This session presents and discusses the key messages from the RiPfA Key Issue: Enablement in Dementia and and the forthcoming Practice Tool of the same title (Jan 2016). We will share examples of good practice and gather your views on a practice tool we are developing on this topic. The session will explore what it means to promote 'enablement', why it matters, consider what the challenges are and help you to identify a variety of approaches practitioners can follow, as well as the actions managers and commissioners need to take to support this. Aimed at: Frontline practitioners and team managers working with people who are living with dementia and their families. Commissioners of dementia services, dementia leads in older people teams and mental health teams.

1. 1
How can we enable people living
with dementia to live independent
and fulfilled lives?
Knowledge Exchange Webinar
Imogen Blood
14 October 2015

2. Webinar aim
To explore what it means to promote dementia
'enablement‘, why it matters and consider what the
challenges are
2

3. Webinar objectives
› To reflect on what ‘enablement’ means, in
relation to dementia and why it matters
› To hear research findings and practice
examples on how people with dementia can be
enabled to live enriched lives
› Consider some of the obstacles to this
happening in the real world and hear your
positive practice examples
› Share some of our thoughts about practice
tools to support dementia enablement and
gather your feedback on these ideas, to help
shape the development of the Ripfa Dementia
Enablement Practice Tool – due out Jan 2016
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4. Agenda
Timing Topic
13:00 Welcome and introduction
13:05 What does enablement mean?
13:20 What works in promoting independence for people
with dementia?
13:40 Practice tool options and poll
13:50 Questions to Imogen
14:00 Close
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5. What does ‘enablement’ mean?
› Strengths-based
› Reducing barriers
› Support before a crisis
› Person-led rather than
service-led outcomes
5

6. Dementia: the rhetoric……..
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7. …..the reality?
Out of 1000 people with dementia
surveyed by Alzheimer’s Society…
2013 2014
People who are living well with
dementia
61% 58%
People who are able to make choices
about how they spend their time
65% 62%
People who feel a part of their local
community
47% 44%
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8. What works in promoting
independence for people with
dementia?
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Messages from research
and practice examples

9. Relationships and social interaction
› The shift to ‘carer’ or ‘cared
for’ – emotional support?
› Mutual support
› Relationship-based care and
support
› The power of peer
support…..but the risk of
‘ghettoising’
› Maintaining and making new
connections
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10. Keeping your connections: NDTi
10http://www.ndti.org.uk/uploads/files/Keeping_your_connections_leaflet.pdf

11. Linking into communities
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What do you
like doing?
What’s going
on locally?
What are the
barriers?
How can we
reduce them?

12. Living environment
› Falls
› Heating
› Labelling, patterns,
reflections
› Technology
› Simple solutions
› Pros and cons of
moving
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13. Having a say
› Communication:
Talking Mats, Dementia
Care Mapping
› Advocacy
› DEEP – network of self-
organising groups
› Co-production/ service
user involvement?
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14. Exercising mind, body and creativity
Mental and physical
exercise can…..
 Improve quality of life
 Improve ability to do
daily activities
 Slow down decline in
memory and thinking
Cochrane Reviews 2013/14
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15. Nature and the outdoors
› Getting out and about
› Pets and animals
› Gardening: Thrive
› Green Farms: making a
contribution
› Views
› Walking
› Dementia Adventures
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16. What gets in the way in organisations?
› High caseloads/ lack of time to work like this
› Need-/Service-led assessments and performance
› Thresholds – people in crisis when they get to us
› Risk aversion/ restrictive safeguarding approach
› Lack of staff skills/ confidence
› Lack of resources to refer people to
› Lack of funding to cover anything but ‘essentials’
› Culture/ attitudes within your organisation
› Culture/ attitudes of partner/ provider organisations
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17. Questions for YOU
› What already exists in your
organisation to help you deliver
effective enabling services?
› Do you have any examples where you
feel you have succeeded in enabling
people with dementia: what are the
messages for others on what worked?
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18. 1. Supporting positive risk-taking
Rationale and learning objectives
› Risk as a barrier (even an excuse?) to enablement
› Share responsibility for and evidence risky decisions
› Take a person-centred, strengths-based approach
› Broader view of risk; balance with risk of not doing
› Consider alternatives, contingencies and review
What it might consist of
› Questions for reflection/ assessment?
› Scenario/ worked example? Links to resources
(including information about the law)? 18

19. 2. Circles of Community Support
Rationale and learning objectives
› Identifying goals, networks, enablers and barriers
› Promote access to mainstream activities/ networks
› Build on and join up Circles of Support (NDTi) and
practical examples of Dementia-friendly
Communities (JRF/ Alz Soc)
What it might consist of
› Tool to map out networks, barriers, enablers visually
› Practical tips, ideas and examples for mainstream
providers and carers/ professionals
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20. 3. Making people’s homes accessible
Rationale and learning objectives
› Accessible homes minimise confusion, accidents and
crisis moves to other settings
› Research from Stirling University/ SCIE shows that
simple changes can make a big difference
What it might consist of
› Checklist for practitioners/ carers under headings
(e.g. flooring, labelling, textiles/ décor, etc.)
› Practical ideas and links to relevant resources to
improve these features and promote independence
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21. 4. Strengths-based assessment
Rationale and learning objectives
› Current tools focus on risk, eligibility, deficits (???)
› These risk overlooking what matters most to people
› ….and what can get in the way in relationships
What it might consist of
› Questions to identify internal resources and
relationship dynamics
› Reflections and links to resources on attachment:
understanding ‘problematic’ behaviours and finding
positive ways to meet needs
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22. 5. Case studies/ practice examples
Rationale and learning objectives
› How can we justify and do enablement given high
caseloads and limited resources?
› Sharing ideas for ‘doing more with less’
› Building a ‘business case’ for enablement
What it might consist of
› Practical cases from YOU; with some commentary
› Individual (anonymous) cases or initiatives
› What difference did they make?
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23. Poll – please select your three
preferred practice tools
› Please select your three preferred options from
the poll on screen now
› Are there other areas you feel should be
covered by the practice tool? Please comment
in the chat pod.
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24. Chat pod
In the chat pod, please say:
› Why these tools would be helpful to practice
› What further detail you would like them to contain
› Any other suggestions for tools to support
dementia enablement practice
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25. Questions/ comments
› Please type your questions to
Imogen into the chat pod
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26. Contact
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www.ripfa.org.uk
help@ripfa.org.uk
@ripfa