“Rabbit stew anyone?”

The role of a dietetic student in a care home

The North Highland health and social care partnership supports a strong and integrated model of care for adults, including care homes. I was appointed as the nutrition and dietetic advisor for care homes in 2014 and took the lead in championing this work, along with Emma Pasieka (the Board’s dietetic placement co-ordinator), Urray House care home (part of the Parklands care group) and Dr Myra MacKenzie from Robert Gordon’s University. AHP practice education lead, Kerrie MacLean, advised and supported the group’s work using her experience of other AHP’s placements and in linking closely with NHS Education Scotland.

We developed a pioneering, first UK experience, of placing a student dietitian in a care home setting in The Highlands. In the course of the placement, the dietetic student and activities co-ordinator engaged with a group of residents with dementia and 2 of their relatives in remembering favourite meals from childhood, mainly from the wartime. Their memories and discussion then helped care home staff and the cook design a World War II themed lunch menu. It included scotch broth, rabbit stew and clootie dumpling.

Photo kindly provided by Urray House care home (part of The Parklands care group)

The themed lunch was open to all residents and their relatives and we also had interest from the local press. Some of the comments from the day are recorded below from residents, relatives and staff, which sum up the event:

“Clootie dumpling was the best part”

“We always got clootie dumpling at birthdays and if you were lucky, you got a silver threepence”

“I was brought up on rabbits; they were tastier before the war”

“The food here is excellent and the chef has a real interest in food and nutrition: it’s great that she was able to prepare this meal for residents”

“I think the whole idea was great. My mother was telling me about when she was little when her mother used to go to the butcher and get a rabbit for a shilling. She’d then sell the rabbit skin to a man that came round the houses; there’s no way she’d have remembered that without this themed lunch bringing back those memories”

“Having a focused discussion around food memories is a great way of engaging

with residents who have dementia and their families, giving them a voice in choosing their favourite menus and following up with a themed meal, where staff dress up to serve the food. Everyone can participate have fun and enjoy the memory.”

The work of the student dietetic placement demonstrated a successful innovative, multi-agency approach to placing a student dietitian in a care home setting, facilitating active conversations with people living with dementia. It worked particularly well with the people who can at times appear quiet or withdrawn. We were also delighted that our work was recognised at last year’s Scottish Dementia Awards as a runner up in “the most innovative partnership” category.

Dietitian Students in Care at Home Settings

We have built on the success of our work in the care home setting with our dietetic students and have been continuing to develop a model of practice placements in “care at home” settings. In NHS Highland alone 19,000 people receive care at home and the provision of adequate nutrition and hydration can be a challenge within this setting. Student dietitians rarely have the opportunity to experience the reasons for this, or the opportunity to present solutions.

As a result, in 2015 NHS Education Scotland, the Care Inspectorate, NHS Highland, Robert Gordon University and Highland Home Carers agreed to go one step further than care home placements, and test another new model of training student dietitians; this time in the context of ‘care at home’ settings. You can find out more about this work in my blog post here https://ahpscot.wordpress.com/2016/01/11/care-at-home-pre-registration-training/. I believe that we are offering a great learning opportunity for our dietetic students while also supporting the needs of individuals and their families, in a very proactive, person-centred placement model.

Our experiences of implementing and evaluating a dietetic social care placement model has just been selected to be presented in a poster session at the International Congress of Dietetic Associations in Granada, Spain in 2016.

Reflections

Thank you for taking the time to read my blog post.

Food forms such a strong part of our social and personal memories and reminiscing about events can offer a fascinating insight to family & friendships, social history and opens conversations up with groups of people from all walks of life. So can I leave with this…..

“Think back to your memories of your 10^th birthday party, what food & drinks were offered to all your friends & guests?”

Evelyn Newman RD, NHS Highland, Nutrition and Dietetic Advisor: care homes, evelyn.newman@nhs.net

@evelynnewman17

Evelyn’s role as nutrition and dietetics advisor: care homes, is unique in the UK. She works within NHS Highland’s integrated adult social care team, working at a strategic advisory level, supporting the 73 care homes in the North of Highland. The role is very varied offering: many forms of training; tailored nutrition/hydration advice for care home managers; up to date food, fluid and nutrition policy and resource development and information.

