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Projects
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Projects
Aim to enable care home staff to achieve excellence in delivering end of life care for people with dementia; support them to live and die in their normal place of care; prevent avoidable hospital admissions at end of life; enhance relative/ carer experience of EOL care.
6 nursing homes; 2 dementia EOL champions in each.
One home experienced 36% reduction in acute admissions during project.
Improved confidence and staff knowledge in all homes and increase in advanced care planning including DNA-CPR.
Fear, anxiety, depression, confusion and depersonalisation are common in older people admitted to acute hospitals, and worse for cognitively impaired. Staffing ratios and working practice makes engagement with these patients difficult. Sensory stimulation can help with these feelings and facilitate healing. Art Care delivers structured programme of arts sessions within Salisbury Hospital. Designed for older people with confusion and dementia.
Positive impact, and now staff actively seek appropriate patients to engage with activities.
Creation of academic post to evaluate all data collected and impact on health outcomes.
Explore if learning using interactive theatre approach produces a transformational learning experience for participants. Audience watches a topic of relevance with unresolved challenges. Play is stopped and replayed through a skilled facilitator and audience can stop the play and demonstrate alternative solutions by replacing an actor. Used in Faculty of Health Sciences teaching 250 student nurses.
Facilitates exploration, reflection and understanding of range of emotions experienced in dementia care. Allows participants to gain exposure to negative emotions experienced in clinical practice in safer environment.
Explore if learning using interactive theatre approach produces a transformational learning experience for participants. Audience watches a topic of relevance with unresolved challenges. Play is stopped and replayed through a skilled facilitator and audience can stop the play and demonstrate alternative solutions by replacing an actor. Used in Faculty of Health Sciences teaching 250 student nurses.
Facilitates exploration, reflection and understanding of range of emotions experienced in dementia care. Allows participants to gain exposure to negative emotions experienced in clinical practice in safer environment.
Explore if learning using interactive theatre approach produces a transformational learning experience for participants. Audience watches a topic of relevance with unresolved challenges. Play is stopped and replayed through a skilled facilitator and audience can stop the play and demonstrate alternative solutions by replacing an actor. Used in Faculty of Health Sciences teaching 250 student nurses.
Facilitates exploration, reflection and understanding of range of emotions experienced in dementia care. Allows participants to gain exposure to negative emotions experienced in clinical practice in safer environment.
Explore if learning using interactive theatre approach produces a transformational learning experience for participants. Audience watches a topic of relevance with unresolved challenges. Play is stopped and replayed through a skilled facilitator and audience can stop the play and demonstrate alternative solutions by replacing an actor. Used in Faculty of Health Sciences teaching 250 student nurses.
Facilitates exploration, reflection and understanding of range of emotions experienced in dementia care. Allows participants to gain exposure to negative emotions experienced in clinical practice in safer environment.
The aim of this project was to develop, test and implement a simulation based educational package on dementia. Following a literature review of simulation in dementia education and analysis of baseline data, a simulation package incorporating three workshops was developed in collaboration with a number of stakeholders from health and social care. The three workshops are: Dementia Diagnostic Assessment, Behaviours that Challenge and Person Centred Care.
Evaluation data showed that participants' overall experience of the training was positive and that knowledge scores were significantly higher post simulation training.
This project is now being rolled out across the 13 LETBs with money awarded from the 2014/15 dementia project budget through the HEE Dementia Priority Programme Board.
This is an observational study assessing the association between cognitive decline and the degree of stress in 134 amnestic Mild Cognitive Impairment (aMCI) subjects and 69 control subjects
This study will lead to a better understanding of the potential for hormonal modulation of the inflammatory pathways, establish the interaction between stress and other modulators of the immune response, and elucidate how stress may influence the cognitive trajectory of an aMCI population.
Impaired colour contrast sensitivity in Alzheimer’s disease; malnutrition common in elderly inpatients; improved nutrition facilitates better health. Care home data suggest increased food intake for cognitively impaired people when food served on coloured plates. Not assessed in hospital inpatients. Assessed impact of blue crockery on food intake; subgroup analysis in those with cognitive impairment.
Confused patients ate significantly less than others, but improvement across all patients with blue crockery was achieved, and also demonstrated in those with confusion.
