this point, so close to the work, it’s hard to pinpoint exactly what made a difference, perhaps the continuity of the work, being there every week at the same time in the same place and holding on to memory on behalf of people.”

Reflection

Question: Thinking about your own reflective processes, what was helpful?

Answer: “Reflection has been important along the way, and will continue in the coming weeks as I write up my professional project. I’ve chosen a clinical project that focuses on personal reflection while carrying out the placement – including a service evaluation element. Process notes along the way were helpful, as were video recordings of sessions (with informed consent by people coming to Alzheimer Scotland).”

Approach

Question: Looking at how you have adapted your approach to meet the needs of people with dementia and their families within Alzheimer Scotland what has been important?

Answer: “Learning repertoire to suit each person has been important, as has learning chord sequences that suit music from their era. General knowledge of the music of the 1940s, 1950s and 1960s in particular has been useful. My own approach relies on listening, which has been vital in hearing what people have to say or sing, though sometimes musical prompting has been required.”

Dementia

Question: In working towards becoming a dementia skilled practitioner, what has been useful?

Answer: “My practice educator provided valuable documentation about working with dementia (NHS/NES manual, articles), also I’ve read Kitwood and other person-centred literature. Working alongside colleagues in Alzheimer Scotland has had the most practical benefit, seeing them with people living with dementia, watching how they are and learning from them.”

Celebration

Question: Looking back at your placement at Alzheimer Scotland, what are you really proud of?

Answer: “It has been a wonderful experience to use music therapy with people who seem to have benefited so much from the experience. Questionnaire feedback from people living with dementia, families and staff has been very positive, and I’ve learned a lot about the unique power of music for each person involved.”

Over to you

Having shared some of Ed’s thoughts, we would be interested to hear about your experiences of being creative and the impact on your health and wellbeing… What has made a difference for you?