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