Commissioned evaluation of Dementia Friendly GP initiative. 2 case study practices (Oakley, Ryde); sample of primary care practices to gauge dementia care already in place; interviews with GP, staff, service users.
Initiative to be evaluated across range of metrics including patient and carer experience, prescribing, referrals, teamwork & care planning.
The evaluation showed the following outcomes:
•Improvement in patient and carer experience
•Increase in diagnosis rates
•Staff attitudes to dementia are more positive
•Clinical consultations improved
PEACE is an anticipatory end of life care plan for those with dementia who no longer have capacity to make end of life decisions for themselves. Experienced nurses helped guide families to understand issues and options. Liaised with nursing home to ensure understanding of care plan and disseminated it to relevant organisations.
34 PEACE plans completed with aim to disseminate findings to GPs, CCG and local nursing homes. Aiming to redesign education programme and train more facilitators.
This is an observational longitudinal study examining whether basic demographic and clinical variables recorded during routine assessment of a patient with aMCI can be used to develop a risk tool that can give a simple stratification of risk of patients with this condition going on to develop dementia within the next 3 years.
Our primary objective is the development of a clinical tool that categorizes subjects into 3 groups (high; intermediate; low risk) of developing dementia (binary outcome yes/no) over a 3 year follow up period.
Commissioned evaluation of Dementia Friendly GP initiative. 2 case study practices (Oakley, Ryde); sample of primary care practices to gauge dementia care already in place; interviews with GP, staff, service users.
Initiative to be evaluated across range of metrics including patient and carer experience, prescribing, referrals, teamwork & care planning.
The evaluation showed the following outcomes:
•Improvement in patient and carer experience
•Increase in diagnosis rates
•Staff attitudes to dementia are more positive
•Clinical consultations improved
Research into low diagnosis rates in Wiltshire and use of Memory Awareness volunteers to give public talks and one-to-one advice at GP surgeries and other community locations.
Survey of 3 distinct groups: service users/ carers (n=146); older adults with potential for memory impairment (N=84); GPs and other health and social care professionals (n=102)
Waiting times a significant barrier to GPs. Service users delaying average of 16 months; 50% thought normal symptoms, others felt nothing could be done. CCG made dementia priority; waiting times 4 weeks (simple), 13 weeks (complex). Diagnosis rates increased 33-46% during project.
The Dementia Adviser (DA) Service supports people with dementia, and their carers, to live well in the community through the provision of information, advice and sign-posting that is individually tailored, right and relevant throughout their dementia journey. DAs work in collaboration with health and social care services, and community organisations and act as the single point of contact.
Improved:
• Knowledge of, and access to available support services
• Support and information to enable them to make choices about their life. and enable them to cope with challenges of living with dementia.
• Living in the community and feeling part of it.
Attitudes of GPs were assessed in Portsmouth (n=76), Dorset (178), and compared to NAO data (n=1001). More than 80% felt that more could be done to improve QoL in dementia. GPs in Wessex felt 66-71% of families would prefer to be told about dementia (vs. NAO 36%). Only 16-26% felt managing dementia was frustrating (NA: 74%), but fewer than 50% felt that there were satisfactory services anywhere.
Results guided further local educational events and enabled service management.
Attitudes of GPs were assessed in Portsmouth (n=76), Dorset (178), and compared to NAO data (n=1001). More than 80% felt that more could be done to improve QoL in dementia. GPs in Wessex felt 66-71% of families would prefer to be told about dementia (vs. NAO 36%). Only 16-26% felt managing dementia was frustrating (NA: 74%), but fewer than 50% felt that there were satisfactory services anywhere.
Results guided further local educational events and enabled service management.
This project aims to achieve excellence in end of life care for people with dementia living in nursing homes.
This will be achieved through Specialist Palliative Care Clinical Nurse Specialist mentoring of care home staff who will work in a ‘hands on’ capacity in nursing homes to model good practice and mentor staff.
A strategy document to support better care and better outcomes for people with dementia.
