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Workshop 5 service developments

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Workshop 5 service developments

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Workshop 5 service developments

  1. 1. Staff, Members’ & Volunteers’ Conference & Awards Ceremony “It takes extraordinary people to help people with dementia do ordinary things”
  2. 2. Enhanced Sensory Community Care The Sensory Programme
  3. 3. What is Enhanced Sensory Community Care? ‒Person centred care ‒Sensory therapeutic interventions ‒Pays attention to nutrition ‒Partnership with families ‒Extended support for families ‒Impeccable management of pain and other symptoms
  4. 4. Background to delivering the programme in Dumfries ‒Jenny Henderson wrote a paper on how to meet the needs of people in the later stages of dementia living at home ‒In Dumfries and Galloway people attending day care now have more complex needs than in past years ‒The challenge of meeting the needs of a diverse group of people ‒Raised at commissioning meeting ‒Funding identified through the Change Fund
  5. 5. Expected Outcomes •People in the later stages of dementia may be more able to continue to live in their own home for longer as a result of improved family carer coping skills. •Potential to achieve improved quality of life for the person with dementia and continued respite for family carers. •Staff and volunteers feel more confident and have increased knowledge and skills in supporting people in the later stage of dementia. Prof D Tolson, Dr K Watchman, Dr Naomi Richards
  6. 6. The service ‒Enhanced Sensory Community Care (known as The Sensory Programme) delivered twice weekly ‒5 places per session (Thursday and Sunday) ‒Two experienced members of staff supported by trained volunteers ‒The Functional Assessment Tool (FAST) and Pool Activity Level (PAL) tool are used to identify the stage of dementia. ‒Steering Group established ‒Externally evaluated
  7. 7. Support and training For families ‒Working in partnership ‒Manage expectation from the beginning ‒Attend practical information sessions ‒Use some of the therapies at home Staff and volunteers ‒Enhanced level promoting excellence framework ‒Specific training in sensory interventions ‒Continuity of staff and volunteer support ‒Close management of staff to prevent „burn out‟
  8. 8. Breakdown of individuals supported to date •A total of 7 people supported - one under 65 •5 transferred from traditional day care •2 direct from the community •2 leavers (died peacefully at home) All the families have been involved in information and support sessions and have taken part in the evaluation
  9. 9. Magic moments captured by staff ‘it’s nice to hear families saying that they didn’t have a lot of communication before, but now they’re getting more back’ She loves having her hair brushed… she will lean forward if you ask her’ ‘The activities brought out occasional words and even full sentences’
  10. 10. Making cup cakes – The Great Bake Off! It was – Extremely messy! Lots of eating of the sugar! But one of the gentlemen was able to demonstrate considerable concentration and icing skills! Very interactive and fun
  11. 11. Lessons learned •Sundays are not popular often considered to be a family day •Initially the assessment criteria was set to high •Difficult to sell the new service to community teams •Transition to new service from traditional day care had to be managed sensitively
  12. 12. ‘I really enjoy volunteering I never hear the staff talking about what a person can’t do only what they can do’ Staff and volunteer comments ‘I did start out feeling a bit like ooohhh, I wonder what was going to happen here… but I can see some real ,real benefits from this’ ‘It just makes me feel good relaxed and compassionate ‘
  13. 13. What next? •Enough funding to deliver the service until summer 2015 •Possible local redesign of day care services in D&G to focus on those in the later stages of dementia •Completion of the evaluation •Inform Alzheimer Scotland work on the later stages of dementia with a view to roll out over Scotland •Possible wider application of the model to home support
  14. 14. Staff, Members’ & Volunteers’ Conference & Awards Ceremony “It takes extraordinary people to help people with dementia do ordinary things”
  15. 15. Service Innovation & Developments Post Diagnostic Support Laura MacKechnie & Gayle Thomson, Dementia Link Workers, Perth & Kinross
  16. 16. Overview ‒ Project Background ‒ Pre-Project Analysis ‒ Project Objectives ‒ Service Model ‒ Project Outcomes & Experiences ‒ Next Steps
  17. 17. Project Background ‒ Funded by Change Fund Workstream 3 -“To improve access to specialist services for people living with dementia and their families by shifting the balance of care from hospital or long term care to community based services and developing sustainable changes in service provision” ‒ Funded since March 2012 ‒ “Facing Dementia Together” Pilot ‒ Dementia Strategy Priority (2010) ‒ Government HEAT Target (effective from April 2013)
  18. 18. Pre – project analysis ‒ April 2012 – 1384 people in Perth & Kinross with a diagnosis of dementia (NHST Dementia QoF Report, September 2013) ‒ September 2013 – increased to 1448 ‒ Significant gaps identified in both Pre & Post Diagnostic Support ‒ Post Diagnostic Support delivered by CMHN‟s within the OPCMHT‟s ‒ No dedicated service for Pre or Post Diagnostic Support or Early intervention
