Transcript Slide 1
CONNAUGHT HOUSE
Do people with Korsakoff Syndrome benefit from supported living accommodation?
Korsakoff Syndrome (KS)
• KS is a memory disorder caused by lack of vitamin B1 (poor diet, poor absorption) • Classical symptoms loss of memory (ST), loss of spontaneity and initiative, confabulations, lack of insight, apathy, talkative or repetitive behaviours, unsteady gait when walking, poor hand, finger control • Affects person’s ability to plan & organise
Affects person’s ability to live an independent life
Alcohol in Northern Ireland
10,000 8,000 6,000 4,000 2,000 0 19 95 /9 6 19 96 /9 7 19 97 /9 8 19 98 /9 9 19 99 /0 0 20 00 /0 1 20 01 /0 2 20 02 /0 3 20 03 /0 4 20 04 /0 5
Year
Amnesic Syndrome Admission to Northern Ireland Hospitals
60 50 40 30 20 10 0
36 41 39 27 30 42 52 40
19 96 /9 7 19 97 /9 8 19 98 /9 9 19 99 /0 0 20 00 /0 1 20 01 /0 2 20 02 /0 3 20 03 /0 4 20 04 /0 5
Year 55
ICD-10 Korsakoff Syndrome included under the umbrella of Amnesic Syndrome
Connaught House
• 5 bedded supported living unit • Opened in June 2004. Data collection began in September 2004.
• First facility in Ireland which is specifically aimed at addressing the needs of people with KS.
Staffing Structure
Co-ordinator Senior Project Worker Scheme Manager Project worker Project worker Project worker Project worker Relief Project worker
Overall Objective
• Encouraging optimum level of independence through receiving practical help and support in dealing with everyday situations. Doing things
with
things
for
them the individual rather than doing For example: Re-discovering old skills lost through and brain damage (alcohol abuse) and lack of use (living situation) Rekindling positive relationships lost through hectic lifestyle
Model of care
• Provide a safe ‘alcohol free’ environment • Provide support with all aspects of daily living e.g. regular nutritious meals, personal hygiene, accessing medical services, budgeting & finances • Encourage meaningful daytime activities • Support & encourage family involvement • Encourage social inclusion/ community involvement • Support alcohol abstinence • Memory exercises
Combining daily tasks with pet therapy
Taking care of the hens Dinner time for Honey the dog
Activities
Memory Exercises
“Memory is the diary that we all carry around with us”. (Oscar Wilde 1969)
Activities
Rediscovering lost skills and uncovering interests
Evaluation
• 3 Year case study based evaluation
Tenant Outcomes
baseline 6 months 12 months • Daily living skills (personal hygiene, household chores) • Quality of life (physical, mental, social) • Depression • Alcohol relapse • Improvements in everyday memory • Family Involvement
Methodological Techniques
• • • • • •
Range of standardised questionnaires
LSP (Parker et al. 1991) QOL-AD ( Logsdon et al. 1999) CES-D (Radloff 1977)
Semi structured Interviews
(tenants & staff)
Postal Questionnaire
(family members)
Record Analysis
incident reporting) (tenant monthly summaries, review notes,
Observation Informal conversations with staff
Overview of 2 tenants Individual Tenant
• • Demographics & Background Outcome from key areas -
& quality of life daily living skills
General Overview
• • Alcohol Relapse Everyday Memory Exercises
Case Study 1: Philip
•
Age on entry to scheme:
38 •
Length diagnosed:
5 yr •
Previous Accommodation:
Psychiatric Hospital/ 5 years Long Stay •
Co-morbidity:
Bi-polar depression
Philip: Daily Living Skills LSP scores- CH002
140 120 100 80 60 40 20 0
106 112 122
LSP Baseline LSP '+6 Months LSP'+12 Months •Feeding hens, hovering his room, helping with meals •Washing & ironing his own laundry •Attending a day centre 2-3 times per week
Philip: Quality of Life
50 40 30 20 10 0
20 30 QOL rating- ch002 38 38 35 43
Base rating +6 month rating + 12 month Tenant Staf f •Uses staff for reassurance & support (mood & cravings) •Regular visits from children on a Sunday
Case Study 2: Mark
•
Age on entry to scheme:
57 •
Length diagnosed:
6yr •
Co-morbidity:
Brain Injury due to fall •
Previous Accommodation:
Health Flat Cluster / 4 years Mental
Mark: Daily Living Skills LSP score- CH003 113 92
120 100 80 60 40 20 0
92
LSP Baseline LSP '+6 Months LSP'+12 Months •Overall improvement in personal hygiene and diet •No incidents of drinking •Physical & mental health problems- limited chores & much help with self care
Mark: Quality of Life
40 30 20 10 0
17 16 QOL rating- su003 35 16 27 34
Base rating +6 month rating Tenant Staff + 12 month •Reluctance to accept support •Higher level of supervision has lead to improved living conditions, general health, personal hygiene
Alcohol Relapse
• 1 alcohol relapse • Family- agree with no alcohol policy • Factor in unsuccessful tenancies
Memory Exercises
• 2-3 times per week i.e. contact family/friends , social events, financial situation, and meals • Reduction in anxiety and challenging behaviour • Improvements in everyday memory • Evening activities i.e. reminiscing games, quiz
Conclusion
Encouraging optimum level of independence through receiving practical help and support in dealing with everyday situations. For more information: www.praxiscaregroup.org.uk
Email: [email protected]
028 91 727195