1. Ensuring dementia awareness in workforce
2. Implement HEE education programme
3. Support delivery in 330 general practices
4. Support workforce in 9 acute care providers
5. Support community care workforce
6. Work with Local Authorities and 3rd sector
7. Ensure quality of provision of education
8. Champion user and carer led evaluation
9. Increase HE-W presence and influence in dementia community
Document available for download from link below.
The aim of this project was to develop, test and implement a simulation based educational package on dementia. Following a literature review of simulation in dementia education and analysis of baseline data, a simulation package incorporating three workshops was developed in collaboration with a number of stakeholders from health and social care. The three workshops are: Dementia Diagnostic Assessment, Behaviours that Challenge and Person Centred Care.
Evaluation data showed that participants' overall experience of the training was positive and that knowledge scores were significantly higher post simulation training.
This project is now being rolled out across the 13 LETBs with money awarded from the 2014/15 dementia project budget through the HEE Dementia Priority Programme Board.
Diagnosis gap of over 22,000 people forecast in Wessex by 2014/15. Difficult to ascertain consistency and quality of dementia diagnosis across region.
Telephone and online surveys conducted with practice managers, GPs and patient focus groups to gather data on pathway, level of support provided to patients and carers, and identify barriers to diagnosis across in primary care.
Surveys in progress; formal outcomes pending. Will develop toolkit of practice to be used in General Practice. Will facilitate common standards for screening and clinical assessment. Significant collaboration across agencies in Wessex is involved.
This project aims to stop the cycle of readmission in crisis by improving end of life care planning starting when a person with dementia is first admitted to a Dorset hospital in an emergency.
Opportunity for patients and relatives to: discuss the future; record their priorities for future care; avoid inappropriate admissions to hospital; improve communication between agencies ; Improve EOL care and a dignified death.
People with dementia get by with a little help from their friends. And anybody can become a Dementia Friend. It’s just about understanding a bit more about dementia and the small things you can do to help people with the condition.
People with dementia want to carry on going about their daily lives and feel included in their local community, but they sometimes need a helping hand to do so. Dementia Friends learn a little bit about what it's like to live with dementia and turn that understanding into action.
Every action counts.
To become a friend you just need to watch our short video or join an information session in your area.
Dementia Friends session available today following the Dementia Collaboration Event.
Public Health England, Alzheimer's Society
Sue Dewhirst
Contact Email: Sue.Dewhirst@Public Health England.gov.uk
Dorset Memory Gateway Service incorporates: Memory Support and Advisory Service, Memory Assessment Service, GP involvement. Aims to provide a simplified and more efficient service for people with memory loss or dementia. Pilot sites in 5 areas tested effectiveness of partnership.
Need identified to expand model Dorset-wide to ensure early identification for wider group. Increase planned in number of support and social groups running. Services will include one-to-one support, memory cafes, training for carers, and support for DFC creation.
Dorset Memory Gateway Service incorporates: Memory Support and Advisory Service, Memory Assessment Service, GP involvement. Aims to provide a simplified and more efficient service for people with memory loss or dementia. Pilot sites in 5 areas tested effectiveness of partnership.
Need identified to expand model Dorset-wide to ensure early identification for wider group. Increase planned in number of support and social groups running. Services will include one-to-one support, memory cafes, training for carers, and support for DFC creation.
A strategy document to support better care and better outcomes for people with dementia.
1. Ensuring dementia awareness in workforce
2. Implement HEE education programme
3. Support delivery in 330 general practices
4. Support workforce in 9 acute care providers
5. Support community care workforce
6. Work with Local Authorities and 3rd sector
7. Ensure quality of provision of education
8. Champion user and carer led evaluation
9. Increase HE-W presence and influence in dementia community
Document available for download from link below.
IOW cafe started in April 2009. Meeting place, without need for appointment, to gain access to information about dementia topics. Monthly sessions, talks, interview, support workers, leaflets in all 6 cafes on the island.
Now receive 200 visits per month. Wide range of people, not just people with dementia and carers. Education programmes supported other professionals, e.g.. Fire and police. Increase awareness, provide post-diagnostic support; education.
Work on delivery of West Hampshire Dementia CQUINS. Identification of how local commissioning can lead to improvements for local patients and carers. Engagement with all Hampshire GP practices to reconcile SHFT and GP data. Raising awareness and conducting interviews of patients and carers to understand the patient perspective.
