At the recent Mental Health Nursing Forum Scotland Awards, the IDEAS team were delighted to lift not only a practice excellence award in the dementia category but received ‘Practice of the Year’ as the overall winner This multidisciplinary team (Nursing, Psychology and Occupational Therapy) was formed in 2012 following a successful bid to the Putting You First fund to address non-pharmacological management of stress and distress in dementia, in line with Scotland’s National Dementia Strategy.
(L-R; F.Edgar, L.Haining, M.Born, W.Chambers, R.Warwick, missing from pic A Groat)
Three members of the team write about their experience of the project to date:
Lorraine Haining, Advanced Nurse Practitioner writes:
As the nurse in the team I was extremely pleased to receive this accolade as it acknowledges and celebrates the work and efforts not only of the team but of the Care Homes and supporting services that have made it possible. In my career I have been lucky enough to have had several opportunities to make a positive contribution to changing the way we value and provide care for people with dementia and the IDEAS Project has been another of those vehicles for change.
This multidisciplinary approach lends itself well to holistic care, with each profession providing education and support from their clinical perspective. In terms of Nursing my aim is to promote the prevention of stress and distress symptoms by ensure screening for treatable physical or mental health conditions, ensuring regular reviews of antipsychotics and other psychoactive medications, addressing polypharmacy issues and ensuring effective care planning incorporating all health and medical needs.
A major personal driver for me is that my father has dementia. His experience on the journey has so far been positive and he is coping well with the diagnosis. We have had that difficult conversation about the future and not wanting to be a burden on his family he has opted that we should consider a care home if he is not coping at home so therefore I need to make sure that his positive journey continues if this turns out to be the case and there is no better driver for the best possible outcomes than your love for your family.
Quotes from Staff attending Nursing session:
Fionnuala Edgar Clinical Psychologist writes:
In Dumfries and Galloway Mental Health services have been at the forefront of reducing reliance on anti-psychotic medications for stress and distress/challenging behaviour in dementia since 2008. Through the IDEAS team we have been able to be more fully committed to the delivery of support and education to carers working in care homes across the region. This has allowed us to deliver a holistic, person-centred approach that has received overwhelmingly positive results across the region. Training has been based on current guidelines developed by the British Psychological Society (BPS) ‘Alternatives to antipsychotic medications: Psychological approaches in managing psychological and behavioural distress in people with dementia’ (BPS)
From a psychological perspective I have seen a positive shift in carer’s understanding and beliefs about dementia and this will, in no doubt, lead to better quality of life for residents. Staff morale has reportedly increased significantly as carers feel more valued and confident in their role and in their ability to successfully manage stress and distress without the need for psyco-active medication.
Quotes from Staff attending the Psychology session:
Alison Groat, Mental Health Occupational Therapist writes:
As one of three Occupational Therapists involved in the IDEAS project (along with Wendy Chambers and Michelle Born) we feel this Team approach has worked very well. From an OT perspective, we wanted to focus on the Environment and creating opportunities for Meaningful Activity within it.
All Care Homes have been offered the opportunity to undergo a dementia design consultation with OT following completion of The Kings Fund Care Home Environmental Checklist (www.kingsfund.org.uk). Working in partnership with Care Home Staff, immediate environmental changes were identified such as improved signage, improved lighting, and contrast. Some areas have also able to include dementia friendly principles within longer term plans for refurbsihment.
Change achieved by visually removing door by blending it into the wall has resulted in a marked reduction and on some days a complete removal of this stress for residents.
Staff were also provided with further information and tools on the implementation of meaningful activity tailored to the individual person. SMART Goals were developed with Staff around activities they planned to implement and follow up was offered. A main focus has been on creating the opportunity for normal everyday activity within the environment. We have been delighted to see Care Homes updating Interest Checklists, carrying out more Life Story work and adding everyday activities in to the environment e.g. dusters and sweepers. We have witnessed excellent examples of meaningful activity already being implemented, which we have been able to share.
Quotes from Staff attending the OT session:
To date, the Foundation Level Training has been attended by over 600 care home staff and the Intermediate Level Training has been attended by 99 care home staff. We are in the planning stages for the Advanced Level training which will include a Train the Trainers element (for Foundation Level training) thus ensuring the long term sustainability of gains made as the project draws to a close in September.
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