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Jason Burton Alzheimer’s Australia WA Research and Consultancy Department

FightDementia.org.au. Jason Burton Alzheimer’s Australia WA Research and Consultancy Department jason.burton@alzheimers.org.au. Relationship Based Care. “Changing Worlds”. Where Have We Come From?. The Medical Model – A Double Edged Sword. Institutional Care. What makes an institution?

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Jason Burton Alzheimer’s Australia WA Research and Consultancy Department

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  1. FightDementia.org.au Jason Burton Alzheimer’s Australia WA Research and Consultancy Department jason.burton@alzheimers.org.au

  2. Relationship Based Care “Changing Worlds”

  3. Where Have We Come From?

  4. The Medical Model – A Double Edged Sword

  5. Institutional Care What makes an institution? • Physical • Social Reference: Wolfensburger

  6. Moving to a Relationship Based Model of Care Requires: • Culture change • Organisational change • Acceptance of risk • Supportive Environment • Leadership

  7. Understanding the Risks • Emotional • Organisational • Liability • Professional

  8. Challenging the Paradigms “We have always done it this way”………..

  9. Paradigm1 Focus Doing v’s Being

  10. Gladys Wilson and Naomi Feil(available on YouTube)

  11. Paradigm2 Outcome Task v Experience

  12. Paradigm3 Behaviour BPSD v Communication of Unmet Need

  13. Paradigm4 Activity Entertainment v Meaning and Purpose

  14. Max “There’s only so much ‘roll out the barrel’ you can take! ....”

  15. Paradigm5 Companionship Role v Relationship

  16. Models to take us forward • All share key concepts and beliefs • Growing evidence base for their effectiveness • Challenge the social and physical environments • Focus on culture change

  17. Wellbeing, illbeing and Personhood • Still misunderstood and misinterpreted • Do we see it? • Do we create our environments to grow and nurture or wither and degenerate?

  18. Mildred’s Move Into A Greenhouse

  19. Person Centred Care Developed by Tom Kitwood 1980’s • Uniqueness of individuals • Dementia as a social experience • Importance of personhood • Rejects “stage” theories of dementia • Challenges “Behaviour” as a consequence of brain damage only www.memorybridge.org

  20. Eden Alternative Developed by Dr Bill Thomas early 1990’s • Focuses on loneliness, helplessness and boredom • Culture change model • Promotes the creation of human habitats in care environments • Promotes wise leadership and shifting of decision making • Challenges the medical model www.edeninoznz.com.au

  21. Spark of Life Developed by Jayne Verity • Focuses on re engagement • Provides a framework change • Brings fun back into people’s lives • Challenges medical model thinking www.dementiacareaustralia.com

  22. Best Friends Approach Developed by Virginia Bell& David Troxel • Breaks down the role of professional v sick person • Focuses on friendship and understanding • Requires understanding of the individual and life story work • Matches staff/volunteers/families and elders based on commonality or connection http://bestfriendsapproach.com

  23. Summary • Relationship based care is paramount in our work with people with dementia • Requires culture change and challenging of existing care paradigms • Needs to be “whole of environment” • Number of models that can be used to start the journey

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