Improved understanding some of the differences around recording data and communicating diagnosis
Development of a mapping tool for ICD10 and GP read codes due to be released in Sept/October.
A directory of health, social and community information/support for people with long term neurological conditions and carers. Leaflet to give basic information and direct people to the booklet
People and professionals have available quality information to support them.
Diagnosis gap of over 22,000 people forecast in Wessex by 2014/15. Difficult to ascertain consistency and quality of dementia diagnosis across region.
Telephone and online surveys conducted with practice managers, GPs and patient focus groups to gather data on pathway, level of support provided to patients and carers, and identify barriers to diagnosis across in primary care.
Surveys in progress; formal outcomes pending. Will develop toolkit of practice to be used in General Practice. Will facilitate common standards for screening and clinical assessment. Significant collaboration across agencies in Wessex is involved.
Dementia clinicians have multiple tests available which have been proven to aid diagnosis (SPECT, PET, MRI, CT, Cerebrospinal fluid analysis), but there is little guidance on how to best use these to optimise clinical diagnostic pathways.
The study will identify clinician knowledge and attitudes to diagnostic tests. We will evaluate how each investigation alters clinician diagnostic certainty, and the cost-effectiveness of introducing these investigations.
In the UK, at any point in time, 25% of all hospital inpatients have dementia. If Dementia was a country, its GDP would be 18th in the world.
Services are stretched with dealing with demand, and this project will involve developing mathematical simulation models to address different aspects of dementia management ranging from individual patient care and models of disease progression, through to system-level care delivery and capacity issues.
The key aim is to make these models useful and usable in practice, so that NHS and Local Authorities commissioners can identify new ways in which they can more effectively manage the anticipated growth in demand.
Jointly funded by Dorset CCG and the National Council of Palliative Care (NCPC) to deliver training to health and social care staff, but also the third and independent sectors, most importantly carers too. As part of this programme 'Train the Trainer (TET) will be completed. Carers will attend 2 sessions - 1 basic training and 1 TET so they can continue to deliver this programme with a professional facilitator.
Individuals who attend the training will feel able to discuss EoLC topic in early diagnosis. To improve EoLC. Planning for patients (people) and their carer. Evaluation is being completed by Bournemouth University (BUDI)
Difficult for Fire Service to identify people with dementia; major factor in increasing someone’s risk of injury or death from fire in the home. OPMH not assessing fire safety before discharge
4 questions:
1. Is there an ignition source at home
2. What means of detecting a fire, raising the alarm and summoning help in place?
3. Is there a clear route of escape?
4. Is the service user mobile?
If the questions highlight a fire risk we can simply refer to the fire service for a free home safety visit.
Online referral is easy and takes no more than five minutes!
www.hantsfire.gov.uk/yoursafety/athome
All patients aged 65 and over are assessed on admission for memory problems.
If they fail 10 point AMT, they are referred to memory service who will see them the same day or following day.
The patient or advocate is asked if they wish to participate in the Butterfly Scheme, offered information about the scheme and. if they opt in a “This is Me” leaflet is given.
A directory of health, social and community information/support for people with long term neurological conditions and carers. Leaflet to give basic information and direct people to the booklet
People and professionals have available quality information to support them.
The Dementia Adviser (DA) Service supports people with dementia, and their carers, to live well in the community through the provision of information, advice and sign-posting that is individually tailored, right and relevant throughout their dementia journey. DAs work in collaboration with health and social care services, and community organisations and act as the single point of contact.
Improved:
• Knowledge of, and access to available support services
• Support and information to enable them to make choices about their life. and enable them to cope with challenges of living with dementia.
• Living in the community and feeling part of it.
The Dementia Adviser (DA) Service supports people with dementia, and their carers, to live well in the community through the provision of information, advice and sign-posting that is individually tailored, right and relevant throughout their dementia journey. DAs work in collaboration with health and social care services, and community organisations and act as the single point of contact.
Improved:
• Knowledge of, and access to available support services
• Support and information to enable them to make choices about their life. and enable them to cope with challenges of living with dementia.
• Living in the community and feeling part of it.
