Validation, Recognition, Protection and Calming of the Resident with Dementia or Mental Illness.

1. Validation, Recognition, Protection and Calming of the Resident with Dementia or Mental Illness. Presented by Leslie Carter RSM &Lisa Cotterill TL Good morning/afternoon everyone I would like to thank the ACS for giving us the opportunity to show case our strategies to assist residents within our ACF who have dementia and/or a mental illness gain validation, recognition, protection and calming. My name is Leslie Carter and I am the Residential Services Manager for Warrigal Care in Goulburn. My name is Lisa Cotterill and I am the Team Leader for the Dementia Secure Unit and Low Care House at Warrigal Care Goulburn. Good morning/afternoon everyone I would like to thank the ACS for giving us the opportunity to show case our strategies to assist residents within our ACF who have dementia and/or a mental illness gain validation, recognition, protection and calming. My name is Leslie Carter and I am the Residential Services Manager for Warrigal Care in Goulburn. My name is Lisa Cotterill and I am the Team Leader for the Dementia Secure Unit and Low Care House at Warrigal Care Goulburn.

2. Warrigal Care Goulburn Our Aged Care Facility is in Goulburn and is one of a number of homes run by Warrigal Care in Eastern NSW. Warrigal Care in a Not-for-profit organization and currently offers care to 1500 older Australians in this area. Warrigal Care Goulburn has been opened since 19th March 2008 and offers accommodation for 120 residents within its walls. There are 5 wings with 2 wings offering accommodation to 54 high care residents, 1 wing of 24 EES beds, 1 wing with 17 low care beds and 25 beds assigned to a Dementia Secure Unit. The site was a amalgamation of two other sites in run by Warrigal Care in Goulburn � a hostel �Pencomas Lodge� and Nursing Home �Mirambeena�. Within the hostel a number of the programs design and innovation began as this little hostel accepted some of the more challenging residents within Goulburn. A vast majority of them suffering from a mental illness. With the building of our beautiful new home the opportunity arose to expand on some of our care directions and innovations in mental health and dementia care and we were fully supported by our Warrigal Care Management. Our Aged Care Facility is in Goulburn and is one of a number of homes run by Warrigal Care in Eastern NSW. Warrigal Care in a Not-for-profit organization and currently offers care to 1500 older Australians in this area. Warrigal Care Goulburn has been opened since 19th March 2008 and offers accommodation for 120 residents within its walls. There are 5 wings with 2 wings offering accommodation to 54 high care residents, 1 wing of 24 EES beds, 1 wing with 17 low care beds and 25 beds assigned to a Dementia Secure Unit. The site was a amalgamation of two other sites in run by Warrigal Care in Goulburn � a hostel �Pencomas Lodge� and Nursing Home �Mirambeena�. Within the hostel a number of the programs design and innovation began as this little hostel accepted some of the more challenging residents within Goulburn. A vast majority of them suffering from a mental illness. With the building of our beautiful new home the opportunity arose to expand on some of our care directions and innovations in mental health and dementia care and we were fully supported by our Warrigal Care Management.

3. Aerial view of Warrigal Care Goulburn This is the Aerial view of Goulburn Warrigal Care � the Secure Dementia Unit is on the side with only two wings � you may be able see the courtyard that is near the front of the building. This court yard contains all edible plants and is the only one with a lawn for sensory exploration. Warrigal Care Goulburn provides 12 tiers of care including our Community Care program, Day Respite Program attached to the facility, Residential Care, In-house Respite Care, Low Care, High Care, Extra Service and the Dementia Specific. This makes us a unique service for older people where residents can advance through the stages of care in a trusting familiar environment that provides continuity of care Planning has begun to expand this facility already with another wing being designed to offer accommodation to another 40 high care residents. Due to this expansion 42 beds will now be assigned to the care of residents with Dementia and/or Mental Health disorders requiring a safe environment. Also commencing this year is the building of 50 Independent Living Units and community hall at the front of this building. This will ensure the ability to offer a range of services to the residents of Goulburn and surrounding areas with the security of knowledge of being cared for by a strong and experienced team.This is the Aerial view of Goulburn Warrigal Care � the Secure Dementia Unit is on the side with only two wings � you may be able see the courtyard that is near the front of the building. This court yard contains all edible plants and is the only one with a lawn for sensory exploration. Warrigal Care Goulburn provides 12 tiers of care including our Community Care program, Day Respite Program attached to the facility, Residential Care, In-house Respite Care, Low Care, High Care, Extra Service and the Dementia Specific. This makes us a unique service for older people where residents can advance through the stages of care in a trusting familiar environment that provides continuity of care Planning has begun to expand this facility already with another wing being designed to offer accommodation to another 40 high care residents. Due to this expansion 42 beds will now be assigned to the care of residents with Dementia and/or Mental Health disorders requiring a safe environment. Also commencing this year is the building of 50 Independent Living Units and community hall at the front of this building. This will ensure the ability to offer a range of services to the residents of Goulburn and surrounding areas with the security of knowledge of being cared for by a strong and experienced team.