1Oct2015

Scotland’s Dementia Awards

by talkingdementia

Celebrating World Alzheimer Scotland Day

#SDA15

Scotland’s Dementia Awards in partnership with Alzheimer Scotland, NHS Education for Scotland, NHS Health Scotland and Scottish Social Services Council; in celebration of World Alzheimer’s Day, provided an opportunity for professionals and communities, who are committed to enhancing the health, wellbeing and experience of people living with dementia and their families, to have their work recognised and promoted. The award scheme helps showcase the creativity, innovation and dedication that make a real difference to the daily lives of people living with dementia and their families. There are six categories, over 90 applicants and in this blog post we are sharing the films and details of our 6 winners. Although do take the time to have a look at all the finalists here

http://www.alzscot.org/news_and_community/news/3413_finalists_announced_for_scotlands_dementia_awards_2015 and remember the Scottish Dementia awards entries for 2016 will open, sign up to our e-newsletter to stay up-to-date.

Best Educational Initiative

Edinburgh Dementia Training Partnership

The Edinburgh Training Partnership comprises representatives from NHS Lothian, City of

Edinburgh Council and independent sectors. Its remit, informed by the National Dementia

Strategies, is to provide good quality training primarily within care settings, which improves the experience of people with dementia, their families and carers, and the staff who support

them. Another key objective is to deliver a sustainable training programme using a train-the trainer model and linking participants with the SSSC Dementia Ambassadors Network. We use the Promoting Excellence resources as a framework, but bolster the programme by making use of a variety of additional ideas and materials which reflect best practice.

Jackie Sloan, Learning and Development Advisor, City of Edinburgh Council,

Telephone: 0131 529 6478, Email: jackie.sloan@edinburgh.gov.uk

Best Acute Care Initiative

Knowing Me, Knowing You

Using storytelling and visual arts in this acute setting, our innovative pilot created a

welcoming and equal space. Here, skilful facilitation by the Village Storytelling Centre brought together patients and carers alongside a multi-disciplinary group of nurses, occupational therapists, Chaplain and Volunteer Services to delight in discovering each other’s stories. Around the table, we shared cake and stories and created multi-sensory art on each week’s theme. Sessions were highly responsive to individual need and population change. Held by a loose structure and adapted in the moment, each stood alone while building towards the co-creation of a personal journal.

Doreen Mall, Occupational Therapist, NHS Greater Glasgow and Clyde, Telephone: 0141 211 3657, Email: doreen.mall@ggc.nhs.uk

Best Innovation in Continuing Care

Namaste Care Team East Ward, Dykebar Hospital

Namaste means to “honour the spirit within” and is a special way of caring for patients with

advanced dementia. The programme supports the philosophy of person-centred care and

offers people with advanced dementia the opportunity to engage with others by therapeutic touch and sensory stimulation. Comfort is a large part of the process and each patient has items that are personal to them and provides pleasure, comfort and stimulates memory. Each session consists of a variety of sensory interventions with the choice being determined by the needs of the patient and informed through life story books, staff and carer’s knowledge.

Maria Banks, Senior Charge Nurse, Dykebar Hospital, Telephone: 0141 314 4060,

Email: maria.banks@ggc.scot.nhs.uk

Best Dementia Friendly Community Initiative

Lanarkshire Mosque & Muslim Community Project

Our Motherwell Dementia Friendly Community Pilot (2012) highlighted a range of inequalities within our BME Communities. The largest group in North Lanarkshire is the Pakistani/ Muslim Community. Our Muslim community realise the challenges in reducing stigma around dementia and want to support future generations of women family carers. Collectively we acknowledge years of marginalisation of Muslims in society and wish to build trust and breakdown barriers between communities and service planners/providers. The Lanarkshire Mosque and Muslim Community project is an emerging movement for change with a strong sense of ownership, open to working in partnership with Alzheimer Scotland, Princess Royal Trust Lanarkshire Carers Centre and other multiagency partners.

