Transcript 6 Month interim review of service - Alzheimer`s & Dementia Support

6 Month interim review of service
Qualitative

Repeat observational audit & satisfaction surveys:

The approach to patients by staff has improved with a better
understanding of communication needs and role modelling of
the Dementia Buddies

The eating and drinking needs of the patients have improved
with the Dementia Buddies providing assistance at lunchtime
and encouraging the patients to drink throughout the morning

Maintenance of cognitive ability and reducing agitation and
behavioural challenges, and freeing up the time of the ward
staff, are helped by the activities provided by the buddies such
as:
 Reading
 Discussing picture books
 Dancing
 Singing
 Board games
 Simply conversing and companionship

More effective signposting of patients and carers to support
both outside of the hospital environment once the person
with dementia is discharged is taking place
What the Buddies did during their visit
Activity
Reminiscence
Talking/chatting
Walking
Reading
Eat/Drink
Music
Encouraged Nutrition
Other
Number
12
120
1
13
10
6
24
8
Daily Records Evaluation
Alert
Lively
Hungry
Neat & Tidy
Happy
Chatty
Thirsty
Untidy
Sad
Quiet
Agitated
Confused
Calm
Withdrawn Frustrated
Depressed
Content
Bored
Tired
Angry
Daily Records- between Oct.2012 and
March 2013. (N=155)
On Arrival
Words circled
Total score
Average score
Total
374
+ 36
+0.1
On Leaving
Difference in Totals
Total
348
+197
+0.6
(26)
+161
+0.5
What Patients have said:
“patient said kind of me to visit and hopes to see me again”
“Patient thanked me for my help”
“Pleased to see me and responded well, talked well, liked her hand held.”
Patient responses recorded by Buddies

Patient pleased to remember us. Enjoyed chatting. Is a
quiet lady but enjoys a laugh. Was thirsty and enjoyed 2
cups of squash.

Patient enjoys holding hands and listening to stories.
She likes hugs and cuddles and kisses and often asks for
company. She won't chat back but she will tell you not to
go away in the end.

Patient was tired eyes closed but happy for me to sit with
her holding her hands. Happy someone there for her.
Carers/Relatives Evaluation
How was your relative/friend today?
10
9
Carers
8
7
6
5
10
4
5
3
2
0
1
0
As well as
expected
Better than
expected
Worse than
expected
Quotes from Carers/Relatives
“When I am not here my mother gets quite tearful and lonely so I
think the scheme is a good idea.”
“Somebody came a few days ago and talked to mum about
Gravesend of many years ago (not today). She really enjoyed this.”
“No matter how little, having company can be sensed and will be a
comfort.”
“Excellent service and much needed”
Staff Evaluation N=9
Question
Yes
No
Ward atmosphere
enhanced
6
0
Improved
Understanding
7
0
Difference made
to your role
5
1
“ my job is administrative...”
Difference made
to patients
5
1
“ my job is administrative...”
Quotes from Ward Staff
“ Patients get more settled, less agitated and more lively and are
more alert and can follow through the routines affectively.” Staff
Nurse
“ They all help us as a health care assistant may help us. They keep
them orientated.” HCA
“ They settle down when they are agitated. Eat/drink well because
of dementia buddy” Staff Nurse
“ The ward has a very good understanding of dementia but the
buddies have enhanced this.” Senior staff Nurse
Quantitative evaluation
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Too early to see impact as buddies not fully
established
However:
Overall LOS on Ebony reduced by 2 days
Average LOS for patients with a diagnosis of
dementia reduced from 30.0 to 20.8 days (30%
reduction)
Complaints baseline was minimal so not meaningful
to measure
Dementia Buddy specific readmissions hard to audit
Falls
The Future

Final Pilot evaluation in June
and share results and
experience with other Trusts

Continue to roll scheme out
to other wards/Depts within
the hospital

Emergency Dept

Business Case for Trust to
continue role:


53 hours (1.42 WTE band 5
co-ordinator posts)
0.5 WTE Admin support Band 2
£10,000 for training
Provide an ‘on request’
service for individual cases

Continue with partnership
working between the
hospital and ADSS

Integration Awards

Nursing Standard
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Jeremy Hunt
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Expand service hours to 6
hours per day, 7 days per
week
Other
initiatives
at
DVH

Evergreen/Geriatrician
of the
Progress
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Education
CQUIN trigger part of EDN
Dementia & MCA pathways
developed and agreed
Cognitive impairment Care
plan implemented
Reduction in LOS
Care Homes Project
MSS & Dr Yu
Extended Therapy Service to
cover weekends
Acute physician
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Week
Elderly Care Specialist Nurse
(Feb-12)
Dignity Champions
Nursing Care complaints
reduced
Productive Older Peoples
Project/Patient Experience
Programmes
National Dementia Audit 2nd
Round
Observational Audit
Programme
PAT Dog
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Dementia Challenge
funding:
Dementia Specialist
Practitioner
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Environmental changes:
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Signage
Pilot Colour Scheme in bays
(Ebony)
Pictures relating to colours
Bed spreads
Curtains
Toilet Seats
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Charitable Funds:

Picture books/memory boxes
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Reminiscence corridor
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MP3
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Sensory Garden
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Laundry
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Expansion of Dementia
Buddy Scheme
Thank you
Any Questions?