“ Person centred approaches to fluid intake for service users with an intellectual disability & dementia” by Mary Mo

1. “ Person centred approaches to fluid intake for service users with an intellectual disability & dementia”byMary Moylan RNID

2. The Issue • Fluid intake – 1,500ml per day on average per service user • Poly pharmacy • Dysphasia issues & the use of fluid thickeners • High levels of bowel care medication used by some service users to maintain regular bowel movement. • Cultural attitudes within the service relating to quantity of fluid intake needed by service users…. • Service users rely on staff for nutritional needs

3. The Change Idea • To increase service users fluid intake in a person centred fashion • To reduce the need for pharmaceutical bowel care intervention • To reduce possible discomfort for service users in relation to thirst, pain & general discomfort. • To change cultural attitudes amongst staff regarding fluid intake in a positive manner through information, knowledge & empowerment.

4. The Plan • Highlight 3 service users who we keep fluid chart on (tick chart in working folder) • Offering drinks outside of meal times, introducing wider variety of hot & cold drinks. • Suggest whilst staff making coffee/tea etc for themselves to offer same to service users • Review regular bowel medication with G.P on weekly basis (elimination & Bristol stool chart) • Night staff to offer drinks before service user’s retire to bed & on awakening.

5. Outcomes to date • Fluid intake increased from 600-800ml a day to 1,500ml+ for one service user • For the 3 service users we have reduced bowel care intervention, decreasing Movical sachets from 28 a week to 14. Review weekly by G.P. • We have discovered that one service user has developed a liking for camomile tea with honey which has improved sleep pattern. • Individuals moods have improved with less incidents responsive behaviours.

6. Room for improvement • Informing staff of the importance of hydration for our service users, particularly issues indicative to people with an I.D. • Difficulties in relation to staffing levels & consistency in delivering change practice. • Documentation and record keeping. • Identifying individuals preferences of what they like to drink, when & how ! • Supporting staff particularly night staff in implementing change practice.

7. Thank You for your attention, any questions