Older peoples services have put in a team of CQUIN nurses led by the Dementia Nurse Specialist at Poole General Hospital. The team screen all inpatients over the age of 65, who are appropriate for screening and pass relevant information on to the GPs.
The team are consistently meeting government targets for the screening process.
A research study investigating the burden of multimorbidity in people with dementia using Hampshire Health Record data to identify:
1. the prevalence of diagnosed dementia and how it varies with demographic factors
2. The multimorbidities that people with dementia have?
3. How multimorbidities in dementia vary across demographic factors
4. the primary reason for admission and relationship to multimorbidity?
The findings may subsequently be used to inform qualitative research into how people with dementia access services for their conditions.
The Borough of Poole to become a dementia friendly local authority and Poole to have a dementia friendly high street
Raise awareness of dementia to staff, businesses and customer facing staff. Improvement in customer service.
The Borough of Poole to become a dementia friendly local authority and Poole to have a dementia friendly high street
Raise awareness of dementia to staff, businesses and customer facing staff. Improvement in customer service.
Reablement project established to test variety of service provisions to reduce admission to emergency and acute care at QAH, Portsmouth. 3 practitioners to support individuals during admission referred as soon as possible (ED, MAU). Provide practical support in hospital for people with dementia, and assistance with care planning. Support for 3-4 weeks post discharge to ensure continuity of care. Variety of interventions described.
Reduction in LOS (Max: 91 to 35 days; average 42 to 14 days) and readmission (30 days: 8 to 4%; 90 days 5 to 0%). Significant proportion of people return to own homes (61%). Improvement on Wellbeing scores; increase in “This is Me” care planning document completion.
A strategy document to support better care and better outcomes for people with dementia.
1. Ensuring dementia awareness in workforce
2. Implement HEE education programme
3. Support delivery in 330 general practices
4. Support workforce in 9 acute care providers
5. Support community care workforce
6. Work with Local Authorities and 3rd sector
7. Ensure quality of provision of education
8. Champion user and carer led evaluation
9. Increase HE-W presence and influence in dementia community
Document available for download from link below.
Provision of Hampshire wide, except unitary authorities of Portsmouth and Southampton, support, education, signposting and advice for carers from pre-diagnosis through to post bereavement. Service includes emotional support, advocacy, benefits advice, signposting on legal matters, opportunities for respite, free counselling and a training course.
Better education and support for carers reduces reliance on secondary services ad enables carers to continue supported in their role for longer.
Princess Royal Trust for Carers in Hampshire
Contact Email: info@carercentre.com
Provision of Hampshire wide, except unitary authorities of Portsmouth and Southampton, support, education, signposting and advice for carers from pre-diagnosis through to post bereavement. Service includes emotional support, advocacy, benefits advice, signposting on legal matters, opportunities for respite, free counselling and a training course.
Better education and support for carers reduces reliance on secondary services ad enables carers to continue supported in their role for longer.
Princess Royal Trust for Carers in Hampshire
Contact Email: info@carercentre.com
Provision of Hampshire wide, except unitary authorities of Portsmouth and Southampton, support, education, signposting and advice for carers from pre-diagnosis through to post bereavement. Service includes emotional support, advocacy, benefits advice, signposting on legal matters, opportunities for respite, free counselling and a training course.
Better education and support for carers reduces reliance on secondary services ad enables carers to continue supported in their role for longer.
Princess Royal Trust for Carers in Hampshire
Contact Email: info@carercentre.com
Admiral Nurse initiative to improve care of people with dementia within an acute hospital setting as well as care for the carers. Development of Dragonfly Approach with symbol above bed to alert staff about potential need to adapt communication strategies. Dementia awareness leaflet available and 600 frontline staff trained on dementia awareness programme.
Significant improvement in carer satisfaction (27.5% to 53.2% in 6 months). UHS exceeded national CQUIN target of 95% screening through IT initiatives and staff training. Ward refurbishment supported, and "This is me" care plans encouraged for all people with dementia.
Once weekly 'sweep' of adult wards throughout the hospital to identify inpatients with a known or suspected diagnosis of dementia to promote sharing of information between mental health and acute medical services and link patients into memory assessment services to gain support or diagnosis if not already done.
