Transforming Ward-based Dementia Care


Amy Uren, Senior Nurse


Cwm Taf University Health Board


AIM:


We must make sure that people living with dementia feel safe and listened to, valued and respected, can get the help that they need, can do the things that matter to them and live in a place that suits them and their lives.


CONTEXT:


As the population ages, the demographic nature of general ward populations is changing. A recent survey revealed that almost 3 in 4 general hospital beds in Cwm Taf were occupied by patients over 65 and 1 in 4 beds were occupied by someone identified as suffering from dementia. People living with a form of dementia and their carers are some of our most vulnerable patients, and we should aspire to deliver the very best for those who are potentially at risk of being excluded from so much that matters to them.


DEVELOPMENT:


Traditionally, institutional care for older people with dementia has been arranged according to the medical model which is focused on the physical and biological aspects of specific diseases and conditions. Enhancing the support for people with long-term conditions is critical. If we aspire to deliver world class quality care we need to do things differently and remove barriers to ensure that people are getting the right care, in the right place at the right time.


Our plan is centred on a more effective focus on safety, quality and improved outcomes. The approach involves dementia friendly changes to the routine on the ward with a focus on individualised care.


Patients wake up naturally in their own time, can do activities that are meaningful for the person. Often, meaning is tied to past occupation or hobbies, so what’s meaningful for one person might not be so for another, dressing as they would at home, spending time socialising with other patients in a dementia friendly homelike dayroom environment and normalisation of daily life.


Changes to the physical environment including comfortable seating, a change in colour scheme evidenced to help people with dementia recognise key areas were also required to support changes to routine, and ensure care is patient-centred, safe and that the environment is dementia friendly.


IMPACT:


Relatives have given the following feedback:


“My mother has had a lovely experience this time, the day room has had a positive effect on my mother's recovery. It’s been so nice to see my mother interacting with other patients."


“Mrs V, has been attending the day room. The carers have been involved. A lot of attention provided for patients needs of simulation."


“What a fabulous surprise to visit my dad today in the day room.”


“Thank you for this facility and all who work here as it brightens my mothers day."


FIT WITH PRUDENT HEALTH:

  • Collaboration between patients and all connected with them is crucial to their health and their wellbeing. This initiative aspires to enhance long-term outcomes and quality of life for patients with dementia;

  • Adopting the principles of John’s Campaign within community hospitals means we are supporting and encouraging the continued connection between carers and those who need their care regardless of the environment that they are in;

  • Families are recognised as more than "visitors" to a person with dementia; they are an integral part of that person's life and identity and often their last and best means of connection with the world.



Part of cohort Bevan Exemplar Projects 2016-17