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DEMENTIA. Positive 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.

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Dementia l.jpg
DEMENTIA

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


Admission l.jpg
Admission

Stressful

Patient

Carers

Staff


Raw deal l.jpg
Raw Deal…

Lack of: -

Time

Patience

Resources

Staff confidence


Others factors l.jpg
Others Factors

Staff inexperience

Complex needs

Behaviour

Lack of “fit”


Benalla district memorial hospital l.jpg
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 l.jpg
Caring For Dementia Patients

Searching for solutions


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AIMS

Safe Environment

Anxiety Free


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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


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Where Did We Start? cont.

Average Monthly Bed Days = 175

50% prone to wandering

Jan ’05 dementia patients = 26% of total bed days


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Analysis

Effect on Casemix - funding

44% NOT recognised in diagnosis


Analysis cont l.jpg
Analysis cont.

Casemix Funding Allocation

  • Average allocation = $2189

  • Dementia conditions = $8885


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What Followed…

  • Education

Seminars

Reading

  • Information Search

Compilation of Resource Folder


Safe environment l.jpg
Safe Environment

Installation of Alarm System


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Safe Environment cont.

Hip Protectors

Use of Signs


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This Is Your Life Book…

Permission granted by

Alzheimer’s Association of Victoria


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This is your life…

  • Past interests & hobbies

  • Present skills

  • Favourite music & TV programs

  • Special friends and pets


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Do’s & Dont’s of Dealing With Dementia

Thanks to Bendigo Health for use of their “Communication with Dementia Clients” Pamphlet.


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Dementia Care Pathway

Directs staff

Tools

Assessments

Thanks to Bendigo Health for use of their Dementia Care Pathway


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Diversional Therapy

MUSICMUSICMUSIC


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MUSIC cont.

Emotional wellbeing

Communication

Behaviour Management

Sleep


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Other Diversional Therapies

  • Old movies

  • Memorabilia

  • Reminiscences

  • Craft/games

  • Touch/tactile/comfort objects

  • Utilization of previous skills












The benefits l.jpg
The Benefits

Equally valued

Soothe symptoms

Relieve apprehension

Less Staff Stress

Excellent Resource Info


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The Benefits Continue

Dementia pathway & flow charts

Education/Personal development

Support and involvement

Positive feedback


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Flexibility of Staff

  • Allocating workloads

  • Minimise disruption


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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”


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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”


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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


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This Project Is….

Grass roots

Sustainable

Highly successful

Replicable

Everyone benefits


Acknowledgements l.jpg
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



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