4. Program Design The strategies were formed to assist the individual resident to succeed and have positive experiences within their living environment. The strategies were formed to assist the individual resident to succeed and have positive experiences within their living environment. It is a vision of supporting their memories and life experiences , acknowledging their illness and assisting them to cope and relax within their environment to promote independence, a degree of autonomy, a feeling of safety and reduce anxiety and depression. In this photo you can see one of our residents thoroughly enjoying a bubble bath in the spa. �Bill� was laughing and enjoying himself a lot but previous to this afternoon intervention he was quite distressed and confused. After he finishes the bubble bath he is relaxed and enjoys his tea and settles for the evening.The strategies were formed to assist the individual resident to succeed and have positive experiences within their living environment. It is a vision of supporting their memories and life experiences , acknowledging their illness and assisting them to cope and relax within their environment to promote independence, a degree of autonomy, a feeling of safety and reduce anxiety and depression. In this photo you can see one of our residents thoroughly enjoying a bubble bath in the spa. �Bill� was laughing and enjoying himself a lot but previous to this afternoon intervention he was quite distressed and confused. After he finishes the bubble bath he is relaxed and enjoys his tea and settles for the evening.

5. Program Design The target group of our 25 residents breaks down to:- 44% with Alzheimer's Dementia 8% Mixed Dementia 28% Diagnosis of Depression with psychoses 8% Diagnosis of Schizophrenia 24% Vascular Dementia 4% Parkinson�s Dementia 12% with a diagnosis of severe anxiety 8% Personality disorder And 100% require secure accommodation due to behaviours of concern. The program is designed to accommodate all our residents with dementia and mental illness with Behaviours of Concern. At the moment this is the breakdown of residents dementia and mental health diagnosis but when I presented this program at the Positive Living Awards the breakdown was significantly different. It is probably important to state that we do not identify the residents by their diagnosis but it does assist to know which area of the brain is damaged. The program is designed to accommodate all our residents with dementia and mental illness with Behaviours of Concern. At the moment this is the breakdown of residents dementia and mental health diagnosis but when I presented this program at the Positive Living Awards the breakdown was significantly different. It is probably important to state that we do not identify the residents by their diagnosis but it does assist to know which area of the brain is damaged.

6. Our strategies A Guide to Behaviour Management Individualised doors �My eyes are Blue� Mental Health First Aid Certificates Mobile Activities Cabinet Hydrotherapy The strategies that are included in our program design are: - A guide to behaviour management, Individualized doors, My Eyes are blue, Mental Health First Aid Certificates, Mobile Activities Cabinet, Hydrotherapy. I will explain the design, analysis, outcomes and effectiveness, consultation, transferability and sustainability for each of these.The strategies that are included in our program design are: - A guide to behaviour management, Individualized doors, My Eyes are blue, Mental Health First Aid Certificates, Mobile Activities Cabinet, Hydrotherapy. I will explain the design, analysis, outcomes and effectiveness, consultation, transferability and sustainability for each of these.

7. A Guide to Behaviour Management This guide was developed as a easy care guide for the staff to manage the many different behaviors and needs of residents with dementia and mental illness. This guide was developed as an easy care guide for the staff to manage the many different behaviors and needs of residents with dementias and mental illness. As you can see in this photo we have a couple of ladies who like to share a bed �top and tail�. For new staff this may be alarming but with easy reference they realize that no harm is being done and they actually find comfort like this during the day. Residents sleep in their own beds at night.This guide was developed as an easy care guide for the staff to manage the many different behaviors and needs of residents with dementias and mental illness. As you can see in this photo we have a couple of ladies who like to share a bed �top and tail�. For new staff this may be alarming but with easy reference they realize that no harm is being done and they actually find comfort like this during the day. Residents sleep in their own beds at night.