Increased referrals into memory gateway service. Point of contact with services. Identifying patients who may have dementia earlier.
A strategy document to support better care and better outcomes for people with dementia.
1. Ensuring dementia awareness in workforce
2. Implement HEE education programme
3. Support delivery in 330 general practices
4. Support workforce in 9 acute care providers
5. Support community care workforce
6. Work with Local Authorities and 3rd sector
7. Ensure quality of provision of education
8. Champion user and carer led evaluation
9. Increase HE-W presence and influence in dementia community
Document available for download from link below.
A directory of health, social and community information/support for people with long term neurological conditions and carers. Leaflet to give basic information and direct people to the booklet
People and professionals have available quality information to support them.
Free weekly art, music, drama and dance sessions for people experiencing mild memory loss and early stage dementia, and their companions. They are led by arts facilitators trained to understand the challenges people face as symptoms of the various types of dementia set in, their communication needs, existing skills and how best to access them.
to create and report on a regional model to integrate the use of arts into the Well Pathway for Dementia, so that it becomes natural for GPs and diagnosticians, both before and after diagnosis to recommend patients to arts (& exercise etc.) activity
to show how patients can be directed to arts activity to help override symptoms etc.
Restructuring of local dementia services led to 54% reduction in organic assessment beds in use (71 beds to 33 beds) and setting up of Intermediate Care Service for Dementia (ICSD) in April 2013.
ICSD is an MDT consisting of 12 MH nurses, 16 health care support workers, an OT and input from 3 consultant psychiatrists. During 10 months, 204 referrals. Only 19% required inpatient admission due to escalated risk.
Positive impact in keeping people with dementia in crisis out of hospital - many in their own care environment. High degree of service satisfaction. Further work emphasised on using appropriate outcome measures.
Providing advice, information and signposting from the point of diagnosis throughout the journey of the illness. All information and support is tailored to a persons individual needs.
Informed Choice. Point of support and information throughout diagnosis. Tailored information to live the life they want. Help to identify information needs.
Andover Mind & Alzheimer's Society
Debra Ramchurn & Amber Reed
Once weekly 'sweep' of adult wards throughout the hospital to identify inpatients with a known or suspected diagnosis of dementia to promote sharing of information between mental health and acute medical services and link patients into memory assessment services to gain support or diagnosis if not already done.
Increased referrals into memory gateway service. Point of contact with services. Identifying patients who may have dementia earlier.
Wiltshire CCG have run a pilot scheme based around Salisbury where all GP practices were offered training in dementia diagnosis and prescribing Donepezil, supported by local mental health teams. The scheme focusses on non-complicated dementia in people aged 75+ and has now been rolled out across Wiltshire.
Nearly all practices are engaged. Reduced waiting times at memory clinics.
Providing advice, information and signposting from the point of diagnosis throughout the journey of the illness. All information and support is tailored to a persons individual needs.
Informed Choice. Point of support and information throughout diagnosis. Tailored information to live the life they want. Help to identify information needs.
Andover Mind & Alzheimer's Society
Debra Ramchurn & Amber Reed
This is work in progress with the main elements being:
To train key members of staff as Dementia Champions - Dec 2014
To promote a train the trainer approach
•To concentrate on non-clinical members of staff first (porters/medical secretaries/housekeepers etc.)
Improved patient/carer experience within the hospital. Staff feel valued and have improved knowledge. Aim to improve communities as a result of this education.
Music improves quality of life and promotes social interaction for those with dementia; sustained musical memories demonstrated despite cognitive impairments in other areas.
10 week intervention; invited to use instruments and sing to create integrated musical ensemble, with public performance at end. Participants assessed using the QoL-AD and interviews. Audience completed a short questionnaire about perceptions and expectations.
Preliminary qualitative findings yielded positive results from participants and musicians. Public performance demonstrated a shift in perception based on written feedback.
This is work in progress with the main elements being:
To train key members of staff as Dementia Champions - Dec 2014
To promote a train the trainer approach
•To concentrate on non-clinical members of staff first (porters/medical secretaries/housekeepers etc.)
Improved patient/carer experience within the hospital. Staff feel valued and have improved knowledge. Aim to improve communities as a result of this education.
