Transcript Dundee Supervisors training session

SCOTLAND’S DEMENTIA
STRATEGY
AND
PERSONALISATION
Scotland’s National
Dementia Strategy
The key points from 2010
document
Dementia Strategy
Published in June 2010, it focuses on two key areas:
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Providing better support and information to people with
dementia and their carers after diagnosis
Providing better support and care in hospitals (including
finding alternatives to admission and improved planning
for discharge)
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Why?
Because they will bring immediate benefits to people with
dementia and their carers and improve efficiency and
quality of the care system
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Dementia Strategy
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A further eight priorities for improving care pathway for
people with dementia and their carers are identified:
Common standards of care for dementia
A definitive skills and knowledge framework for dementia
Transformational change involving all health and care sectors
Improved management and outcome information
Continued work on diagnosis
Better response to challenging behaviour
Accelerated implementation of Dementia Integrated Care
Pathway
Continued action to support dementia research
Dementia Strategy
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The strategy is designed to tackle five key challenges:
The fear of dementia that means people delay in coming
forward for diagnosis
Poor or non-existent information and support after diagnosis
for those with dementia and their carers
Poor outcomes in general healthcare services
A lack of dignity and respect for people with dementia and
their carers
Inadequate support for family members and those who care
for people with dementia
Dementia Strategy
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Action already taken:
Alzheimer Scotland have 19 Dementia Advisers in 18 local
authorities
They fund three Dementia Nurse posts in NHS Lothian, NHS
Borders and NHS Ayrshire and Arran – and have launched a
£1.5 million appeal to place a nurse in all 14 health boards
Dementia has been established as a national clinical priority by
the Scottish Government
New self-directed support legislation introduced to enable
more people with dementia to have control of their care funds
The Scottish Dementia Forum, including people with dementia
and carers, has been created and meets regularly
Dementia Strategy
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The next steps
The first annual report on the progress of the strategy will be
published in June 2011 by the Dementia Strategy
Implementation and Monitoring Group
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This Strategy has long-term objectives, but there is an
immediate focus on action over the next 3 years
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A revision of the Dementia Strategy is due to be completed by
June 2013
Dementia: By NHS Board
Scottish
Borders
Dumfries
&
Galloway
Fife
Forth
Valley
Lothian
_65
37
48
115
93
255
65-74
328
477
909
709
1775
75-84
657
942
1854
1358
3693
85+
686
902
1738
1232
3494
No
people
with
1708
2369
4616
3392
9217
Population
106764
147765
349429
279480
778367
Est. %
with
dementia
1.6%
1.6%
1.3%
1.2%
1.2%
dementia
of area
Dementia in Scotland
120000
100000
80000
males
females
total
60000
40000
20000
0
2007
2012
2017
2022
2027
2031
(Alzheimer’s Scotland 2007)
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Currently 71,000 in total
- 60% in community
- 40% in institutional (long stay) care
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Projected to rise to 127,000 by 2031
Scotland 2010)
(Alzheimer’s
PERSONALISATION
AN INTRODUCTION
Starting with the Person
Personalisation means thinking about public
services and social care in an entirely different
way – starting with the person rather than the
service. It will require the combined
transformation of adult care.
Julie Jones, Chief Executive, SCIE
What support do people
with dementia need?
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Information about their illness and what's available
The tools to become active in their own planning and
decision making
Control enabling them to take decisions when they
have capacity to make decisions and plan ahead
Knowledge of the allocated budget to their care
Ability to control their budget to meet their personal
needs and understanding the options available to them
(e.g. self directed support, direct payments purchasing
services or personal assistants)
What is Personalisation
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Begins with the person, not the service
Recognises the person’s strengths,
preferences, networks of support
Individual is best placed to make decisions
about their life
What is Personalisation
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Accessible information and advice
Irrespective of whether self funded or publicly
funded
It’s about giving people choice and control
over their lives
What Personalisation is NOT
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A completely new idea
Just about giving people individual
budgets
Only for people eligible for Council
funding
Or those needing traditional services
only
What Personalisation is NOT
“Importantly, the ability to make
choices about how people live their lives
should not be restricted to those who
live in their own homes. It is about
better support, more tailored to
individual choices and preferences in all
care settings”
(DH, 2008a,p5)
What it does mean
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Finding new collaborative ways of working and
developing local partnerships, which produce a
range of services for people to choose from
and opportunities for social inclusion
Tailoring support to meet individual needs
Recognising and supporting carers in their
role, while enabling them to maintain a life
beyond their caring responsibilities.
What it does mean
Access to universal community
services and resources – a total
system response
 Early intervention and prevention
so that people are supported early
on and in a way that’s right for
them
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Some Common Terms
Person centred planning
 Person centred care
 Person centred support
 Independent living
 Self directed support
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Personalisation
Implementing
Personalisation
The experience of dementia
Consider
 Trying to make sense of an increasingly unfamiliar world
 Unable to access memory
 Being disorientated – time, place, person
 Unable to respond to emotional demands
 Unable to verbalise your needs
 Loss of strengths – weaknesses come to the fore
 Loss of identity and control over your life
 Being ignored, talked over or treated as stupid
 Loss of coping skills
Implementing Personalisation Environment
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Does it make sense to the person
Does it lack crucial information
Signs and cues
Areas of importance not highlighted
Inappropriate lighting
Too much noise and conflicting stimuli
Patterned carpet and shiny flooring
Mirrors
Communication tips
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REMEMBER – challenging behaviours are not
always a problem for the person with
dementia
For the person with dementia – their
behaviour often makes perfect sense to them
Due to communication difficulties the
behaviour of people with dementia should be
seen as an expression of need
Communication tips
DON’T
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Try to communicate when there are distractions
Use long complicated sentences (or jargon)
Talk about doing something long before you do it
Assume that pronoun’s like he, she or it will be clear to the
person
Keep repeating something if you are misunderstood
Use gestures that could be seen as threatening
Assume that the person does not understand
Communication tips
DO:
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Seek out a quiet area
Identify yourself by name
Speak slowly and clearly – no need to shout
Ensure that only one person speaks at a time
Use other cues and gestures to maximise understanding
Give time and remain unhurried
Listen and give the person your full attention
FINAL POINT
The person with dementia can’t adapt to us – we
need to adapt our social, clinical and structural
environment around the person.
At the very least – don’t disable the person
further!
THANK YOU