8. The chart identifies the resident by name and preferred name (for privacy all last names have been deleted). The residents previous occupations listed as this is a vital clue at times to behaviours being exhibited. Using the residents listed � Marie was a Bar Maid � so in her job she had to talk a lot to patrons of the bar � Marie talks all day and confabulates extensively but always on triggers from another resident or staff member initiating a conversation. Annabella was a Registered Nurse who worked a great number of night shifts so therefore her sleep pattern is disturbed and she will try to sleep excessively during the day and up at night. Eileen was a Homemaker and her history was looking after her extended families children � her hallucinations centre around children and them being hurt. Shirley was an accomplished artist and does not enjoy regular activities such as bingo, word games etc � she belonged to a different circle of people � the �artsy� world� and is very critical of main stream people. Audrey was a Registered Nurse who ran the nurses home and was in charge of all the young nurses. She does not interact well with the residents but loves the care staff � but reorganizes all her room items over and over and advises them.. Maria was an executive manager who was extremely important and held a powerful position. She is authoritative in her directions to staff and residents and does not tolerate anyone not following her requests. These are just a few of our residents on our front page but each one is listed in working document. We also list the Causative factors so again staff are reminded the residents have a brain injury or illness or some type. A list of common behaviours is made � this can change and as it does the list is updated. Then suggestions for day interventions, afternoon interventions and night interventions. Also special directions are listed such Marie suffers pain and needs to watched for non verbal clues, Annabella and Eileen doesn�t eat or drink enough if not monitored closely and sometimes need to be offered an alternative dining arrangement, Referrals to other services, communication deficits and very specific instructions such as Maria and her religious needs.The chart identifies the resident by name and preferred name (for privacy all last names have been deleted). The residents previous occupations listed as this is a vital clue at times to behaviours being exhibited. Using the residents listed � Marie was a Bar Maid � so in her job she had to talk a lot to patrons of the bar � Marie talks all day and confabulates extensively but always on triggers from another resident or staff member initiating a conversation. Annabella was a Registered Nurse who worked a great number of night shifts so therefore her sleep pattern is disturbed and she will try to sleep excessively during the day and up at night. Eileen was a Homemaker and her history was looking after her extended families children � her hallucinations centre around children and them being hurt. Shirley was an accomplished artist and does not enjoy regular activities such as bingo, word games etc � she belonged to a different circle of people � the �artsy� world� and is very critical of main stream people. Audrey was a Registered Nurse who ran the nurses home and was in charge of all the young nurses. She does not interact well with the residents but loves the care staff � but reorganizes all her room items over and over and advises them.. Maria was an executive manager who was extremely important and held a powerful position. She is authoritative in her directions to staff and residents and does not tolerate anyone not following her requests. These are just a few of our residents on our front page but each one is listed in working document. We also list the Causative factors so again staff are reminded the residents have a brain injury or illness or some type. A list of common behaviours is made � this can change and as it does the list is updated. Then suggestions for day interventions, afternoon interventions and night interventions. Also special directions are listed such Marie suffers pain and needs to watched for non verbal clues, Annabella and Eileen doesn�t eat or drink enough if not monitored closely and sometimes need to be offered an alternative dining arrangement, Referrals to other services, communication deficits and very specific instructions such as Maria and her religious needs.

9. Individualised doors The vision behind this activity was to allow the residents to select a choice of door decal which at present is easily identified by them. The residents are able to have sense of ownership and uniqueness, often showing off their door to their families and loved ones. Bill has had many picture of his door taken by his family and friends.The vision behind this activity was to allow the residents to select a choice of door decal which at present is easily identified by them. The residents are able to have sense of ownership and uniqueness, often showing off their door to their families and loved ones. Bill has had many picture of his door taken by his family and friends.