Free weekly art, music, drama and dance sessions for people experiencing mild memory loss and early stage dementia, and their companions. They are led by arts facilitators trained to understand the challenges people face as symptoms of the various types of dementia set in, their communication needs, existing skills and how best to access them.
The idea behind Reawakening is:
to create and report on a regional model to integrate the use of arts into the Well Pathway for Dementia, so that it becomes natural for GPs and diagnosticians, both before and after diagnosis to recommend patients to arts (& exercise etc.) activity
to show how patients can be directed to arts activity to help override symptoms etc.
A directory of health, social and community information/support for people with long term neurological conditions and carers. Leaflet to give basic information and direct people to the booklet
People and professionals have available quality information to support them.
Evaluation of 7 Dementia Friendly Communities (DFC) using questionnaires, interviews and focus groups.
Within each locality, an increase in dementia awareness raising activity was noted. Local champion given information to disseminate to others was a helpful mechanism to raise awareness. Difficult to ensure perspective of people with dementia and carers included.
Recommendation that guidance developed by Alzheimer's Society 10 areas of focus is followed.
Two memory advisory services evaluated in South of England. 10 staff and 20 service users interviewed. Comparison of memory cafe to provide stimulation with provision of home visits for tailored support including signposting.
Both models successful to some degree, but home visits were more able to identify and meet individual needs and thereby help people with dementia and their carers sustain good QoL.
Significant challenges in ensuring adequate hydration and nutrition in people with dementia, but no evidence based guidelines exist. Care staff are key, but require skills, knowledge and attitudes to support. Project has gathered information on nutrition-related care from wide range of providers.
Planned quantitative measures of nutritional status in 20 residents across 2 care homes will determine if nutritional needs are met.
Core themes identified were availability of food and drinks, tools and resources, environmental factors, participation in activities, consistency of care and provision of information. Nutritional and hydration needs and meal preferences need to be understood.
The research will represent an in-depth investigation into the experiences of younger onset dementia patients and caregivers, of how care and service provision can be improved, and of how research in this area can be enhanced.
Improved QoL instruments, resource use measurement and service mapping will identify outcome measures relevant to this group.
Partnership creating Dementia Friendly Communities in Hampshire.
1. Define a DFC
2. Identify existing conditions for people with dementia
3. Identify what people with dementia want
4. Set key objectives and evaluation for project
5. Establish operations
450 people consulted & 1305 dementia friends created.
Launch Dementia Action Alliance
Definition established for dementia friendly high streets
Mapping exercise of peer support groups in county completed
11 Dementia Ambassadors identified
The project will use modelling techniques to explore the potential role of telecare in supporting care delivery, enabling people with dementia to remain within their own homes for longer and out of long term institutional care. These techniques will contribute to the overall cost-benefit analysis of telecare, determining whether the intervention would be beneficial (and for whom) if it were rolled out on a larger scale.
This research will lead to the development of a discrete event simulation (DES) model which will be used to examine the facilitating or obstructive factors that influence telecare uptake and its success for people with dementia
Quality improvement project to map and evaluate patient and carer experiences of service provision to identify the types of services needed, when and where they are required in LTC management and how they respond to changes in clinical, neurological or psychiatric status.
Work will focus on the development of an integrated care pathway and care navigator role for those with Huntington's Disease and other complex dementias, and their families.
The introduction of the CNS role has facilitated follow up domiciliary care, including crisis intervention, enabling identification of areas for improvement in accessing service provision and a first-hand insight into negotiating service pathways for younger patients with neurodegenerative conditions.
A survey / questionnaire was carried out with individuals attending Age UK IOW Memory Groups
A Dementia Awareness Training Session has been delivered
- Presentations around the Island about what is a Dementia Friendly Community
- Intergenerational work in schools
- A series of events during Dementia Awareness Week
- Launch events
- Creating Safe Havens
A pilot study in which participants who had recently received a diagnosis of dementia were randomised to either a 10-week group intervention or a waiting-list control. Memory clinic staff with limited previous experience of group therapy were trained to lead a 10-week group therapy intervention called ‘Living Well with Dementia’, incorporating psychotherapy and psycho-educational elements.
