Workshop 5 service developments

Staff, Members’ & Volunteers’

Conference & Awards Ceremony

“It takes extraordinary people to help people

with dementia do ordinary things”

Enhanced Sensory Community Care

The Sensory Programme

What is Enhanced Sensory

Community Care?

‒ Person centred care

‒ Sensory therapeutic

interventions

‒ Pays attention to nutrition

‒ Partnership with families

‒ Extended support for families

‒ Impeccable management of pain and other symptoms

Background to delivering the

programme in Dumfries

‒ Jenny Henderson wrote a paper on how to meet the

needs of people in the later stages of dementia living at

home

‒ In Dumfries and Galloway people attending day care

now have more complex needs than in past years

‒ The challenge of meeting the needs of a diverse group

of people

‒ Raised at commissioning meeting

‒ Funding identified through the Change Fund

Expected Outcomes

• People in the later stages of

dementia may be more able to

continue to live in their own home for

longer as a result of improved family

carer coping skills.

• Potential to achieve improved quality

of life for the person with dementia

and continued respite for family

carers.

• Staff and volunteers feel more

confident and have increased

knowledge and skills in supporting

people in the later stage of dementia.

Prof D Tolson, Dr K Watchman, Dr Naomi

Richards

The service

‒ Enhanced Sensory Community Care (known as

The Sensory Programme) delivered twice weekly

‒ 5 places per session (Thursday and Sunday)

‒ Two experienced members of staff supported by

trained volunteers

‒ The Functional Assessment Tool (FAST) and

Pool Activity Level (PAL) tool are used to identify

the stage of dementia.

‒ Steering Group established

‒ Externally evaluated

Support and training

For families

‒ Working in partnership

‒ Manage expectation from

the beginning

‒ Attend practical

information sessions

‒ Use some of the

therapies at home

Staff and volunteers

‒ Enhanced level promoting

excellence framework

‒ Specific training in

sensory interventions

‒ Continuity of staff and

volunteer support

‒ Close management of

staff to prevent „burn out‟

Breakdown of individuals supported

to date

• A total of 7 people supported - one

under 65

• 5 transferred from traditional day care

• 2 direct from the community

• 2 leavers (died peacefully at home)

All the families have been involved in

information and support sessions and

have taken part in the evaluation

Magic moments captured by staff

‘it’s nice to hear

families saying that

they didn’t have a lot

of communication

before, but now

they’re getting more

back’

She loves having her

hair brushed… she

will lean forward if

you ask her’

‘The activities brought

out occasional words

and even full

sentences’

Making cup cakes – The Great Bake

Off!

It was –

Extremely messy!

Lots of eating of the

sugar!

But one of the gentlemen

was able to demonstrate

considerable

concentration and icing

skills!

Very interactive and fun

Lessons learned

• Sundays are not popular often

considered to be a family day

• Initially the assessment criteria was

set to high

• Difficult to sell the new service to

community teams

• Transition to new service from

traditional day care had to be

managed sensitively

‘I really enjoy volunteering I

never hear the staff talking

about what a person can’t do

only what they can do’

Staff and volunteer comments

‘I did start out feeling a bit like

ooohhh, I wonder what was

going to happen here… but I

can see some real ,real

benefits from this’ ‘It just makes me

feel good relaxed

and

compassionate ‘

What next?

• Enough funding to deliver the service until

summer 2015

• Possible local redesign of day care services in

D&G to focus on those in the later stages of

dementia

• Completion of the evaluation

• Inform Alzheimer Scotland work on the later

stages of dementia with a view to roll out over

Scotland

• Possible wider application of the model to home

support

Service Innovation & Developments

Post Diagnostic Support

Laura MacKechnie & Gayle Thomson, Dementia Link Workers, Perth & Kinross

Overview

‒ Project Background

‒ Pre-Project Analysis

‒ Project Objectives

‒ Service Model

‒ Project Outcomes & Experiences

‒ Next Steps

Project Background

‒ Funded by Change Fund Workstream 3

-“To improve access to specialist services for people living

with dementia and their families by shifting the balance

of care from hospital or long term care to community

based services and developing sustainable changes in

service provision”

‒ Funded since March 2012

‒ “Facing Dementia Together” Pilot

‒ Dementia Strategy Priority (2010)

‒ Government HEAT Target (effective from April 2013)

Pre – project analysis

‒ April 2012 – 1384 people in Perth & Kinross with a

diagnosis of dementia (NHST Dementia QoF Report,

September 2013)

‒ September 2013 – increased to 1448

‒ Significant gaps identified in both Pre & Post Diagnostic

Support

‒ Post Diagnostic Support delivered by CMHN‟s within the

OPCMHT‟s

‒ No dedicated service for Pre or Post Diagnostic Support

or Early intervention

Project Objectives

‒ To provide post diagnostic support to 100 families per

year using Alzheimer Scotland Five Pillar Model across

Perth City (Year 1) and North Perthshire, Perth City &

South Perthshire (Year 2)

