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1
How are we doing?
Stock-take of spiritual provision in New
Zealand dementia units
Dr. Chris Perkins
July 2013 2
• The Louisa and Patrick Emmet-Murphy Trust
• The Selwyn Foundation
• Dementia units throughout NZ
• Dr. Rod Perkins (Selw...
• Background
• Methods
• Participants
• Results
– What is spirituality and what does it mean?
– Extent to which being met ...
• People with dementia are spiritual beings
• Still have spiritual needs despite (or more so, because
of) cognitive impair...
• Spirituality is seen as part of “wellbeing” in government
policy documents
• Spiritual care mandated and audited in aged...
“ Residents of dementia rest homes are mobile and
show confusion that requires specialist care in a
secure environment.”
S...
My questions
• What do staff of dementia units
understand by “ spirituality”?
• Are spiritual needs met in dementia
care?
...
• Initial qualitative study in 2 dementia units
• A survey adapted from similar survey of NZ hospices
(R.Egan 2010)
• Surv...
The participants
10
0
10
20
30
40
50
60
70
Profit Not for profit
percent
percent
57.4%
42.6%
227 responses, from 117 facil...
Participant’s role %
11
0
5
10
15
20
25
30
35
40
Owner Manager Charge
Nurse/
Clinical
Coordinator
Chaplain/
spiritual
advi...
Years in job
12
“ spirituality includes beliefs, values, sense of meaning
and purpose, identity and to some people religion”
(Egan 2010).
...
Later asked what spirituality means to
you personally?
14
Importance of spirituality to people in
dementia unit
15
16
In this dementia unit how important
is spirituality over all?
17
To what extent are spiritual needs of
residents within your organisation being
met?
18
Is attending to spiritual needs
part of your role?
Room for improvement?
19
•Increased chaplain / spiritual
advisor time or dedicated chaplain
•Improved staff awareness and
...
How are needs being met?
• Policy and
assessment
• Resources
• Activities
• Religious input
• Staff training and
support
20
21
Spiritual Policy?
22
Spiritual Assessment?
Spiritual resources available
23
Activities
24
Uplifting events
“ Activities personal to the
dementia resident to feel a
sense of self worth and
belonging.”
Access to the outdoors
94.6% had access
to the outdoors
25
26
•Often 80.9% •Sometimes 7.1%
Arts and crafts
27
Often 92.9%
Sometimes 7.1%
Music and dancing
Religious input
28
• Employed
Yes, 38.4% No,58.9%
D/K 2.4%
• Voluntary
Yes, 67.9% No,29.9%
D/K 2.3%
• To call in crisis
Ye...
Frequency of visits from
community churches
29
30
ACE training (mandated) 38.6 %
Other: 51.5%
Don’t know 7.9%
Other types on training included:
•Yearly in-house training...
Support for staff in spiritual
matters?
31
Available: 65.3% None: 34.2%
D/K: 0.4%
Who supports?
Personal benefit from
working with people with
dementia
32
33
• Surprising acknowledgement of importance of
spirituality. NZ not an especially religious country and
most respondents...
34
•Self report
•Results reflect positivity bias
•These are not the caregivers- what
happens on the ground
•Don’t know dep...
35
Questions:
• How does this compare with others’
experience?
• Are you surprised by the positive response?
• What would ...
36
37
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Chris Perkins - How are we doing? A survey of spiritual provision in New Zealand Dementia Units.

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Chris Perkins - How are we doing? A survey of spiritual provision in New Zealand Dementia Units.

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Chris Perkins - How are we doing? A survey of spiritual provision in New Zealand Dementia Units.