10. Individualised doors The artists who created these wonderful doors are our own Recreational Therapy Officers. The Recreational Therapy Officer assigned to the unit takes a lot of time finding the correct symbol to paint and at present is painstakingly trying to get a painting of a tractor exactly right for one of our newest residents. The artists who created these wonderful doors are our own Recreational Therapy Officers. The Recreational Therapy Officer assigned to the unit takes a lot of time finding the correct symbol to paint and at present is painstakingly trying to get a painting of a tractor exactly right for one of our newest residents.

11. Individualised doors The bright colors used in the individual doors often alleviate depression and proved the residents with a sense of pride. An additional affect of the bright colors and large picture reduces the institutionalized d�cor and assists with enhancing moods. It has made the hallway bright and a more cheerful environment which has enhanced the resident� general demeanor.The bright colors used in the individual doors often alleviate depression and proved the residents with a sense of pride. An additional affect of the bright colors and large picture reduces the institutionalized d�cor and assists with enhancing moods. It has made the hallway bright and a more cheerful environment which has enhanced the resident� general demeanor.

12. Individualised doors The residents responses varied when interviewed with some verbally responsive and other residents just nodding to pictures shown to them. What ever the decision the resident comes up with every effort is made to make their choices come to life.The residents responses varied when interviewed with some verbally responsive and other residents just nodding to pictures shown to them. What ever the decision the resident comes up with every effort is made to make their choices come to life.

13. Individualised doors The pictures were chosen with knowledge of their background, information obtained by their families and observations made by staff whilst they have been in the unit. Marie�s choice is painting of the bears that sit on her bed that her family gave her.The pictures were chosen with knowledge of their background, information obtained by their families and observations made by staff whilst they have been in the unit. Marie�s choice is painting of the bears that sit on her bed that her family gave her.

14. Individualised doors Residents cognitive ability has been supported by recognition of their rooms. This provides independence and lessens anxiety for the residents as they re able to identify their rooms through visual sensory.Residents cognitive ability has been supported by recognition of their rooms. This provides independence and lessens anxiety for the residents as they re able to identify their rooms through visual sensory.

15. Individualised doors This picture is a doorway to a double room � it shows two individual choices - so sharing a room is no obstacle to having some individuality. The residents admire all the doors and it is a wonderful talking point for visitors.This picture is a doorway to a double room � it shows two individual choices - so sharing a room is no obstacle to having some individuality. The residents admire all the doors and it is a wonderful talking point for visitors.

16. My Eyes are Blue This tool is used as a communication means capturing the resident�s life experience and personal preferences and identifying each resident as an individual. The completed document is done by hand, in many colors, in a personalized format not in regimented lines and has a photo of the resident included. This is an example of a �My Eyes are Blue� completed by care staff. Staff feel they know the resident prior to meeting them as the form provides a brief history and outlines the residents likes and dislikes. The completed A4 �Eyes are Blue� is mounted on the wall outside the residents room so the resident has another identification marker for their room and all staff and visitors that enter the room are reminded of the residents humanity and personality i.e. - they are more than a dementia or mental health diagnosis.This tool is used as a communication means capturing the resident�s life experience and personal preferences and identifying each resident as an individual. The completed document is done by hand, in many colors, in a personalized format not in regimented lines and has a photo of the resident included. This is an example of a �My Eyes are Blue� completed by care staff. Staff feel they know the resident prior to meeting them as the form provides a brief history and outlines the residents likes and dislikes. The completed A4 �Eyes are Blue� is mounted on the wall outside the residents room so the resident has another identification marker for their room and all staff and visitors that enter the room are reminded of the residents humanity and personality i.e. - they are more than a dementia or mental health diagnosis.

