DEMENTIA
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Transcript of DEMENTIA
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DEMENTIAPositive Solutions In Acute Care
Priscilla Taylor Clinical Nurse Specialist
Benalla & District Memorial Hospital North East Victoria
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Admission• Stressful
• Patient
• Carers
• Staff
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Raw Deal…Lack of: -
• Time
• Patience
• Resources
• Staff confidence
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Others Factors
• Staff inexperience• Complex needs• Behaviour• Lack of “fit”
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Benalla & District Memorial Hospital• 85 bed rural facility
• 31 bed Medical Unit
• 24 bed Mid/Surg/DSU
• 30 bed Nursing Home
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Caring For Dementia Patients
Searching for solutions
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AIMS
• Safe Environment
• Anxiety Free
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Where Did We Start?Total Dementia Bed Days:
Mar 2003 - 109 June 2003 - 180
April 2003 - 166 July 2003 - 221
May 2003 - 192 Aug 2003 - 178
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Where Did We Start? cont.
• Average Monthly Bed Days = 175• 50% prone to wandering• Jan ’05 dementia patients = 26%
of total bed days
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Analysis
• Effect on Casemix - funding
•44% NOT recognised in diagnosis
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Analysis cont.
Casemix Funding Allocation
• Average allocation = $2189
• Dementia conditions = $8885
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What Followed… Education
Information Search
•Seminars
•Reading
•Compilation of Resource Folder
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Safe Environment Installation of Alarm System
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Safe Environment cont.• Hip Protectors
• Use of Signs
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This Is Your Life Book…
Permission granted by
Alzheimer’s Association of Victoria
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This is your life…
Past interests & hobbies
Present skills
Favourite music & TV programs
Special friends and pets
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Thanks to Bendigo Health for use of their “Communication
with Dementia Clients” Pamphlet.
Do’s & Dont’s of Dealing With
Dementia
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Dementia Care Pathway
• Directs staff
•Tools
•Assessments
Thanks to Bendigo Health for use of their Dementia Care Pathway
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Diversional Therapy
MUSIC MUSIC MUSIC
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MUSIC cont.
• Emotional wellbeing
• Communication
• Behaviour Management
• Sleep
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Other Diversional Therapies Old movies
Memorabilia
Reminiscences
Craft/games
Touch/tactile/comfort objects
Utilization of previous skills
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Old Movies
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Memorabilia
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Reminiscing
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Craft and Memory Games
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Tactile Diversion
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Utilizing Previous Skills
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Strategies For Restless Hands
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IV Line Decoy Part I
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IV Line Decoy Part II
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Occupying Restless Hands
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The Benefits
• Equally valued
• Soothe symptoms
• Relieve apprehension
• Less Staff Stress
• Excellent Resource Info
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The Benefits Continue
• Dementia pathway & flow charts
• Education/Personal development
•Support and involvement
•Positive feedback
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Flexibility of Staff
• Allocating workloads
• Minimise disruption
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STAFF SATISFACTION SURVEY
“There is less aggression”“The wandering alarm is the best thing the
hospital has implemented, it gives me confidence to go about my other nursing tasks knowing that I will be alerted if a patient with an alarm attempts to leave”
“Patient’s faces light up when you know a bit about their past and their hobbies”
“Family members statements of …relief, impressed, reassuring and pleasantly surprised”
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STAFF SATISFACTION SURVEY CONT.
“Lady with dementia fondly held and talked to her stuffed toy dog; the man who spent hours looking at old magazines; the lady who many times watched old movies and dancing on videos; the man who spent ages soaking stamps off envelopes; the IV site decoy was pulled, poked and played with but the IV remained insitu”
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STAFF SATISFACTION SURVEY CONT.
If you were asked to look after only the more ambulant patients with dementia for a full shift, would you be willing to do so now that we have these strategies in place?
UNSURE - 3
NO RESPONSE - 2 YES - 12
NO - 1
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This Project Is….• Grass roots
• Sustainable
• Highly successful
• Replicable
• Everyone benefits
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• BDMH Board and Management
• Jenny Bickerdike, NUM, BDMH
• Matt Gill, Discharge Planner, BDMH
• Clients and Family members.
• Bendigo Health
• Alzheimer’s Association of Victoria
Acknowledgements
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