  1. 1. 1
  2. 2. How are we doing? Stock-take of spiritual provision in New Zealand dementia units Dr. Chris Perkins July 2013 2
  3. 3. • The Louisa and Patrick Emmet-Murphy Trust • The Selwyn Foundation • Dementia units throughout NZ • Dr. Rod Perkins (Selwyn Foundation), Bronwen Peterken, Dr. Arden Corter (University of Auckland) Acknowledgements 3
  4. 4. • Background • Methods • Participants • Results – What is spirituality and what does it mean? – Extent to which being met and possible improvements – How are needs being met? • Policy / assessment • Resources • Activities • Religious input • Support and training • Discussion Overview 4
  5. 5. • People with dementia are spiritual beings • Still have spiritual needs despite (or more so, because of) cognitive impairment • It is possible to attend to spiritual needs of even those with severe dementia • Spiritual care is part of holistic care Background 5
  6. 6. • Spirituality is seen as part of “wellbeing” in government policy documents • Spiritual care mandated and audited in aged residential care • Spirituality is a small part of training of caregivers in residential care • Culture/spirituality increasingly taught in nursing training in line with Aotearoa /NZ bicultural policies Spirituality in NZ Aged Care 6
  7. 7. “ Residents of dementia rest homes are mobile and show confusion that requires specialist care in a secure environment.” Specialist or psychogeriatric hospitals: “The residents have high dependency needs coupled with challenging or noisy behaviours.” Generally GDS stages 6-7: moderately severe to very severe dementia (Global Deterioration Scale Reisberg 1983) Categories of dementia care 7
  8. 8. My questions • What do staff of dementia units understand by “ spirituality”? • Are spiritual needs met in dementia care? • How are needs met? Approved by Southern Ethics Committee. Ethics ref. 12 STH 12 8
  9. 9. • Initial qualitative study in 2 dementia units • A survey adapted from similar survey of NZ hospices (R.Egan 2010) • Survey mailed to 4 contacts in each of all 201 NZ dementia units • Analysis and collation of written responses. Method 9
  10. 10. The participants 10 0 10 20 30 40 50 60 70 Profit Not for profit percent percent 57.4% 42.6% 227 responses, from 117 facilities = 58.2%
  11. 11. Participant’s role % 11 0 5 10 15 20 25 30 35 40 Owner Manager Charge Nurse/ Clinical Coordinator Chaplain/ spiritual advisor Diversional therapist Other
  12. 12. Years in job 12
  13. 13. “ spirituality includes beliefs, values, sense of meaning and purpose, identity and to some people religion” (Egan 2010). It seemed important to start by having people think beyond religion 13 Definition of spirituality- given initially
  14. 14. Later asked what spirituality means to you personally? 14
  15. 15. Importance of spirituality to people in dementia unit 15
  16. 16. 16 In this dementia unit how important is spirituality over all?
  17. 17. 17 To what extent are spiritual needs of residents within your organisation being met?
  18. 18. 18 Is attending to spiritual needs part of your role?
  19. 19. Room for improvement? 19 •Increased chaplain / spiritual advisor time or dedicated chaplain •Improved staff awareness and education •More staff, more volunteers, more resident-contact time •Doesn’t need improvement •Better access to community resources including churches: •Change in culture of facility , closer work with pastoral team •Chapel/ quiet room •Other denominations to be available •Cultural resources
  20. 20. How are needs being met? • Policy and assessment • Resources • Activities • Religious input • Staff training and support 20
  21. 21. 21 Spiritual Policy?
  22. 22. 22 Spiritual Assessment?
  23. 23. Spiritual resources available 23
  24. 24. Activities 24 Uplifting events “ Activities personal to the dementia resident to feel a sense of self worth and belonging.”
  25. 25. Access to the outdoors 94.6% had access to the outdoors 25
  26. 26. 26 •Often 80.9% •Sometimes 7.1% Arts and crafts
  27. 27. 27 Often 92.9% Sometimes 7.1% Music and dancing
  28. 28. Religious input 28 • Employed Yes, 38.4% No,58.9% D/K 2.4% • Voluntary Yes, 67.9% No,29.9% D/K 2.3% • To call in crisis Yes 92% No,3.5% D/K 4.4% Spiritual advisors
  29. 29. Frequency of visits from community churches 29
  30. 30. 30 ACE training (mandated) 38.6 % Other: 51.5% Don’t know 7.9% Other types on training included: •Yearly in-house training – some with chaplain •Local cultural advisors •Palliative care courses •Specific courses “Walking in Another’s Shoes”, “Spark of Life” Staff education re spirituality
  31. 31. Support for staff in spiritual matters? 31 Available: 65.3% None: 34.2% D/K: 0.4% Who supports?
  32. 32. Personal benefit from working with people with dementia 32
  33. 33. 33 • Surprising acknowledgement of importance of spirituality. NZ not an especially religious country and most respondents NZ born. ? Maori influence- whare tapa wha • Broad definition of spirituality- in keeping with this attitude. Would it be the same with caregivers who are frequently new immigrants?
  34. 34. 34 •Self report •Results reflect positivity bias •These are not the caregivers- what happens on the ground •Don’t know depth of assessment or extent of education •More research directly with residents, families and caregivers Limitations
  35. 35. 35 Questions: • How does this compare with others’ experience? • Are you surprised by the positive response? • What would you do next to understand what is really happening? Thank you
  36. 36. 36
  37. 37. 37

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