‒ To support individuals and families with dementia for a

minimum of 1 year post diagnosis, in line with HEAT

Target (effective from April 2013)

‒ Improvement in access to quality Post Diagnostic

Support by a dedicated Alzheimer Scotland Dementia

Link Worker

Service Model

Year 1

‒ 3 Alzheimer Scotland Dementia Link Workers

‒ Based within Perth City OPCMHT

‒ Dedicated to provide Post Diagnostic Support

‒ Referrals received via OPCMHT

Service Model

Year 1

‒ Individual Caseload Supervision via CMHN‟s

‒ Management Supervision by Alzheimer Scotland Service

Manager

‒ Direct Access to Social Work Community Care Services

‒ Alzheimer Scotland‟s Five Pillar Model of Post

Diagnostic Support

‒ Social Work Documentation

Service Model

Year 2

‒ Model of support adapted following evaluation

‒ Locality based within 3 OPCMHT‟S: North West

Perthshire, Perth City & South Perthshire

‒ Clarification of referral criteria and pathway

‒ Removal of direct access to Social Work Community

Care Services

‒ Alzheimer Scotland Documentation/Health System

Project Outcomes &

Experiences

1. To provide Post Diagnostic Support to 100 families and

support for a minimum of 1 year

‒ Referral rate -132 families per year (January 2014)

‒ Carer Support provided in 60% of all referrals

‒ Locality split:

North Perthshire 19%

Perth City 35%

South Perthshire 46%

Project Outcomes &

Experiences

2. To improve access to quality Post Diagnostic Support in

Perth & Kinross

‒ All people referred to Dementia Link Worker Service

have been supported using Alzheimer Scotland‟s Five

Pillar Model

‒ Interviews with sample population (including people with

dementia & carers)

‒ Key common themes identified

‒ Short & medium term outcomes identified

Project Outcomes &

Experiences

Theme 1 - Reduction in fear and uncertainty surrounding

diagnosis

I‟m going to be honest, at the

beginning of last year, I was getting

quite depressed…I didn‟t know

where I was going – I was really

down so I really needed that help

from the Dementia Link Worker… If you didn‟t have

that link, you‟d be

lost I think – where

else would you go

apart from the

Doctor?

There were certain things, that I knew

within myself, that were happening that

were not due to depression…but I just felt

we were not being listened to. For a while

to be honest, I felt I was banging my head

against a brick wall trying to get someone

to listen…

Project Outcomes &

Experiences

Theme 2 - Importance of using a Person-Centred Approach

He‟d always say the Dementia

Link Worker understood…He‟s

often said I really think she

understands how I feel about

this. She‟s not dreary. Not too

light hearted either but more of

a positive thing. Which I think is

a good thing…

Everybody speaks about support,

but support is a word and a

nothing, but when you see the

person that makes a world of

difference

(At the Information group) I‟m

known as the chairman and I

came home and I

thought…isn‟t it nice that they

have that attitude to me? So

this is what I want to do…

But I think that‟s how the

Dementia Link Worker made

a difference, because she

was actually listening to

what we were saying…she

was an absolute breath of

fresh air!

Project Outcomes &

Experiences

Theme 3 - Reduction in carer stress and isolation through

carer support and involvement in Post Diagnostic Support

and planning

But I need that time to adjust, it takes

me a wee while to adjust. As long as I

can keep my health, that‟s the biggest

bit that worries me…but it‟s always at

the back of your mind you know, but

there again, the Dementia Link

Worker has been helping me with

that, with what I should be doing and

we‟ve got one or two things into place

The Dementia Link

Worker has been great

because she gives you a

surge of “that‟s a good

idea…you‟re living with

Alzheimer‟s…but you‟re

not going to stop living”

Project Outcomes &

Experiences

Theme 4 - Consistent Post Diagnostic Support and

progress within the 5 Pillar Model

‒ Written/Verbal information

‒ Dementia Information & Support Group

‒ Making/ maintaining/ reconnecting

‒ Dementia Café

‒ Discussions regarding future care needs/wishes

‒ Awareness raising regarding legal aspects

Project Outcomes &

Experiences

Theme 5 - Value of Peer Support

It’s a load off your mind,

knowing there is someone who cares and who has been through the same

experience that you have been through

She finds getting together very helpful

Project Outcomes &

Experiences Theme 6 - Importance of a specialist, knowledgeable and

reliable Link Worker

If I’m really concerned about something I can

mention it to the Dementia Link Worker

and she’ll get it attended to

She’s very knowledgeable, I think she would do a lot of homework . She would say something and surprise you