  19. 19. Project Objectives ‒ To provide post diagnostic support to 100 families per year using Alzheimer Scotland Five Pillar Model across Perth City (Year 1) and North Perthshire, Perth City & South Perthshire (Year 2) ‒ To support individuals and families with dementia for a minimum of 1 year post diagnosis, in line with HEAT Target (effective from April 2013) ‒ Improvement in access to quality Post Diagnostic Support by a dedicated Alzheimer Scotland Dementia Link Worker
  20. 20. Service Model Year 1 ‒ 3 Alzheimer Scotland Dementia Link Workers ‒ Based within Perth City OPCMHT ‒ Dedicated to provide Post Diagnostic Support ‒ Referrals received via OPCMHT
  21. 21. Service Model Year 1 ‒ Individual Caseload Supervision via CMHN‟s ‒ Management Supervision by Alzheimer Scotland Service Manager ‒ Direct Access to Social Work Community Care Services ‒ Alzheimer Scotland‟s Five Pillar Model of Post Diagnostic Support ‒ Social Work Documentation
  22. 22. Service Model Year 2 ‒ Model of support adapted following evaluation ‒ Locality based within 3 OPCMHT‟S: North West Perthshire, Perth City & South Perthshire ‒ Clarification of referral criteria and pathway ‒ Removal of direct access to Social Work Community Care Services ‒ Alzheimer Scotland Documentation/Health System
  23. 23. Project Outcomes & Experiences 1. To provide Post Diagnostic Support to 100 families and support for a minimum of 1 year ‒ Referral rate -132 families per year (January 2014) ‒ Carer Support provided in 60% of all referrals ‒ Locality split: North Perthshire 19% Perth City 35% South Perthshire 46%
  24. 24. Project Outcomes & Experiences 2. To improve access to quality Post Diagnostic Support in Perth & Kinross ‒ All people referred to Dementia Link Worker Service have been supported using Alzheimer Scotland‟s Five Pillar Model ‒ Interviews with sample population (including people with dementia & carers) ‒ Key common themes identified ‒ Short & medium term outcomes identified
  25. 25. Project Outcomes & Experiences Theme 1 - Reduction in fear and uncertainty surrounding diagnosis I‟m going to be honest, at the beginning of last year, I was getting quite depressed…I didn‟t know where I was going – I was really down so I really needed that help from the Dementia Link Worker… If you didn‟t have that link, you‟d be lost I think – where else would you go apart from the Doctor? There were certain things, that I knew within myself, that were happening that were not due to depression…but I just felt we were not being listened to. For a while to be honest, I felt I was banging my head against a brick wall trying to get someone to listen…
  26. 26. Project Outcomes & Experiences Theme 2 - Importance of using a Person-Centred Approach He‟d always say the Dementia Link Worker understood…He‟s often said I really think she understands how I feel about this. She‟s not dreary. Not too light hearted either but more of a positive thing. Which I think is a good thing… Everybody speaks about support, but support is a word and a nothing, but when you see the person that makes a world of difference (At the Information group) I‟m known as the chairman and I came home and I thought…isn‟t it nice that they have that attitude to me? So this is what I want to do… But I think that‟s how the Dementia Link Worker made a difference, because she was actually listening to what we were saying…she was an absolute breath of fresh air!
  27. 27. Project Outcomes & Experiences Theme 3 - Reduction in carer stress and isolation through carer support and involvement in Post Diagnostic Support and planning But I need that time to adjust, it takes me a wee while to adjust. As long as I can keep my health, that‟s the biggest bit that worries me…but it‟s always at the back of your mind you know, but there again, the Dementia Link Worker has been helping me with that, with what I should be doing and we‟ve got one or two things into place The Dementia Link Worker has been great because she gives you a surge of “that‟s a good idea…you‟re living with Alzheimer‟s…but you‟re not going to stop living”
  28. 28. Project Outcomes & Experiences Theme 4 - Consistent Post Diagnostic Support and progress within the 5 Pillar Model ‒ Written/Verbal information ‒ Dementia Information & Support Group ‒ Making/ maintaining/ reconnecting ‒ Dementia Café ‒ Discussions regarding future care needs/wishes ‒ Awareness raising regarding legal aspects
  29. 29. Project Outcomes & Experiences Theme 5 - Value of Peer Support It’s a load off your mind, knowing there is someone who cares and who has been through the same experience that you have been through She finds getting together very helpful
  30. 30. Project Outcomes & Experiences Theme 6 - Importance of a specialist, knowledgeable and reliable Link Worker If I’m really concerned about something I can mention it to the Dementia Link Worker and she’ll get it attended to She’s very knowledgeable, I think she would do a lot of homework . She would say something and surprise you with saying something about another side of the condition, another way of looking at things
