SCOTLAND’S DEMENTIA STRATEGY

ANDPERSONALISATION

Scotland’s National Dementia Strategy

The key points from 2010 document

Dementia Strategy

Published in June 2010, it focuses on two key areas: Providing better support and information to people with

dementia and their carers after diagnosis Providing better support and care in hospitals (including

finding alternatives to admission and improved planning for discharge)

Why? Because they will bring immediate benefits to people with

dementia and their carers and improve efficiency and quality of the care system

Dementia Strategy

A further eight priorities for improving care pathway for people with dementia and their carers are identified:

Common standards of care for dementia A definitive skills and knowledge framework for dementia Transformational change involving all health and care sectors Improved management and outcome information Continued work on diagnosis Better response to challenging behaviour Accelerated implementation of Dementia Integrated Care

Pathway Continued action to support dementia research

Dementia Strategy

The strategy is designed to tackle five key challenges: The fear of dementia that means people delay in coming

forward for diagnosis Poor or non-existent information and support after diagnosis

for those with dementia and their carers Poor outcomes in general healthcare services A lack of dignity and respect for people with dementia and

their carers Inadequate support for family members and those who care for

people with dementia

Dementia Strategy

Action already taken: Alzheimer Scotland have 19 Dementia Advisers in 18 local

authorities They fund three Dementia Nurse posts in NHS Lothian, NHS

Borders and NHS Ayrshire and Arran – and have launched a £1.5 million appeal to place a nurse in all 14 health boards

Dementia has been established as a national clinical priority by the Scottish Government

New self-directed support legislation introduced to enable more people with dementia to have control of their care funds

The Scottish Dementia Forum, including people with dementia and carers, has been created and meets regularly

Dementia Strategy

The next steps The first annual report on the progress of the strategy will be

published in June 2011 by the Dementia Strategy Implementation and Monitoring Group

This Strategy has long-term objectives, but there is an immediate focus on action over the next 3 years

A revision of the Dementia Strategy is due to be completed by June 2013

Dementia: By NHS Board Scottish Borders

Dumfries &

Galloway

Fife Forth Valley

Lothian

_65 37 48 115 93 255

65-74 328 477 909 709 1775

75-84 657 942 1854 1358 3693

85+ 686 902 1738 1232 3494

No people

with dementia

1708 2369 4616 3392 9217

Population of area

106764 147765 349429 279480 778367

Est. % with

dementia

1.6% 1.6% 1.3% 1.2% 1.2%

Dementia in Scotland

0

20000

40000

60000

80000

100000

120000

2007 2012 2017 2022 2027 2031

males

females

total

(Alzheimer’s Scotland 2007)

Currently 71,000 in total - 60% in community- 40% in institutional (long stay) care

Projected to rise to 127,000 by 2031 (Alzheimer’s Scotland 2010)

PERSONALISATION

AN INTRODUCTION

Starting with the Person

Personalisation means thinking about public services and social care in an entirely different way – starting with the person rather than the service. It will require the combined transformation of adult care.

Julie Jones, Chief Executive, SCIE

What support do people with dementia need?

Information about their illness and what's available The tools to become active in their own planning and

decision making Control enabling them to take decisions when they

have capacity to make decisions and plan ahead Knowledge of the allocated budget to their care Ability to control their budget to meet their personal

needs and understanding the options available to them (e.g. self directed support, direct payments purchasing services or personal assistants)

What is Personalisation

Begins with the person, not the service Recognises the person’s strengths,

preferences, networks of support Individual is best placed to make decisions

about their life

What is Personalisation

Accessible information and advice Irrespective of whether self funded or publicly

funded It’s about giving people choice and control

over their lives

What Personalisation is NOT

A completely new idea Just about giving people individual

budgets Only for people eligible for Council

funding Or those needing traditional services

only

What Personalisation is NOT

“Importantly, the ability to make choices about how people live their lives should not be restricted to those who live in their own homes. It is about better support, more tailored to individual choices and preferences in all care settings”

(DH, 2008a,p5)

What it does mean

Finding new collaborative ways of working and developing local partnerships, which produce a range of services for people to choose from and opportunities for social inclusion

Tailoring support to meet individual needs Recognising and supporting carers in their

role, while enabling them to maintain a life beyond their caring responsibilities.

What it does mean

Access to universal community services and resources – a total system response

Early intervention and prevention so that people are supported early on and in a way that’s right for them

Some Common Terms

Person centred planning Person centred care Person centred support Independent living Self directed support

Personalisation

Implementing Personalisation

The experience of dementia

Consider Trying to make sense of an increasingly unfamiliar world Unable to access memory Being disorientated – time, place, person Unable to respond to emotional demands Unable to verbalise your needs Loss of strengths – weaknesses come to the fore Loss of identity and control over your life Being ignored, talked over or treated as stupid Loss of coping skills

Implementing Personalisation - Environment

Does it make sense to the person Does it lack crucial information Signs and cues Areas of importance not highlighted Inappropriate lighting Too much noise and conflicting stimuli Patterned carpet and shiny flooring Mirrors

Communication tips

REMEMBER – challenging behaviours are not always a problem for the person with dementia

For the person with dementia – their behaviour often makes perfect sense to them

Due to communication difficulties the behaviour of people with dementia should be seen as an expression of need

Communication tips

DON’T Try to communicate when there are distractions Use long complicated sentences (or jargon) Talk about doing something long before you do it Assume that pronoun’s like he, she or it will be clear to the

person Keep repeating something if you are misunderstood Use gestures that could be seen as threatening Assume that the person does not understand

Communication tips

DO: Seek out a quiet area Identify yourself by name Speak slowly and clearly – no need to shout Ensure that only one person speaks at a time Use other cues and gestures to maximise understanding Give time and remain unhurried Listen and give the person your full attention

FINAL POINT

The person with dementia can’t adapt to us – we need to adapt our social, clinical and structural

environment around the person.

At the very least – don’t disable the person further!

THANK YOU