17. My Eyes Are Blue To make eye contact with someone is engaging the person on an intimate level. To be able to identify some of the residents� most important memories, thoughts and feelings gives the carer an ability to communicate with meaning, feeling and validates the resident as a fellow human being.\ What color are your eyes? What do you like best about yourself? What color was your hair when you were young? What do you remember best about your wife/husband? Tell me the best thing that happened to you? Tell me the worst thing that happened to you? What did you �want to be when you grew up� & what did you eventually do? Does anything scare you now? 9. Where was the best place you lived? 10. Where was your favorite holiday? 11. Did you have a favorite pet? 12. What is your favorite plant/flower? 13. Do you believe in god or do you have any special spiritual beliefs? 14. Do you have any regrets? 15. Were you a good:- Cook Gardener Mechanic Builder Knitter This is the questions that are asked on the format Starting with the statement �To make eye contact with someone is engaging the person on an intimate level. To be able to identify some of the residents most important memories, thoughts and feelings give the carer an ability to communicate with meaning, feeling and validates the resident as a fellow human being.This is the questions that are asked on the format Starting with the statement �To make eye contact with someone is engaging the person on an intimate level. To be able to identify some of the residents most important memories, thoughts and feelings give the carer an ability to communicate with meaning, feeling and validates the resident as a fellow human being.

18. My Eyes are Blue Sewer Mother/Father/daughter/son? 16. What do you like to read? 17. What is your favorite food and drink? 18. Do you like sport and did you play any when you were young? 19. What is your favorite color? 20. What makes you cross? Sewer Mother/Father/daughter/son? 16. What do you like to read? 17. What is your favorite food and drink? 18. Do you like sport and did you play any when you were young? 19. What is your favorite color? 20. What makes you cross? 21. What type of music do you enjoy? 22. Who is your favorite movie/TV star? 23. What is the best fun you can have? 24. What is your best memory? Please take a photo of the resident looking their best. Take a foot print and hand print. If the resident is unable to give you the information please contact their representative who may be able to give you some insight. �The eyes are the windows to the soul� English Proverb 21. What type of music do you enjoy? 22. Who is your favorite movie/TV star? 23. What is the best fun you can have? 24. What is your best memory? Please take a photo of the resident looking their best. Take a foot print and hand print. If the resident is unable to give you the information please contact their representative who may be able to give you some insight. �The eyes are the windows to the soul� English Proverb The resident or family member does not have to answer all the questions just the ones that are important to them � It allows the resident to debrief, remember in safety, express emotions and state their preferences. Remember the �The eyes are the windows to the soul�The resident or family member does not have to answer all the questions just the ones that are important to them � It allows the resident to debrief, remember in safety, express emotions and state their preferences. Remember the �The eyes are the windows to the soul�

19. Mental Health First Aid Certificates Staff able to intervene quickly when resident is in crisis Staff gain confidence Staff are competent Staff gain valuable knowledge Secures a good working partnership with Aged Care Mental Health. Warrigal Care Goulburn works closely with the Aged Care Mental Health Team who provided the trainer while Warrigal Care paid for the care staff to attend. This training directly impacted on the way staff were able to manage the residents with mental health illness or disease as well as those with dementia and challenging behaviors. It gave staff invaluable knowledge about mental illness and how to deal with challenges of the illness, for example managing aggression and inappropriate responses, experienced daily by these residents. Staff who have completed their mental Health First Aid Certificate have been able to intervene quickly when a resident is in crisis, with the appropriate initial reactions. It has created confident and competent staff that are able to manage initially a variety of mental healthy crisis events until further assistance is sought. A Guide to Behaviour Management has been developed through learnt strategies and interventions gained from the Mental Health firs Aid course and ongoing education.Warrigal Care Goulburn works closely with the Aged Care Mental Health Team who provided the trainer while Warrigal Care paid for the care staff to attend. This training directly impacted on the way staff were able to manage the residents with mental health illness or disease as well as those with dementia and challenging behaviors. It gave staff invaluable knowledge about mental illness and how to deal with challenges of the illness, for example managing aggression and inappropriate responses, experienced daily by these residents. Staff who have completed their mental Health First Aid Certificate have been able to intervene quickly when a resident is in crisis, with the appropriate initial reactions. It has created confident and competent staff that are able to manage initially a variety of mental healthy crisis events until further assistance is sought. A Guide to Behaviour Management has been developed through learnt strategies and interventions gained from the Mental Health firs Aid course and ongoing education.