Gabriela Mitas, Community Activity Organiser, Alzheimer Scotland, Telephone: 01698275300

Email: gmitas@alzscot.org

Best Community Support Initiative

‘Fit for Life’

‘Fit for Life’ is an NHS community-based exercise group for older people living with dementia, depression or anxiety, which aims to improve balance, mobility, fitness and confidence in clients who are often socially isolated, have poor balance or who have low levels of physical functioning. Through the support of physiotherapists and volunteers, clients attend a 12 week programme of specific exercises and tai chi. Fit for Life has helped people with dementia become more physically active; re-establish a sense of personal control and provide greater involvement in the community. It can be seen as a benchmark in person-centred care and integrated working with third sector agencies.

Jackie Hodge, Physiotherapist, NHS Lothian, Telephone: 0131 537 6606

Email: jackie.hodge@nhslothian.scot.nhs.uk

Most Innovative Partnership

Arky’s Resident Nail Bar

Since August 2013, our pupils have established and built upon links with staff and residents of Renfrew Care Home. Fortnightly visits ensure regular contact where not only residents can enjoy friendships, love and chat, but our pupils too. Life skills which cannot be taught in the classroom environment, naturally blossom through our partnership. These visits are both ways; the residents look forward to attending tea dances, singalongs, open afternoons and annual events. We have also widened our pupils’ skills through working closely with Salon Services for hand massage and nail painting which the residents thoroughly enjoy. This stimulates talk.

Laura Thomson, Primary Teacher, Arkleston Primary School, Telephone: 0781 7869598,

Email: gw09thomsonlaura7@glow.sch.uk

Life time achievement – Nancy McAdam

In addition, Nancy McAdam was recognised with the event’s Lifetime Achievement Award. In 2004, Nancy and another person with dementia became the founder members of the Inverness Dementia Memory Group – the first Highland Involvement Group of People with a diagnosis of dementia. Since 2005, Nancy has volunteered on local and national awareness-raising, campaigning and service improvement – including speaking at and taking part in conferences and volunteering for local and national media opportunities on dementia issues.

1Jun2015

“A blog a day blether” for #DAW2015

by talkingdementia

Allied Health Professionals Q&A

Day 1

Hello & Welcome

During Dementia awareness week allied health professionals are posting a “blog a day” as a Q&A by four of our allied health professional colleagues. We invited the Scottish Dementia Working Group (@S_D_W_G), National Dementia Carers Action Network and people we work with, to ask questions to a dietitian, an occupational therapist, a physiotherapy and a speech & language therapist. This is the first blog in our series of five and offers an introduction to our Q & A blog posts

Day 1 Q & A

Three questions of my questions we were asked by the Scottish Dementia Working Group. The final question was asked at the Age Scotland member’s conference with colleagues Yolanda @Yol_ahp and Jenny @JennyAckland2.

Question 1

“How would we know about what services AHPs could provide for us if we hadn’t come to this meeting?”

Answer

You can find out more about each profession on their professional body website. Each one of the allied health professionals have their own professional body, standards of professional practice and can be contacted directly. In our blog we include the links to these professional bodies in our “Useful Links” section.

You will also find contact details of AHP services in your local health board website where there maybe be a list of what services are available. Here is an example in NHS Lothian.

http://www.nhslothian.scot.nhs.uk/Services/A-Z/AlliedHealthProfessionals/Pages/default.aspx

You can also contact your local authority who can link you to the occupational therapists. Here is an example by Edinburgh Council http://www.edinburgh.gov.uk/info/20057/housing_support_and_advice/435/adapting_your_home

You will find a few of us on social media so you can connect with us there too. If you follow the hash tag #AHPDementia you will see some of us there. All our twitter handles are included in our contributors pages too.

Question 2

“How do you know what you are entitled to and where to go to get help?”