  31. 31. Project Outcomes & Experiences Theme 7 –Being supported to live positively with dementia The Dementia Link Worker has been just what we needed… She’s so positive about things We’re a lot more determined I think…we’ve got big plans for this year. She’s given me this feeling that this is not necessarily that we’ve got to allow this to rule our lives or to overwhelm us. What we’ve got to do is live life as if there was nothing wrong and deal with things as they come up but not to sit and worry about them all the time
  32. 32. Project Outcomes & Experiences 3. Enhancement of existing services I strongly agree that the Dementia Link Worker has improved the quality of post diagnostic support…I feel that they have been able to offer support early which is crucial after being given a diagnosis. Dementia Link Workers have time to spend with the person with dementia and are able to deliver a personalised approach - CMHN The introduction of an Alzheimer Scotland Link Worker has been invaluable in providing post diagnostic support in a timely and person centred way. My sense is that the provision of this support to people with dementia and their carers has prevented and alleviated distress. This is a good outcome for patients and carers but has also allowed mental health professionals more time to assess new patients and respond to the escalating needs of people progressing through their illness – Consultant Psychiatrist
  33. 33. Project Outcomes & Experiences 4. Additional Outcomes and Service Development ‒ Development of Dementia Information & Support Groups ‒ Delivery of training and education to staff
  34. 34. Next Steps Project Sustainability ‒ Self-sustaining peer support ‒ Self Management ‒ Future funding/Mainstreaming of Service
  35. 35. Staff, Members’ & Volunteers’ Conference & Awards Ceremony “It takes extraordinary people to help people with dementia do ordinary things”
  36. 36. Partnerships with Education including the Digital Commonwealth Iain Houston, Dementia Advisor 0141 887 1289 ihouston@alzscot.org
  37. 37. ‒A key aim: Raising awareness of dementia and reducing stigma ‒Argyll & Clyde dementia advisors have been involved in education partnerships for several years, these continue to strengthen and grow Partnerships with Education
  38. 38. Most recently: Alzheimer Scotland Education Initiative won ‘Best Education Initiative’ at the 2014 Scottish Dementia Awards
  39. 39. ‒The Initiative: Based on partnerships with several local primary schools in West Dunbartonshire & Secondary schools in Renfrewshire. ‒Primary Schools: 2 sessions were delivered to primary 7 pupils at 2 primary schools in West Dunbartonshire as part of a dementia friendly community initiative. ‒Session 1: what is dementia?, our brain & how it works, what can happen if our brain is damaged by something like dementia ‒Session 2: things that help people with dementia and how people live well with dementia
  40. 40. Activity: How Does our Brain Work?
  41. 41. “It was really good, I can now help my neighbour” (Primary 7 pupil)
  42. 42. ‒Secondary Schools: Renfrewshire dementia advisor facilitated several dementia session for 3rd year pupils as part of their Youth Philanthropy Initiative. ‒Following these sessions several groups chose to represent Alzheimer Scotland, with 2 groups reaching the final.
  43. 43. ‒DAs are keen to continue making annual commitments on an ongoing basis to schools in their area and more schools have started to show an interest in becoming involved. ‒Through this initiative the Renfrewshire DA has now began working with the University of the West of Scotland, paisley campus, BA(hons) Social Work students. ‒This is leading to further exciting projects within the university. Further & Future Developments
  44. 44. Visit to UWS, Paisley, with SDWG
  45. 45. ‒‘I’m more than a piece of paper’ (Member of the SDWG)
  46. 46. •Initiative inspired by the Commonwealth Games coming to Glasgow and the attention this draws to ideas of Global Citizenship and identity •Aim: To enhance the capacity of individuals and groups to use digital media to ensure that their voices are heard and a digital commonwealth legacy is created. •Reaches out to individuals and groups who may experience social, cultural or economic marginalization and help make sure their stories are heard. •Ensure that people are not forgotten and outside society but an INTEGRAL part of it. The Digital Commonwealth
  47. 47. ‒Through our partnership work with the UWS (Jennifer Jones) we developed a 4 week creative voices song writing group with 2 community musicians; Robert & Carol, and members of our memory lane club. ‒The project: •4 x 2hr sessions •Sing-a-longs to reminisce through song •Facilitated discussions to understand things that are important to the group •Developing these thoughts creatively into song •Digitally recording this and making it available to share as part of a digital commonwealth Creative Voices
  48. 48. ‒https://www.youtube.com/watch?v=W5NFSJN1y- I&index=2&list=PLcc0TZ9aBvemdCivUz0CEzxntFhvGM_-c ‘Memory Lane’ Robert, Carol & members of memory lane club
  49. 49. Staff, Members’ & Volunteers’ Conference & Awards Ceremony “It takes extraordinary people to help people with dementia do ordinary things”

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