20. Mobile Activities Cabinet This cabinet was purchased to assist residents who exhibit challenging behaviors, deliriums and anxiety states and assist by providing a calming, pleasant and gently visual distraction. The mobile sensory cabinet can be transferred to a residents bedroom, lounge room or quiet area and set up. The variety of equipment of sensory equipment allows the staff member to either relieve an agitated resident or provide stimulation to a resident with severe dementia. We have found using the sensory cabinet has assisted to calm agitation in some residents making them more manageable, especially in the afternoon. The lights provide a focal stimuli of interest for residents with severe dementia. This was the first item we fund raised for when we came to our new home and as we progress we will fundraise to purchase more sensory equipment to be added to this cabinet. We do have a number of sensory items permanently around the Dementia Secure Unit such as balls, fish, waterfalls, and mobiles.This cabinet was purchased to assist residents who exhibit challenging behaviors, deliriums and anxiety states and assist by providing a calming, pleasant and gently visual distraction. The mobile sensory cabinet can be transferred to a residents bedroom, lounge room or quiet area and set up. The variety of equipment of sensory equipment allows the staff member to either relieve an agitated resident or provide stimulation to a resident with severe dementia. We have found using the sensory cabinet has assisted to calm agitation in some residents making them more manageable, especially in the afternoon. The lights provide a focal stimuli of interest for residents with severe dementia. This was the first item we fund raised for when we came to our new home and as we progress we will fundraise to purchase more sensory equipment to be added to this cabinet. We do have a number of sensory items permanently around the Dementia Secure Unit such as balls, fish, waterfalls, and mobiles.

21. Hydrotherapy The ability to give a resident a spa bath has a multitude of benefits including relaxation, behaviour management as well as reducing muscle tension and pain relief. Visual and sensory stimulus is provided through the decorative effects on the bathroom wall, the bubbles in the bath and aromatherapy oils.The ability to give a resident a spa bath has a multitude of benefits including relaxation, behaviour management as well as reducing muscle tension and pain relief. Visual and sensory stimulus is provided through the decorative effects on the bathroom wall, the bubbles in the bath and aromatherapy oils.

22. Hydrotherapy The spa bath is utilized thought the day using aromatherapy oils or bubble bath to assist residents relax or when they are experiencing behavioral issues. Through fundraising the bathroom wall has been decorated in soothing stickers of sea creature such as dolphins, fish and turtles.The spa bath is utilized thought the day using aromatherapy oils or bubble bath to assist residents relax or when they are experiencing behavioral issues. Through fundraising the bathroom wall has been decorated in soothing stickers of sea creature such as dolphins, fish and turtles.

23. Needs Analysis, Partnerships and collaboration. Develop a robust network of support Expand staffs knowledge Research & Resources Demand for beds increasing ACMHT � Aged Care Mental Health Team Helping other services The Dementia Secure Unit opened with just 18 beds but due to demand increased the size to 25. To support our residents we have endeavored to increase our staffs knowledge and develop a robust network of support. This has been done by working closely with our local Aged Care Mental Health workers, local Transitional Basis Unit, Psychiatrists, Geriatricians, Psychologists, social workers and ACAT. We are visited on nearly a daily basis due to the care needs of the residents currently living in our Secure Unit. Many of them having a dual diagnosis of a mental health illness and a dementia. Their expert advice guides our behaviour management and daily programs. When the original designing of the building was occurring key staff were taken to other sites to research best practices and find out what did and did not work. One of the main items that was a great success was the use of spa baths and thus two were included in the new building. Our efforts to ensure the residents environment is therapeutic recognized when we were involved in offering some advice to the local hospital to assist set up a specific room to manage resident with delirium and/or dementia The Dementia Secure Unit opened with just 18 beds but due to demand increased the size to 25. To support our residents we have endeavored to increase our staffs knowledge and develop a robust network of support. This has been done by working closely with our local Aged Care Mental Health workers, local Transitional Basis Unit, Psychiatrists, Geriatricians, Psychologists, social workers and ACAT. We are visited on nearly a daily basis due to the care needs of the residents currently living in our Secure Unit. Many of them having a dual diagnosis of a mental health illness and a dementia. Their expert advice guides our behaviour management and daily programs. When the original designing of the building was occurring key staff were taken to other sites to research best practices and find out what did and did not work. One of the main items that was a great success was the use of spa baths and thus two were included in the new building. Our efforts to ensure the residents environment is therapeutic recognized when we were involved in offering some advice to the local hospital to assist set up a specific room to manage resident with delirium and/or dementia

