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Sharing best practice for delivering excellence in ... · Sharing best practice for delivering...
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Sharing best practice for
delivering excellence in nutrition
and dignity in dementia care
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Partnership project
Started January 2014
BU
Council
Dorset LEP
Care homes
Service users/ carers
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Overview of afternoon
Welcome by Jane Murphy
Dame Christine Beasley, Burdett Trust for Nursing
Hilda Hayo, Chief Admiral Nurse, Dementia UK
Overview of the key research findings
Panel discussion
Networking
Training film viewing
Next steps
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Social Media
@nutri_dementia
#nutridignityindementia
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Dame Christine Beasley
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@nutri_dementia
#nutridignityindementia
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Hilda Hayo
Working with People Living with
Dementia
Hilda Hayo
Chief Admiral Nurse/CEO
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What are the issues?
Growing numbers of people with dementia
Majority live in their own homes
Growing number of family members
providing care estimated to save the nation
£17.4 billion
Patchy services and postcode lottery
High multiple health and social care needs
Multi morbidity
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A ‘potted history’ of Admiral
Nursing
Family experience
Hosts
Specialist dementia nurses
Family focus
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Tier 3
Admiral Nurses
Tier 2
Dementia Skilled
Tier 1
Dementia Awareness
3 Tier Dementia Pathway
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Dementia Pathway
Pre diagnosis
Diagnosis Living with dementia
End of life
Grief and bereavement
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Supporting families affected by dementia through
the trajectory of dementia
What does an Admiral Nurse do?
Family & relationship centred approach
Work in partnership
Specialist assessment & intervention
Promote and implement best practice
Provide supportive education
Provide bio psychosocial support for the family
Liaison with other professionals and organisations
Work in consultancy and supervisory role
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Some nutritional issues
encountered
Under nutrition
Reluctance to eat
Obsessions
Overeating
Dental and oral issues
Swallowing issues
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Recommendations from
Nutrition and Dementia Review
(ADI, 2014)
More research into: supplementation;
MIND diet; Vitamin E; fortification
Clear, consistent and independent advice
Nutritional standards of care for dementia
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Nutritional standards of care
for dementia Weight and nutritional status assessed
Dietary advice from a dietician to all families
affected by dementia.
Under nutrition: dietician and OT assessment.
Natural food fortification to be tried first but
then oral nutritional supplementation.
Staff training in hospitals and care homes re:
nutrition
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Diet and Brain Health
Fish oils: heart disease, arthritis, cancer,
cognitive function
Vitamins – especially B vits and antioxidants
Flavonoids: antioxidant properties, protect
against cell damage
No one food / nutrient likely to reduce risk of
developing AD/ Dementia – need a mixture
The MIND Diet
Developed to help Improve brain function and reduce risk of Dementia
Combination of the Mediterranean diet and diet to reduce blood pressure (DASH diet)
Which key foods most important?
American study, 960 older people, spanned 9 years (2004-2013)
52% reduction in Dementia, slower mental decline
MIND Diet
“brain healthy” foods
Green leafy & colourful veg
Nuts & berries - blueberries,
strawberries etc
Beans, lentils, soya
Wholegrains
Fish
Poultry
Olive oil
5 “unhealthy” foods
Red meats
Butter and margarines
Cheese
Pastries and sweets
Fried and “fast foods”
Should you follow the MIND Diet? Maybe hard to follow it rigidly
Even those who followed it partly obtained some benefit
Making your diet more MIND like – easier to follow long term
Diet important, but only one aspect of lifestyle changes associated with reduced risk.
Need to consider nutrients that may be missing/reduced that have other important functions
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@nutri_dementia
#nutridignityindementia
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Nutrition and Delivering
Dignity in Dementia Care
• No standardised interventions
to maintain adequate nutrition
• Lack of nutrition training, skills,
empowerment and leadership
to embed values and
behaviours in care
• Poor recognition of the ‘meal
experience’ to deliver person-
centred care
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Challenging…...
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Complex….
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Aims
1. To identify and understand best practice and
delivering excellence in nutrition and dignity in
dementia care to provide quality improvement in
food and nutrition for people living with
dementia.
2. To establish high quality nutrition education
and learning.
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Identify best practice
Qualitative and Quantitative
Research Methods
• Measures of nutritional status:
food & fluid intake intake,
energy expenditure/physical
activity & sleep patterns
(accelerometry)
• Focus groups/interviews: all
those responsible for food,
nutrition and delivery of care in
care homes.
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Quantitative research –
Take homes…
• Variable physical activity and sleep patterns contribute
to low intakes in some residents
• Majority of residents were not meeting
recommendations for hydration
• Real time monitoring using wearable technology can
support better food and nutrition for person-centred
care in people living with dementia
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Qualitative research
• Nurse managers of care homes
• Key care staff
• Family carers
• Chefs and kitchen staff
• Dietitians
• Speech and language therapists
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What do these aromas
mean to you?
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Establish high quality
education
• Delivered and evaluated ‘face to face’ training and
education
• Assessed impact of learning – follow up
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Comments from attendees
I would recommend this learning to all within the care-sector
no matter what their role. Everyone would benefit ultimately”
Activities Coordinator
“Lots of valuable research-how to deliver, ways to deliver and
a good combination of data and references to real life
practice”
Care Home Manager
“Absolutely fantastic! So Inspiring! Really varied material-
engaging-really thought provoking-so many new ideas and
perspectives. So much to take away. Thank you so much”
Care Assistant
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@nutri_dementia
#nutridignityindementia
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Discussion panel
Dr Michele Board RGN DPSN, Senior Lecturer,
Bournemouth University
Dr Janet Scammell RN, DNSci, Associate
Professor, Bournemouth University
Professor Keith Brown, Director of National
Centre for Post Qualifying Social Work,
Bournemouth University
Rebecca Robson RMN, Registered Manager,
Waypoints Care Home, Verwood
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@nutri_dementia
#nutridignityindementia
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Break
@nutri_dementia
#nutridignityindementia
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Training tools
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Elaine Atkinson OBE
Closing Comments
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Thank you for listening!
Further information
http://www.bournemouth.ac.uk/nutrition-dementia
@nutri_dementia
#nutridignityindementia
Register your interest for a copy
of the training material before
you leave