Answer

One document you may want to look at for the allied health professionals is their Consensus Statement on Quality Service Values which brings together, for the first time, the minimum, collective service values of the Allied Health Professions into one clear statement and clarifies for service users what they can expect from Allied Health Professionals and Allied Health Professional service providers. You should expect to meet a group of professionals that are responsive, engaged, inclusive, safe, effective and most importantly person centred

http://www.gov.scot/resource/0043/00438291.pdf

Added to that, all the allied health professionals in the health service and local authority will be registered to the Health Care Professions Council (HCPC) www.hcpc-uk.org. HCPC are a regulator, who were set up to protect the public and they keep a Register of health and care professionals who meet their standards for their training, professional skills, behaviour and health. Use this website to ensure that any private AHP practitioner is a registered Allied Health Professional

More specifically to what you are “entitled” to if you are living with dementia, you could also look at the Standards of Care for Dementia in Scotland. These standards have been developed to help people living with dementia and their carers understand their rights, and how these rights can help make sure that you receive the support you need to stay well, safe and listened to. The standards are based on your rights. You should use them to get the care, treatment and support you need.

Some extract from the standards that link to the role of allied health professionals

“Service providers will ensure that the actions of their staff and their policies and procedures demonstrate that staff use a variety of communication aids to help communication, including the use of life story books, talking mats, digital stories, interpreters as appropriate and referral to speech and language therapy”. (page 15)

“NHS Boards will ensure that a range of non-drug based interventions are available and include evidence based therapies, such as group based or individual cognitive stimulation, individual reality orientation therapy, art therapy, therapeutic activities and physical exercise programmes”. (page 25)

“All service providers will give people with dementia the support they need, wherever they are living, to continue to be involved in their ordinary activities such as; exercise, involvement in music, dance, social events and religious activity and to become involved in new activities and experiences”. (page 32)

http://www.gov.scot/Resource/Doc/350188/0117212.pdf

To ensure continuous improvement, the standards should be used in conjunction with Promoting Excellence: A framework for health and social care staff working with people with dementia and their carers. The framework outlines in detail the skills and knowledge health and social care staff should have depending on the role they play in supporting people with dementia. We aspire that all allied health professionals on graduation and in practice worked at the minimum of “skilled”.

http://www.gov.scot/resource/doc/350174/0117211.pdf

Question 3

“The role of community psychiatric nurse is still seen as central for our members. Do AHPs have close links with them? “

Answer

Allied health professionals build strong partnerships with other agencies, community providers and also other members of the multidisciplinary team both in the NHS and local authority. This will also include our community psychiatric nurses, district nurses and more recently the Alzheimer Scotland Link workers too. So yes we do have close links with the community psychiatric nurse who you can ask to refer you to an allied health professional in your local area.

Question 4

“How do I get in touch with an AHP if I need one?””

Answer

This is a question we are asked a lot and we have developed a new leaflet to help answer this question. Today we launch our Alzheimer Scotland allied health professionals leaflet, click here to access the leaflet.

Over the forthcoming weeks, this leaflet will be available in all our Alzheimer Scotland resource centres and directs you to how to get in touch with five of the allied health professions including dietitians, occupational therapy, physiotherapy, podiatrists and speech and language therapy.

We have many other allied health professionals not included in this leaflet as this leaflet was about those you are most likely to see in a community setting. Email us at TalkingDementia@alzscot.org if you would like to hear more about arts therapies, orthoptists, paramedics, prothetists, orthotists and radiographers (diagnostic & radiographers) in Scotland and we will and offer you a link to these professions too.

What’s next in this week’s blog series?

Finally, over the remaining four’s days, we have a Q & A series of real questions from people living with dementia and their carers being answered by members of the Alzheimer Scotland allied health professions dementia expert group so look out for them and please join in our “blog a day blether” for #DAW2015.

: 5th June will be by Joy @joysltdem

We welcome ideas and comments from our readers this blog to any of the answers in case I have missed out anything.

Tomorrow’s blog will be by Gillian and “Ask a Dietitian” Q & A.

