DEMENTIA

1. DEMENTIA Positive Solutions In Acute CarePriscilla Taylor Clinical Nurse SpecialistBenalla & District Memorial Hospital North East Victoria

2. Admission Stressful Patient Carers Staff

3. Raw Deal… Lack of: - Time Patience Resources Staff confidence

4. Others Factors Staff inexperience Complex needs Behaviour Lack of “fit”

5. Benalla & District Memorial Hospital 85 bed rural facility 31 bed Medical Unit 24 bed Mid/Surg/DSU 30 bed Nursing Home

6. Caring For Dementia Patients Searching for solutions

7. AIMS Safe Environment Anxiety Free

8. 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

9. Where Did We Start? cont. Average Monthly Bed Days = 175 50% prone to wandering Jan ’05 dementia patients = 26% of total bed days

10. Analysis Effect on Casemix - funding 44% NOT recognised in diagnosis

11. Analysis cont. Casemix Funding Allocation • Average allocation = $2189 • Dementia conditions = $8885

12. What Followed… • Education Seminars Reading • Information Search Compilation of Resource Folder

13. Safe Environment Installation of Alarm System

14. Safe Environment cont. Hip Protectors Use of Signs

15. This Is Your Life Book… Permission granted by Alzheimer’s Association of Victoria

16. This is your life… • Past interests & hobbies • Present skills • Favourite music & TV programs • Special friends and pets

17. Do’s & Dont’s of Dealing With Dementia Thanks to Bendigo Health for use of their “Communication with Dementia Clients” Pamphlet.

18. Dementia Care Pathway Directs staff Tools Assessments Thanks to Bendigo Health for use of their Dementia Care Pathway

19. Diversional Therapy MUSICMUSICMUSIC

20. MUSIC cont. Emotional wellbeing Communication Behaviour Management Sleep

21. Other Diversional Therapies • Old movies • Memorabilia • Reminiscences • Craft/games • Touch/tactile/comfort objects • Utilization of previous skills

22. Old Movies

23. Memorabilia

24. Reminiscing

26. Craft and Memory Games

27. Tactile Diversion

28. Utilizing Previous Skills

29. Strategies For Restless Hands

30. IV Line Decoy Part I

31. IV Line Decoy Part II

32. Occupying Restless Hands

33. The Benefits Equally valued Soothe symptoms Relieve apprehension Less Staff Stress Excellent Resource Info

34. The Benefits Continue Dementia pathway & flow charts Education/Personal development Support and involvement Positive feedback

35. Flexibility of Staff • Allocating workloads • Minimise disruption

36. 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”

37. 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”

38. STAFF SATISFACTION SURVEYCONT. 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? NO - 1 UNSURE - 3 NO RESPONSE - 2 YES - 12

39. This Project Is…. Grass roots Sustainable Highly successful Replicable Everyone benefits

41. Acknowledgements BDMH Board and Management Jenny Bickerdike, NUM, BDMH Matt Gill, Discharge Planner, BDMH Clients and Family members. Bendigo Health Alzheimer’s Association of Victoria

42. That's all folks!