Professor Dawn Brooker
Association for Dementia Studies
Presentation HEE Conference
The Association
for Dementia Studies
• Established 2009 as a university research centre
aligned with the National Dementia Strategy
• Multi-professional group of educationalists,
researchers and practitioners
• Cutting edge contribution to developing evidencebased practical ways of working with people living
with dementia, their families, friends and carers
that enable them to live well.
• Using this evidence we deliver education
programmes that empower people to provide
skilled, competent and compassionate care
Association for Dementia Studies
Director - Professor Dawn Brooker
Early interventions and Primary
Care
• Lead on Timely Diagnosis
Recommendations for EU ALCOVE
programme
• Development of Primary Care Dementia
competencies
• In-depth evaluation of the Worcestershire
Early Intervention Dementia Service & the
Dementia Adviser Service
• Specialist Education Modules in Early
interventions & primary care
• PhD research on Early Cognitive Change
Living well with dementia
ADS is a multi-professional group of
educationalists, researchers and practitioners
with many years of experience in the field of
person-centred dementia care and support.
The perspective of people living with dementia,
their families and their carers are intrinsic to
the work of ADS at all stages.
We make a cutting edge contribution to
developing evidence-based practical ways of
working with people living with dementia, their
families, friends and carers that enable them to
live well.
We do this primarily through research,
•Supporting people from all communities to live
education,
scholarship and policy advice. We
well with dementia
draw on and contribute to the international
•ESRC Seminar Series: Age, Race and Ethnicity
evidence base for person-centred dementia
•Connecting Communities Programme
care. Using this evidence we deliver education
evaluation
programmes that empower people to provide
•Innovative interventions to support people
skilled, competent and compassionate care
and their families, including new service model
for RSAS.
•Development and evaluation of MEETING DEM
Supporting choice and control at home
in UK, Italy & Poland JPND/ESRC funded
and in supported housing
• Research network and conferences in
creative therapies and dementia.
• The Enriched Opportunities Programme
• Understanding Dementia and sight loss:
• The ASSET project – adult social care in housing with
care schemes
• PhDs on direct payments in rural areas and on
home-based support in Israel
Excellence in person-centred care in
care homes
• PIECE-dem observational framework for
advanced dementia
• CHOICE – organisational culture and care
experiences in care homes
• ‘Care Fit for VIPS’ free web-based toolkit for
care homes www.carefitforvips.co.uk
• Specialist education modules in care home
leadership and dementia specialists
• FITS – Focussed Interventions in Training and
Support to reduce anti-psychotic prescribing;
funded by the Alzheimer’s Society
Dementia-friendly hospital care
• Development and evaluation of a suite of
interventions including a care bundle approach
with the Royal Wolverhampton Hospitals Trust
• Steering group membership of the National
Audit of Dementia
• Partners in NIHR Delirium Programme and PIE
observation tool
• Dementia Leadership and Specialist education
modules in acute and community hospital
dementia care.
• End of life care evaluation
For more information please contact: dementia@worc.ac.uk, call us on 01905 542531 or visit our website at
http://www.worcester.ac.uk/discover/association-for-dementia-studies.html
Association for Dementia Studies
Core Team June 2013
• The experience
of people living
with dementia
and their
families inform
the work of ADS
at all stages.
University of Worcester Association for
Dementia Studies
Bespoke courses – early adopters?
Type of Commissioning
Organisation
Number of
organisations (approx
days) 2011-14
Types of providers covered
Local authorities, city
councils, county councils
8
(550)
Care homes, dom care, extra
care housing, mental health,
acute hospitals
NHS Trusts
10
(70)
Acute hospitals, community
hospitals, community health
teams, early intervention
team
Care Providers (charitable,
not for profit)
5
(140)
Care homes, extra care & dom
care
Others: FITS programme
30 (100 plus 90)
100 care homes to reduce
anti-psychotic prescribing
Number of participants
Dates
Specialist Managers
Acute
Primary
care
Other
Total
01/09/12
–
31/08/13
307
193
58
41
48
647
01/09/13
–
10/01/14
234
85
17
-
15
351
Total
541
278
75
41
63
998
This shows the number of participants completing a pre-course questionnaire
© The Association for Dementia Studies
Job roles (3)
•
1187 responses from 998 participants.
