5 Environmental Hints & Tips

“If you get it right for dementia, you get it right for everyone”

1. Signage

• Should be clear and concise and have good contrast between text and background
• There should be contrast between sign and mounting surface
• Should be fixed to the doors they refer to (not adjacent surfaces)
• Signs should be at eye level and visible
• Avoid the use of stylised or abstract images when implementing signage
• Implement signs at key decision points to help with navigation / way finding
• Signs are critical for toilets and exits
• Always have glass doors visibly marked to avoid accidents.

2. Orientation

• Research has shown that people with dementia use landmarks to navigate their way around both inside and outside
• The more attractive and interesting the landmark is, the easier it is to use (plants and pictures are good examples).

3. Lighting

• Entrances should be well lit and easy to access
• Use natural light as much as possible as artificial lights can be dazzling
• Overly bright lights and shadows should be prevented where possible
• Use of brighter primary colours can help to lighten up dark areas.

4. Seating

• In large premises a seating / waiting area can be very beneficial to avoid fatigue
• Seating should resemble traditional seats for example a ‘wooden bench’ or ‘chair’ as apposed to a ‘Z’ new style seat.

5. Flooring / Stairs

• Avoid highly reflective and slippery floor surfaces
• Changes in floor finish should be flush
• Stairs should be contrasting colour to floor in order to show the obstacle clearly
• Avoid using mats/rugs where possible as they may pose an obstacle.

You can download this information to share with others. Let us know how, where and who you shared the 5 environmental hints and tips with.

http://www.alzscot.org/assets/0001/2899/Environmental_Hints___Tips.pdf

We also have a new resource called “Building Motherwell’s Dementia Friendly Community” which you may also find interesting.

Click to access Dementia_Everyone_27s_Business.pdf

‘Pocket Ideas…for a moment in time’ a person centred approach in Acute Care

Pocket Ideas, what is it?

So if a person with dementia or carer wanted to know what to expect when being introduced to “pocket ideas” what would I say?

‘Pocket Ideas’ is a portable pocket sized book filled with prepared activities and inspirational quotes to help stimulate conversation. These conversations can take place whilst working with a patient in the ward, as the book is very portable, or in a group situation.

It’s an opportunity for us all to remember to see the person who has had many life experiences, skills and knowledge. It helps to build therapeutic relationships, reduce distress, reinforce the benefits of meaningful activity and person centred care. It’s a tool that anyone can use and anywhere, reminding us that every moment we have to offer older people in meaningful experiences is valuable, and essential in our professional practice. Enjoy the experience using it and the opportunity to reminisce, remember and even talk about new topics.

I would also tell them that this initiative won an award last year, in the category of “Best Acute Initiative” of Scotlands Dementia Awards 2014.

5 Top Tips using ‘Pocket Ideas’

1. Only takes 5 minutes to have a moment in time with an individual, and it reinforces the importance of meaningful activity.
2. Simple prepared activities and inspirational pictures to stimulate a conversation.
3. Encourages positive therapeutic relationships and reinforces the importance of humanity, compassion, person centred care and being actively engaged.
4. Portable pocket sized tool and can be used anywhere by anyone.
5. Enjoy using it, as a moment in time can bring back a memory, reduce stress, provide comfort and make you smile.

5 things you need to know when designing a resource like this

1. Understand what the problem is and creative ways to address it.
2. Importance of engaging relevant staff members to support project ideas.
3. Establish a working group to talk about ideas, set achievable goals and support each other to realise a possibility and make a difference.
4. Create a prototype using creative ideas.
5. Develop a means to measure the benefits of using the prototype and then pilot the project idea in the relevant area.

My top recommendation to make something happen, surround yourself with a great team.

Our team picture includes; left to right Jean Knox, (Technical instructor), Gillian Agnew (Occupational therapists), me in the middle, Elaine Tizzard (Technical instructor) and Darrell Line (Technical instructor).

I would welcome any reflections on my blog post

I would also like to leave you with a question to consider and reflect on

How can we ensure, if you are living with dementia and require to go into an acute care setting that every contact with a health care professional is person centred and we ask you “what is important to you”

Andrea Boyd

Occupational Therapist, NHS Ayrshire and Arran

@AndreaBoydahpmh

I am currently on secondment and leading up the project ‘Pocket Ideas…for a moment in time’. I have been an Occupational Therapist for many years, but this is such an exciting opportunity to continue with the development of our person centred tool with the support of my ‘Activity Team’.

 

Living well through activity in care homes

This week I have been involved in filming a rough cut for a short film for people who are looking for a care home. The idea for the film rose from the publication last year of the College of Occupational Therapists’ Living well through activity in care homes toolkit.

It is really important for people with dementia to be supported to maintain normal daily life and to live in their own home. For some there may come a point when residential or nursing care is the best option for meeting their needs. The idea for the film was born out of conversations with relatives of people with dementia and their experience of not knowing where to start in their search.

Judging a home by the feel of the place and the décor seems a common experience. Many report the rapid decline they see in their relative on entering into care and how sad it is to visit when everyone is sat around the communal areas with the television on but little conversation or activity. We recognise the truth behind the saying if you don’t use it, you lose it but we appear accepting that once someone is requiring 24 hour support they no longer need opportunities to retain their existing skills, interests and ways of doing things.

