A New Approach toA New Approach toDementia CareDementia Carein Hospitalsin Hospitals

Phil PordesPrivacy & Dignity Matron

The way it was …o Good care was inconsistent across wards and departments

o No identified senior clinician to lead on quality improvement

o Environment not conducive to those with cognitive impairment

o Training and education for staff was limited

The Dementia Care Pathway Group

• The creation of a pathway• Training and education• Leadership• The environment• Patient and carer engagement

KEYInvolve patients, carers, family and

friends in the care planning process from admission

ACHIEVEMENTSCare Pathway / Guidelines

• Electronic dementia care pathway in the form of user-friendly guidelines and prompts

• Guidance taken from NICE, the National Dementia Strategy, lessons learned through complaints, and local and national best practice

• Pathway covers:– Their first 24 hours in hospital– Their in-patient stay– Discharge planning

Recommendations 3 & 7

Training and Education

• “Respect” course• Customer care training programme• Study days• Links to Cheshire East• Links to Cheshire Hospice Education• Learning and development• Job swap!

Recommendation 5

Leadership

• Clinical lead identified• Close relationship with liaison psychiatry• Executive support• Financial investment

Recommendations 3 & 5

Environment 1

• Coloured doors– “I always look for the colour when I

come back from the toilet.”Patient B with no cognitive impairment

• Signage– Patient A – with dementia – reported not

being able to find the toilet before the signage was installed, resulting in frequent incontinence which has now resolved as she is able to find her own way to the toilet and return to her bedside

– Nurse A reported that less time is spent directing visitors within the ward

Recommendation 6

Environment 2

• Communication friendly menus• Memory aids• Activity Lounge

– Increased privacy,dignity and autonomy reported by patientsand visitors/families

Recommendation 6

Patient and Carer Engagement

• Complaints feedback / meetings• Patient carer representation• Outside links

Recommendation 7

OTHER ACHIEVEMENTSOTHER ACHIEVEMENTSNutritionNutrition

• Nutritional guidelines• Protected mealtimes• ‘Red Plate’ scheme• Volunteer feeders• Relative involvement

Recommendations 8 & 9

Staff Awareness

• OPERA magazine

• Privacy and Dignity roadshows• Audit (Essence of Care, Dignity Challenge)• Dementia tea party• Privacy and Dignity policy

What next?

• To meet future challenges• Be innovative• Build upon what we have achieved so far• Share best practice– East Cheshire– signage to be used by NWSHA at conference in

Bolton in December

Thank you …

… for listening.

Questions?