Job roles overall
© The Association for Dementia Studies
Administrator
Care Home Manager
Care worker
Catering
Commissioner
Counsellor
Deputy Manager
Educator/trainer
Family carer
General Nurse
General Physician
General Practitioner
Health Care Assistant
Health Visitor
Manager
Mental Health Nurse
Occupational Therapist
Patient
Personal Assistant
Physiotherapist
Psychiatrist
Social Worker
Speech & language therapist
Student
Support services
Other
Time spent working with people with
dementia
Time spent working with people with dementia
100%
90%
80%
70%
More than 20 years
60%
10-19 years
50%
5-9 years
1-4 years
40%
Less than 1 year
30%
Never
20%
10%
0%
01/09/12 - 31/08/13
01/09/13 - 10/01/14
Overall
© The Association for Dementia Studies
Age information
Age of participants
100%
90%
80%
70%
65 and over
60%
50-64
50%
31-49
40%
20-30
30%
Less than 20
20%
10%
0%
01/09/12 - 31/08/13
01/09/13 - 10/01/14
Overall
© The Association for Dementia Studies
The Challenge for existing workforce
•
•
•
•
Overwhelmed
Lacking knowledge about dementia
Lacking skills to help
The way services are set up work against people
with dementia and their families getting the best
help
• Delivering brief sessions that raise awareness of
short-fall may actually make the situation worse
University of Worcester
Association for Dementia Studies
Leadership
Historically education in dementia care has:
• Focused on training those at the ‘coal face’ of
health and social care.
• Inspired staff to make changes only to be faced
with barriers when returning to the work place
One of those barriers is that the ‘leaders’ of the
service do not recognise their crucial role in culture
change.
University of Worcester
Association for Dementia Studies
Tiered Educational model
• The Association for Dementia Studies
education programme is based on research
that has considered ways of increasing the
likelihood of services improving, and more
importantly maintaining this
improvement.
University of Worcester
Association for Dementia Studies
ADS TIERED MODEL OF DEMENTIA Leadership
Start the
education
programme with
the Managers
Managers choose
specialists to act
Dementia Care
as a co-partners in
Services
leading and
(Leadership for managers)
embedding
change
Managing
Dementia Specialist Practitioner
(Leadership at the individual service
user level)
FUNDAMENTALS IN DEMENTIA CARE (ALL STAFF)
Managing Dementia Care:
leading the team (4-8 days)
• Senior staff / managers
• Provide clear vision, using VIPS
framework.
• Ensure know what “good” looks like.
• Identifying priorities for change,
who, what, when, how and identify
barriers
• Person centred management style
• Increased confidence and
competence to lead others and find
solutions.
• Working across service boundaries.
University of Worcester
Association for Dementia Studies
Leading by example
Dementia Specialists (5-10 days)
• Managers cannot make the change alone. This is
where the second part of the model comes into
action– the specialists.
• These are motivated staff members who are
supported through the education programme to
be specialists in their area in working directly
with people with dementia and families.
• Chosen by managers to be part of the change in
practice.
University of Worcester
Association for Dementia Studies
Specialist’s role
• Role model person centred care.
• Expert up-to date knowledge & tool-kit in
their specific area
• Offer support and guidance to other staff.
• Develop other staff through a coaching model.
• Act as a link between leaders and other staff
members.
University of Worcester
Association for Dementia Studies
4 key elements of learning
1
Interactive
Workshops;
hearts & minds
3
2
Self Learning / Inquiry
relating to specific work
setting
4
Putting into Practice –
Trying out new ways of
working
completed project
(university module 20
credits)
University of Worcester
Association for Dementia Studies
• The lack of knowledge and confidence, even
at senior levels, is serious
• There is an active dynamic between attitude
change and knowledge acquisition
• Aim to support staff to operate with clarity,
creativity, and resilience and rather than with
insecurity and doubt.
• This is an experienced and intelligent workforce
• Need to equip staff to make good decisions
not to think there is an instruction to follow
• Recognise changing the culture of care is
about people’s hearts and minds. This is a
people service; tools need to be well cared for,
staff need to feel valued for a job well done.
• Research consistently points to the high
failure rate of change initiatives - not because
of poor strategies or funding but rather a
result of poor attitudes and behaviours.
• The combination of empowering leadership at
management and specialist level is powerful
• Once these are unlocked the potential for
change is great
Reflection on whole system working
• By having leaders who can remove the grit that is
blocking the system we can support sustainable
change within and across organisations.
• Dementia is complex – all staff need to know who
to call on when they are out of their depth
• Competence needed across the whole system –
eg If GPs or mental health services are not
competent/ accessible even the best skilled care
services struggle.
Care Fit for VIPS website
www.carefitforvips.co.uk
Dementia Pledge
Thank you for listening!
Professor Dawn Brooker
University of Worcester
Association for Dementia Studies
d.brooker@worc.ac.uk
http://www.worc.ac.uk/discover/association-fordementia-studies.html
Photographs of people living with dementia taking part in
ExtraCare Charitable Trust Enriched Opportunities Programme