Dementia training in Norwich – to reduce the reliance on antipsychotic medication

1. Dementia training in Norwich – to reduce the reliance on antipsychotic medication Training to support Care workers in care homes Clare Daly and Penny Levett

2. Origins • In advance of the national strategy • Safeguarding issue in West Norfolk • Developed in conjunction with CSCI • To introduce alternative management techniques rather than over reliance on medication

3. Combines medication and alternatives One day Training Developed and delivered by specialist staff Off site Part of wider PCT initiative Follows national guidance

4. Pharmacy training • Outlines the appropriate use of medication in dementia • Looks at Behavioural and Psychological Symptoms of Dementia • Looks at treatment with antipsychotics • Looks at side effects / cautions • Looks at medication management as part of the broader picture in dementia

5. Non medication training • Based on principles of Tom Kitwood • ‘Person Centred Care’ overused and misused • Go back to PCC roots – looks at the flower and the support these people need to achieve these basics rights • If support not there or forth coming - clash

6. Non medication training • Considers full understanding of persons history • and how it impacts on current presentation • Insight into coping strategies • How the past influences their responses to others

7. Looks at practical application of this • Potential restrictive nature of risk assessments • Removal of all risk impractical and restricting

8. Looks at memory • How it is stored and how that influences and disorientates

9. Behaviour • Challenging behaviour arises from misinterpretation of intentions and actions • Get carers to think about it in a situation that they can relate to

10. Busy boxes and diaries • Appropriate to the person • Distraction and enjoyment • Allow you to become a detective • Can accurately report to GP

11. Case studies allows learning into practice Allows sharing of good practice Encourages discussion Real life examples

12. Challenges we have encountered • Keenness to change but perceived difficulties • Lack of awareness of alternatives to medication • Lack of awareness from GPs about alternatives – reliance on mediation • Change from ‘prn’ medication to regular medication Culture Resources Time Rules

13. Future direction • Waiting for outcome of a research bid RfBP to take this further

14. Any questions