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
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
•Seminars
•Reading
 Information Search
•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
Do’s & Dont’s of
Dealing With
Dementia
Thanks to Bendigo Health for
use of their “Communication
with Dementia Clients”
Pamphlet.
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?
NO
- 1
NO RESPONSE - 2
UNSURE
-
3
YES
-
12
This Project Is….
• Grass roots
• Sustainable
• Highly successful
• Replicable
• Everyone benefits
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