24. Sustainability At Warrigal Care Goulburn, our strategy to improve outcomes for resident with dementia or mental illness works very well. Staff enjoy utilizing the various strategies and can see the positive effects on the residents in the special care unit. This fact alone will ensure the continuation and sustainability of the project at Goulburn. The program is part of the way we do things in our special unit and has become part of the culture of our home. The strong connection with Mental Health Team, specialist nurse and doctors, who visit each week and offer support and advice, will ensure our program is ongoing.At Warrigal Care Goulburn, our strategy to improve outcomes for resident with dementia or mental illness works very well. Staff enjoy utilizing the various strategies and can see the positive effects on the residents in the special care unit. This fact alone will ensure the continuation and sustainability of the project at Goulburn. The program is part of the way we do things in our special unit and has become part of the culture of our home. The strong connection with Mental Health Team, specialist nurse and doctors, who visit each week and offer support and advice, will ensure our program is ongoing.

25. Sustainability All elements of our program are included with our admission and care planning process will continue into the future. Warrigal Care has several ways of ensuring sustainability of successful projects as follows Warrigal Care has five specialty Care Practice Committees, one of which focuses on strategies to support residents with dementia and challenging behaviors. The committee consist of member from our 8 aged care homes. These project was tabled at the Dementia and Challenging behaviour committee where it was shared will all participants. The fact sheet will be handed out at the next meeting. The Quality co-coordinator, who�s role it is to support our CPC�s is responsible to disseminate information on new quality activities, such as the behaviour management project, and encourage implantation of the same. The fact sheet developed for this project has been set up in a resource folder on the common drives so it can be shared with all homes and to ensure the sustainability of the program.All elements of our program are included with our admission and care planning process will continue into the future. Warrigal Care has several ways of ensuring sustainability of successful projects as follows Warrigal Care has five specialty Care Practice Committees, one of which focuses on strategies to support residents with dementia and challenging behaviors. The committee consist of member from our 8 aged care homes. These project was tabled at the Dementia and Challenging behaviour committee where it was shared will all participants. The fact sheet will be handed out at the next meeting. The Quality co-coordinator, who�s role it is to support our CPC�s is responsible to disseminate information on new quality activities, such as the behaviour management project, and encourage implantation of the same. The fact sheet developed for this project has been set up in a resource folder on the common drives so it can be shared with all homes and to ensure the sustainability of the program.

26. Is this the end of Improvements? NO !!!! Short term goals 1. Remove walls in our dementia unit to provide an increase in the living and dining areas 2. Implement a new roster and training system in preparation for expansion of the Dementia Unit 3. Applied for funding to purchase sensory equipment for current quiet room NO !!!! Short term goals 1. Remove walls in our dementia unit to provide an increase in the living and dining areas 2. Implement a new roster and training system in preparation for expansion of the Dementia Unit 3. Applied for funding to purchase sensory equipment for current quiet room NO !!!! Short term goals 1. Remove walls in our dementia unit to provide an increase in the living and dining areas 2. Implement a new roster and training system in preparation for expansion of the Dementia Unit 3. Applied for funding to purchase sensory equipment for current quiet room

27. Is this the end of improvement? Long Term goals � Increase Dementia Specific Unit to a 42 bed unit Provide a separate area for residents with behaviors of concern Include individualized living and dining rooms Provide education and training for staff and relatives Long Term goals � Increase Dementia Specific Unit to a 42 bed unit Provide a separate area for residents with behaviors of concern, smaller seating areas Include individualized living and dining rooms, multiple areas Provide education and training for staff and relatives Long Term goals � Increase Dementia Specific Unit to a 42 bed unit Provide a separate area for residents with behaviors of concern, smaller seating areas Include individualized living and dining rooms, multiple areas Provide education and training for staff and relatives

28. Questions and Thanks I would like to thank you all for listening today and we are happy to answer any questions that you may have. The picture above is one of our resident choir doing a dress rehearsal� this incorporated our residents who live in our Special Care Unit. With tolerance, love and understanding all our residents have a good quality of life and enjoyment.I would like to thank you all for listening today and we are happy to answer any questions that you may have. The picture above is one of our resident choir doing a dress rehearsal� this incorporated our residents who live in our Special Care Unit. With tolerance, love and understanding all our residents have a good quality of life and enjoyment.