LLT dementia 1

Dementia -Update and implications for

Later Life Training- 1st steps

LLT dementia 2

Session overview

• Why dementia now ?

• Sources of information (group activity)

• The strengthening evidence - summary

• Implications for LLT programmes

• Implications for LLT tutors (group activity)

• Next steps

LLT dementia 3

Purpose of session

• To understand the importance of dementia to Later Life Training and tutors

• To share own knowledge and experience of working with people with dementia

• To begin to look at issues and topics that (might) affect the delivery of LLT courses

• To highlight sources of information

LLT dementia 4

Why dementia and LLT now ?

• The number of people with dementia is increasing as our population ages

• To ensure where possible, the inclusion of all (frailer) older people in LLT programmes

• At last, significant activity in national policy and strategy development

• Evidence re physical activity and exercise is getting stronger – we have a role to play

• As a response to tutor and partner requests• Our own personal experiences

LLT dementia 5

Paired activity

Pub quiz

– what do we know ?

Just how important is this ?

LLT dementia 6

A growing concern

• Increasing with the ageing population• Costs to society are huge• A cure may be some 25 -30 years away• Causes are not fully understood but

lifestyle factors are know to be significant• Not a normal part of ageing, it is a disease• Everyone experiences dementia differently

The New Cancer ?

LLT dementia 7

Coming to the top of the agenda ?

• National Strategy (England) to be launched in the New Year

• Complimentary activity across the UK• NICE SCIE Guidance already published (2006)• Whole systems approach, not just mental health services• Current costs (£17 B) already outstrip CHD, cancer and

stroke put together• We are now concerned with/about the (increasing) older,

older generation• French EU presidency gives priority to Alzheimer’s

disease

LLT dementia 8

Stand by your man !”

• Jack Wooley has Alzheimer’s Disease

• He is being sprung out of the Willows Nursing Home by Peggy

• “Where are we going dear ?”

LLT dementia 9

The Dementia Strategy (England)

• Three Key components

• Improving public and professional awareness of dementia

• Early diagnosis and intervention

• High quality care and support for people with dementia and their carers

LLT dementia 10

The potential to contributee.g. to the Dementia Strategy

• Key components• Improving public and professional awareness of

dementia (our professional audiences ?)• Early diagnosis and intervention (quality of life,

independence and mobility)• High quality care and support for people with

dementia and their carers (programming + carer support and functioning)

LLT dementia 11

The potential to contribute: - physical activity and exercise

• The evidence is getting stronger all the time• Prevention (lifestyle factors)• Treatment (delay of progression) and care

(maintaining independence)• Related health/risk factors e.g. stroke, diabetes,

falls• People with dementia will experience a range of

associated benefits (improved mood, sleep, digestion, social inclusion)

• Physical functioning, quality of life of care-givers

LLT dementia 12

Falls and dementia

• Dementia is a risk factor for falls

• Evidence is emerging but not strong• Wraith M  (2008) Reduction in falls found for people with dementia

from carer-directed home exercise program.

• Wraith M  (2008) Carer-directed home exercise programs maintain

quality of life for people with dementia over 12 months.

• Rapp K (2008) Falls intervention (multifactorial) more effective in those

with cognitive impairment

• Shaw F (2005) Falls intervention (multifactorial) NOT effective in those

with cognitive impairment – but little exercise in intervention!

LLT dementia 13

Exercise and the brain

• Enhancement of growth factors

• Increased blood flow• Lower loss of corticol

volume• Activation of attention

and memory

Structure and function

LLT dementia 14

Application to delivery of our current programmes

Skills, strategies and components that might affect out teaching

Individuality – person centre care

Working with the carer

Challenging behaviours

The environment Communications Performance

Risk assessment Screening and assessment to

exercise

Pain

LLT dementia 15

Application to delivery of our current programmes

Skills, strategies and components that might affect out teaching

Individuality – person centre care

Working with the carer

Challenging behaviours

The environment Communications Performance

Risk assessment Screening and assessment to

exercise

Pain

LLT dementia 16

Communications - guidelines and advice

Use the list provided and apply to your teaching of one of the following exercises

• Walking and turning around (OEP & PSI)

• Knee bends with support (OEP)

• Side stepping (PSI)

• Heel or toe walk (PSI)

What are the implications for your teaching and communication strategies ?

LLT dementia 17

Implications for LLT Tutors

1. Application to delivery of our current programmes – how ?

2. Exercise, physical activity and movement for all people with dementia

3. Awareness raising amongst service providers, commissioners and care givers

4. The health and functioning of care givers

LLT dementia 18

Next steps

• Discussions with NAPA and Alzheimer’s Society have begun

• Further look at emerging evidence

• Piloting work on awareness raising, physical activity and exercise

• More detailed proofing of LLT programmes

• Working towards CPD and other products ?

LLT dementia 19

Thank you and we would welcome your

thoughts, ideas, skills and experience

as we move this forward