Elaine Hunter
Allied Health Professional Consultant, Alzheimer Scotland
@elaineahpmh

My remit in Alzheimer Scotland is to bring the skills of AHPs to the forefront of dementia practice and to share with them the principles and practice of working in a major charity that is dedicated to “making sure nobody faces dementia alone”. I am leading the delivery of commitment 4 of Scotland’s Dementia Strategy. In short, a great job working with great people.

15Jan2015

Actualising work potential in dementia care

by talkingdementia

I am delighted to share with you in this blog, my work as an occupational therapist with a young man. This is only possible as I am working closely with his family and community partners. The DVD is five minutes long and I hope you can see how work/vocational potential can be actualised with the right support, at the right time

My special interest is community connections. During my last posting with NHS Lanarkshire, I was involved in designing an occupational therapy based leisure group in partnership with older adults and multi-agencies. This was open to ALL older adults and took place at the Time Capsule Leisure centre. It continues to attract around sixty older adults to the weekly group since 2009. Current leaders are looking into opening the group for an additional day as more older adults want to join in. This leisure group was chosen as the platform to launch Scotland’s first National Dementia strategy.

I would now welcome your reflections around this filming and any further discussion points it raises within you.

Many thanks for taking the time to view this blog.

Pasna Sallis- Occupational Therapist, Young Onset Dementia Team, NHS Greater Glasgow and Clyde

@pasna

My work involves timely occupational therapy input with the younger person with dementia and their family to live well within their community. In my current role I address self management issues within home, hospital, Care home settings, as well as within the wider community for example, work and/or leisure domain. I provide a consultancy role to OTs within our Board who are looking for specialist working knowledge in dementia care.

18Dec2014

Sharing Practice and Sharing Stories in Dementia Care

by talkingdementia

“Storytelling is the most powerful way to put ideas into the world today”

Robert McAfee Brown (attributed)

Monday 15 December 2014 saw the official launch of three new publications for Allied Health Professionals in Scotland: Agents of Change; Living Well with Dementia; and Living Well with Community Support. Published by the Scottish Government and Alzheimer Scotland, these publications highlight the impressive work carried out by AHPs in delivering improvement for people living with dementia and those who care for them, as well as leading change in practice. This week’s blogs is a Q & A on the “suite of three AHP documents”

What’s included?

The reports are full of rich stories of how it ‘can be’ when allied health professionals are getting it right for people living with dementia and their carers. Together the reports have 9 forewords, 41 narratives from a range of organisations including 10 NHS Boards, 1 specialist board, 2 third sector organisations and 3 local authorities.

Who has contributed?

Scottish Dementia Working Group (@S_D_W_G), National Dementia Carers Action Network, 8 allied health professionals (art therapy, dieticians, music therapy, occupational therapy, paramedics, physiotherapy, podiatry, speech and language therapy), Scottish Government and Alzheimer Scotland.

What has been the key to success?

The success of this work has relied heavily on leadership and partnership. Professional leadership from all the contributors who use their skills to help people with dementia cope better and improve their quality of life. Also, the work of the AHP’s in dementia care is only possible as a result of partnership working, partners in the same organisation and many new partnerships being developed and built upon.

Why did you do three publications?

All 41 narratives are focused on real life, real people, and are a powerful way to highlight the positive impact, Allied health professional led interventions can have. We wanted to share the many creative ways allied health professionals are linking policy to practice in the areas of acute care and community care The narratives give a voice to the work of the allied health professionals and those we work with, showcasing how we can be “engaging, enabling and empowering”

What next?

The personal narratives outlined in the three publications will contribute to the developing strategic AHP vision that directly links to Commitment 4 in Scotland’s current National Dementia Strategy. With our partners we will consider how we spread the practice examples outlined in all three reports and enact the vision “Making sure nobody faces dementia alone”.

What have been your top three highlight in doing this work?

This is the first publication we have included our paramedical professionals who recently joined the “AHP family” in Scotland
Working with a motivated and inspiring group of people who all said “yes” when invited to share their story
The celebration and launch event of the three publications on the 15^th December where we had the opportunity to say “thank you” to all our partners