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Alzheimer Scotland’s Advanced
Dementia Practice Model:
understanding and transforming
advanced dementia and end of life care
Amy Dalrymple, Head of Policy, Alzheimer Scotland
Alzheimer Scotland Annual Conference
3 June 2016
The range of physical, psychological and social issues in advanced
dementia requires a bio-psychosocial approach in understanding and
responding to individual experience.
There is a need to bring together the expertise of dementia care
practitioners and palliative care specialists in responding to advanced
dementia.
Alzheimer Scotland
8 Pillars Model of
Community Support
Alzheimer Scotland
Advanced Dementia
Practice Model
Facilitating a planned
and coordinated
approach by bringing
together the skills and
knowledge of the
Advanced Dementia
Specialist Team and
the 8 Pillars Team
Access to care and
treatment aimed at
achieving optimal
physical health and
comfort
Supporting psychological
wellbeing by minimising
stress and distress and
addressing practical,
emotional and spiritual
needs
A person-centred and
relationship centred
approach that supports
personhood, wellbeing
and social connection
A therapeutic approach that
promotes physical,
psychological and social
wellbeing
A proactive approach to
the health and wellbeing
of others who are
important in the
person’s life, including
support in their caring
role and with their
physical and emotional
responses over time
Adaptations, aids,
design changes and
environmental
considerations to
support the wellbeing of
the person and assist
those providing care
The role of an inclusive
and enabling community
in promoting wellbeing
and supporting caring
relationships
Transition to
Advanced
Dementia
Practice
Model
‒ The Advanced Dementia Practice Model report is
available to download at
http://www.alzscot.org/campaigning/advanced_dementia_mod
‒ Please feel free to contact me with any additional
queries or points – adalrymple@alzscot.org
Further information or discussion
Thank you

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Amy Dalrymple

  • 1. Alzheimer Scotland’s Advanced Dementia Practice Model: understanding and transforming advanced dementia and end of life care Amy Dalrymple, Head of Policy, Alzheimer Scotland Alzheimer Scotland Annual Conference 3 June 2016
  • 2.
  • 3.
  • 4.
  • 5. The range of physical, psychological and social issues in advanced dementia requires a bio-psychosocial approach in understanding and responding to individual experience. There is a need to bring together the expertise of dementia care practitioners and palliative care specialists in responding to advanced dementia.
  • 6. Alzheimer Scotland 8 Pillars Model of Community Support
  • 8.
  • 9. Facilitating a planned and coordinated approach by bringing together the skills and knowledge of the Advanced Dementia Specialist Team and the 8 Pillars Team
  • 10. Access to care and treatment aimed at achieving optimal physical health and comfort
  • 11. Supporting psychological wellbeing by minimising stress and distress and addressing practical, emotional and spiritual needs
  • 12. A person-centred and relationship centred approach that supports personhood, wellbeing and social connection
  • 13. A therapeutic approach that promotes physical, psychological and social wellbeing
  • 14. A proactive approach to the health and wellbeing of others who are important in the person’s life, including support in their caring role and with their physical and emotional responses over time
  • 15. Adaptations, aids, design changes and environmental considerations to support the wellbeing of the person and assist those providing care
  • 16. The role of an inclusive and enabling community in promoting wellbeing and supporting caring relationships
  • 17.
  • 19.
  • 20. ‒ The Advanced Dementia Practice Model report is available to download at http://www.alzscot.org/campaigning/advanced_dementia_mod ‒ Please feel free to contact me with any additional queries or points – adalrymple@alzscot.org Further information or discussion

Editor's Notes

  1. Based on the 8 pillars
  2. Specialist overview in care of elderly. Whilst the involvement of other consultants will also be relevant – e.g. for younger people and for psychological conditions – the vast majority of people receiving the Advanced Dementia Practice Model will be in the older age groups. Psychiatrist, psychology and community psychiatric nurse for promotion of psychological wellbeing and responses to stress/distress and psychological conditions. District nurse - Management and guidance on physical health conditions such as bowel and bladder function and skin integrity. Occupational therapy for engagement, occupation and environment. Physiotherapy for pain management and movement. Speech and language therapy for communication and nutrition/hydration issues. Dietitian for nutrition and hydration. Palliative care specialist for approaches to the management of pain and other distressing symptoms and end of life care.
  3. A named and skilled Practitioner Enhanced Level of the Promoting Excellence Framework Coordinate the collective impact of all pillars Identify the point at which the Advanced Dementia Specialist Team should become involved Facilitate input of Advanced Dementia Specialist Team
  4. Advanced Dementia Specialist Team provide advice, assessment and treatment for: complex symptoms of advanced dementia underlying health conditions complications such as infection Issues vary between individuals GP, Consultant Geriatrician, District Nurse, Allied Health Professionals, Palliative Care specialists
  5. A range of people working with the person have a role in responding to moment-to-moment distress. The possible reasons for stressed and distressed behaviour are multifaceted. Delivery of a four staged stepped care approach as recommended by the British Psychological Society
  6. Person-centred approaches to promote communication, care-giving and social connection Maintaining and enhancing existing caring relationships Interpreting needs and identifying appropriate person-centred approaches
  7. Continued need for meaningful occupation and social stimulation Working with non-verbal responses, behaviours and communication Equip family carers and care workers with approaches that foster connection and shared experience Moment to moment experiences
  8. Practical and emotional support Maintaining the health and wellbeing of the carer Carer is a key part of the 8 Pillars Team Access to counselling and support for bereavement
  9. Can include occupational therapy, physiotherapy, nursing, podiatry and housing practitioners Housing issues – adaptations and equipment Care homes - environmental aspects, culture, routine and structure Therapeutic movement Seating Minimise risk of falls and maximise mobility
  10. Recent public attitude survey showed overwhelming readiness to help people living with advanced dementia identifying opportunities to link with natural supports within the community facilitate the development of coping strategies and shared understanding of particular importance when the person does not have informal supports such as family and friends