with saying something about another side of the condition, another way of

looking at things

Project Outcomes &

Experiences Theme 7 –Being supported to live positively with dementia

The Dementia Link Worker has been just

what we needed… She’s so positive about things

We’re a lot more determined I think…we’ve got big plans for this year. She’s given me this feeling that this is not necessarily that

we’ve got to allow this to rule our lives or to overwhelm us. What we’ve got to do is live life as if

there was nothing wrong and deal with things as they come up but not to sit and worry about them

all the time

Project Outcomes &

Experiences

3. Enhancement of existing services

I strongly agree that the Dementia

Link Worker has improved the quality of post diagnostic support…I

feel that they have been able to offer support early which is crucial

after being given a diagnosis. Dementia Link Workers have time

to spend with the person with dementia and are able to deliver a

personalised approach - CMHN

The introduction of an Alzheimer Scotland Link Worker has been invaluable in

providing post diagnostic support in a timely and person centred way. My sense is that the provision of this support to people

with dementia and their carers has prevented and alleviated distress. This is a good outcome for patients and carers but

has also allowed mental health professionals more time to assess new patients and respond to the escalating

needs of people progressing through their illness – Consultant Psychiatrist

Project Outcomes &

Experiences

4. Additional Outcomes and Service Development

‒ Development of Dementia Information & Support Groups

‒ Delivery of training and education to staff

Next Steps

Project Sustainability

‒ Self-sustaining peer support

‒ Self Management

‒ Future funding/Mainstreaming of Service

Partnerships with Education including the

Digital Commonwealth

Iain Houston, Dementia Advisor

0141 887 1289

[email protected]

‒ A key aim: Raising awareness of dementia and

reducing stigma

‒ Argyll & Clyde dementia advisors have been

involved in education partnerships for several

years, these continue to strengthen and grow

Partnerships with Education

Most recently: Alzheimer Scotland Education

Initiative won ‘Best Education Initiative’ at the 2014

Scottish Dementia Awards

‒ The Initiative: Based on partnerships with several local

primary schools in West Dunbartonshire & Secondary

schools in Renfrewshire.

‒ Primary Schools: 2 sessions were delivered to primary 7

pupils at 2 primary schools in West Dunbartonshire as

part of a dementia friendly community initiative.

‒ Session 1: what is dementia?, our brain & how it works,

what can happen if our brain is damaged by something

like dementia

‒ Session 2: things that help people with dementia and

how people live well with dementia

Activity: How Does our Brain Work?

“It was really good, I can now help

my neighbour” (Primary 7 pupil)

‒ Secondary Schools: Renfrewshire dementia

advisor facilitated several dementia session for

3rd year pupils as part of their Youth Philanthropy

Initiative.

‒ Following these sessions several groups chose

to represent Alzheimer Scotland, with 2 groups

reaching the final.

‒ DAs are keen to continue making annual commitments

on an ongoing basis to schools in their area and more

schools have started to show an interest in becoming

involved.

‒ Through this initiative the Renfrewshire DA has now

began working with the University of the West of

Scotland, paisley campus, BA(hons) Social Work

students.

‒ This is leading to further exciting projects within the

university.

Further & Future Developments

Visit to UWS, Paisley, with SDWG

‒ ‘I’m more than a piece of paper’

(Member of the SDWG)

• Initiative inspired by the Commonwealth Games coming to Glasgow and the attention this draws to ideas of Global Citizenship and identity

• Aim: To enhance the capacity of individuals and groups to use digital media to ensure that their voices are heard and a digital commonwealth legacy is created.

• Reaches out to individuals and groups who may experience social, cultural or economic marginalization and help make sure their stories are heard.

• Ensure that people are not forgotten and outside society but an INTEGRAL part of it.

The Digital Commonwealth

‒ Through our partnership work with the UWS (Jennifer

Jones) we developed a 4 week creative voices song

writing group with 2 community musicians; Robert &

Carol, and members of our memory lane club.

‒ The project:

• 4 x 2hr sessions

• Sing-a-longs to reminisce through song

• Facilitated discussions to understand things that

are important to the group

• Developing these thoughts creatively into song

• Digitally recording this and making it available to

share as part of a digital commonwealth

Creative Voices

‒ https://www.youtube.com/watch?v=W5NFSJN1y-

I&index=2&list=PLcc0TZ9aBvemdCivUz0CEzxntFhvGM

_-c

‘Memory Lane’

Robert, Carol & members of memory lane club

https://www.youtube.com/watch?v=W5NFSJN1y-I&index=2&list=PLcc0TZ9aBvemdCivUz0CEzxntFhvGM_-c









Workshop 5 service developments

Government & Nonprofit

Transcript of Workshop 5 service developments