Activity: something someone does

As occupational therapists believe that human beings have an innate drive to do we recognise that taking away choice and opportunity to engage in occupation can lead to boredom, frustration, irritability and ill health. We define activity as something someone does and being active as showing involvement. Regardless of age or diagnosis we have the right to remain active throughout our life span. Recent research highlights the risk of early mortality associated with feelings of loneliness and that those who are sedentary are much more likely to be depressed than those who are active (Steptoe et al, 2012)

Living with dementia and living life

As AHPs we need to support the message to the general public that living with dementia is not just about being a recipient of care but it is about living life. We cannot expect care home staff to have the levels of skills and expertise to address the often complex needs an older person with dementia but we do need them to understand when and whom to turn to for advice be it with eating, moving or communicating. The way forward is not seeing the care home as the be all and end all of care but ensuring equality of access by care home residents to AHP services and working in partnership with care staff.

Environment, staff attitude and communication all support activity.

To start changing perceptions of the public and the understanding of care home staff, the Living well through activity in care homes toolkit touches on ideas for activities for people in the later stages of dementia, and the role the environment, staff attitude and communication has in supporting activity. All AHPs have a part to play in enabling activity and I would be keen to hear other people’s successes in working with care homes and residents with dementia.

The toolkit can be downloaded from our website- www.cot.org.uk

 

Karin Tancock
Professional Adviser for Older People and Long Term Conditions
@karinTancock

I provide advice and information to occupational therapists to support best practice and highlight service innovation. I also maintain professional networks with key organisations and government departments and represents the College of Occupational Therapists at key influencing events related to older people and long term conditions.

Reference:

• College of Occupational Therapists (2013) Living well through activity in care homes toolkit. London: COT. Available at: http://www.cot.co.uk/living-well-care-homes

Accessed on 14.08.2014

• Steptoe, Demakakos & de Oliverira (2012). The psychological wellbeing and health functioning of older people in England. The Dynamics of Ageing: Evidence from the English Longitudinal Study of Ageing 2002-10

A snapshot of what an allied health professional can do for you

 “People with dementia will have the opportunity to be included in community life and meaningful activities as they wish.  All services 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”

This is a direct quote from the Standards of Care for Dementia in Scotland (2011) and reminds us all that people with dementia can be involved in everyday activities, both old and new.

The standard also states “services will give people with dementia the support they need”. In Scotland we invited my allied health professionals colleagues to share with us what they can do to support someone with dementia.  In this blog I am sharing a “snapshot” of how 5 of the allied health professions describe their role when working with people with dementia and their carers, partners and families.

Who are we?

Allied health professionals are registered therapists who can help when people are worried about their memory, if a person has a diagnosis of dementia or if someone in the family has dementia. They offer information, advice and treatment tailored to individual needs. They are experts in rehabilitation, focusing on strengths and assisting people to stay connected to their community and remain in their home for as long as possible. In no more than 50 words this is what they say they can do for you if you have a diagnosis of dementia or are caring for someone with dementia:

• Dietitian – will help you to eat well
• Occupational therapist – will help you take part in social activities, hobbies and interests that are important to you.
• Physiotherapist – will help with physical activity
• Podiatrists – will help you look after your feet
• Speech and language therapists – will help you maintain everyday conversations

 

How can a dietitian help?

A dietitian can assess, diagnose and treat diet and nutrition problems at an individual level.  Uniquely, they use the most up to date public health and scientific research on food, health and disease, which they translate into practical advice to help people make appropriate lifestyle and food choices.

 

How can an occupational therapists help?

The occupational therapist can help people to continue to do as much as they can in their daily lives, offering strategies to allow people to participate in social activities, hobbies and interests that are important to them. They understand the link between occupation and good health. They can advise people on small changes to the home environment to make life easier, recommending the right type of equipment to meet a person’s needs from memory equipment to kitchen equipment.

 

How can a physiotherapist help?

A physiotherapist can help if the person has difficulties with walking; experiencing falls or feel they are unable to access the activities they enjoy.   They can provide the person with advice on, or offer an exercise programme to improve strength and balance, equipment to help walking and help with accessing community services.

 

How can a podiatrist help?

Healthy, pain free feet are important in maintaining mobility and enabling people to engage in a range of activities and be an active member of the community. NHS Podiatry services are available for people who have a foot problem or have a medical condition requiring podiatric intervention. (Personal foot care such as toenail cutting is not provided by NHS Podiatry services).

 

How can a speech and language therapist help?

Speech and language therapists are experts in communication and interaction and help people who have difficulty with everyday conversations. They are also experts in eating, drinking and swallowing difficulties. The speech and language therapist’s aim is always to enable a person to participate to their full potential in their chosen activities.

We are collating this information, with a description of how to access these professions into a leaflet that will be available in the Alzheimer Scotland resources centres, on our mini bus, available from our link workers and will be in our offices throughout Scotland.  However we are really interested to know, when living with dementia or caring for someone with dementia “what matters to you and how can we help?”

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.