dementia positive solutions in acute care priscilla taylor clinical nurse specialist benalla &...
TRANSCRIPT
DEMENTIAPositive Solutions In Acute Care
Priscilla Taylor Clinical Nurse Specialist
Benalla & District Memorial Hospital North East Victoria
Admission• Stressful
• Patient
• Carers
• Staff
Raw Deal…Lack of: -
• Time
• Patience
• Resources
• Staff confidence
Others Factors
• Staff inexperience• Complex needs• Behaviour• Lack of “fit”
Benalla & District Memorial Hospital• 85 bed rural facility
• 31 bed Medical Unit
• 24 bed Mid/Surg/DSU
• 30 bed Nursing Home
Caring For Dementia Patients
Searching for solutions
AIMS
• Safe Environment
• Anxiety Free
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
Where Did We Start? cont.
• Average Monthly Bed Days = 175• 50% prone to wandering• Jan ’05 dementia patients = 26%
of total bed days
Analysis
• Effect on Casemix - funding
•44% NOT recognised in diagnosis
Analysis cont.
Casemix Funding Allocation
• Average allocation = $2189
• Dementia conditions = $8885
What Followed… Education
Information Search
•Seminars
•Reading
•Compilation of Resource Folder
Safe Environment Installation of Alarm System
Safe Environment cont.• Hip Protectors
• Use of Signs
This Is Your Life Book…
Permission granted by
Alzheimer’s Association of Victoria
This is your life…
Past interests & hobbies
Present skills
Favourite music & TV programs
Special friends and pets
Thanks to Bendigo Health for use of their “Communication
with Dementia Clients” Pamphlet.
Do’s & Dont’s of Dealing With
Dementia
Dementia Care Pathway
• Directs staff
•Tools
•Assessments
Thanks to Bendigo Health for use of their Dementia Care Pathway
Diversional Therapy
MUSIC MUSIC MUSIC
MUSIC cont.
• Emotional wellbeing
• Communication
• Behaviour Management
• Sleep
Other Diversional Therapies Old movies
Memorabilia
Reminiscences
Craft/games
Touch/tactile/comfort objects
Utilization of previous skills
Old Movies
Memorabilia
Reminiscing
Craft and Memory Games
Tactile Diversion
Utilizing Previous Skills
Strategies For Restless Hands
IV Line Decoy Part I
IV Line Decoy Part II
Occupying Restless Hands
The Benefits
• Equally valued
• Soothe symptoms
• Relieve apprehension
• Less Staff Stress
• Excellent Resource Info
The Benefits Continue
• Dementia pathway & flow charts
• Education/Personal development
•Support and involvement
•Positive feedback
Flexibility of Staff
• Allocating workloads
• Minimise disruption
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”
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”
STAFF SATISFACTION SURVEY CONT.
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?
UNSURE - 3
NO RESPONSE - 2 YES - 12
NO - 1
This Project Is….• Grass roots
• Sustainable
• Highly successful
• Replicable
• Everyone benefits
• BDMH Board and Management
• Jenny Bickerdike, NUM, BDMH
• Matt Gill, Discharge Planner, BDMH
• Clients and Family members.
• Bendigo Health
• Alzheimer’s Association of Victoria
Acknowledgements