There were strong trends towards improvements in quality of life and self-esteem in the Living Well with Dementia group. The intervention can be delivered by staff who have relatively little background of leading group interventions.
‘Join dementia research’ is a national service that enables people to register their interest in dementia research and be matched with potentially suitable research studies. People with dementia, their carers and anyone interested in participating in dementia research can register into the system either online, by post or via a telephone helpline.
Our aim is to have at least one study, and all Memory Services in the CRN: Wessex region promoting ‘Join dementia research’ as soon as possible after its national launch planned for December 2014.
Southampton City Council and Southampton City CCG have provided an opportunity for local providers to bid for funding (£150K) to support community based dementia support services. This will provide for a wide range of initiatives; for example working with community farms and gardening schemes, IT equipment to support reminiscence therapy and stimulation and a Seafaring Memories Group.
Contact details below
Southampton Community Admiral Nurses work with carers of people living with dementia in Southampton city. Our model is overseen by Dementia UK, providing skilled assessment of needs and offering emotional and psychological support.
Our aim is to improve the quality of life for people living with dementia and their carers by giving time, educating, and maintaining relationships.
Aims to develop a comprehensive, integrative, quantitative set of models to estimate current and future needs, and the outcomes and costs of interventions aimed at meeting them for use in health and social policy.
In association with Prof. Martin Knapp, LSE and colleagues with Universities of Newcastle, Southampton and Sussex
Social influences on cognitive functioning from base to final wave measurements in National Child Development Study (from birth to age 50, 8 waves of data) and English Longitudinal Study of Ageing (from age 50+, 6 waves of data)
Overall aim of this research is to investigate and improve service provision for older homeless people with memory problems (consistent with mild memory problems [MCI] or dementia).
Led by Prof Jill Manthorpe, King's College London, with partners from St Mungo's Trust, South London and Maudsley NHS Foundation Trust, Universities of Surrey and Southampton.
A case is made for a collaborative model of clinical practice led by a mental health nurse. The model is to result from an investigation into whether a ward-based mental health nurse can alleviate the emotional pressures on nurses who work in older persons acute wards and care for patients with dementia.
The envisaged role of the ward-based mental health nurse is to deliver consistent one-to-one mental health care to older persons with dementia, thereby supporting nurses to deliver physical care that remains compassionate and is more fulfilling. In progress.
This studentship focuses on the feasibility of implementing and evaluating a compassionate care intervention for health care teams working with people with dementia and is part of a large intervention study running in two Hampshire NHS acute trusts.
If you are interested in applying for a studentship, please contact jackie.bridges@soton.ac.uk
This studentship focuses on exploring ways to better manage the continence and toileting problems of older people with dementia living in their own homes. Qualitative methods will be used to explore the toileting and product needs of both the person and their family carers.
If you are interested in applying for a studentship, please contact jackie.bridges@soton.ac.uk
A regional longitudinal observational study for people with younger onset dementia and their companions.
This study aims to improve clinical care through research into clinical assessment, diagnosis and treatment options.
Identification of individuals at high risk of disproportionate decline.
Improved framework for long-term monitoring and follow-up.
Better characterisation of prognosis, care burden in younger dementias, and identification of associated health and social care costs.
Butterfly Scheme (identification and associated care approach for people with dementia, cognitive impairment or confusion) implemented across all patient wards, and is really embedded within the orthopaedic ward. Interest from physiotherapy to link with nursing staff.
ED taken on principles, and use their own logo.
Memory service hold well attended monthly dementia champion meetings
Pain tool is being piloted across 2 areas by pain specialist.
Following the Butterfly Scheme staff are better able to support someone with a dementia in their care and physical and mental health care needs on a ward or in a clinic.
Replication of dementia environments across all Medicine for Older People (MOP) wards.
Use of volunteers to stimulate conversation with the patient and to read to them on the wards in Poole Hospital.
Results in decreased incidences of agitation and challenging behaviours.
Systematic review performed to identify most robust, reliable and valid measures of quality of life (dementia) for use in study.
Journal paper:
Bowling et al. Quality of life in dementia: a systematically conducted narrative review of dementia-specific measurement scales. Ageing and Mental Health, 2014.
DOI:10.1080/13607863.2014.915923
This project aims to implement a training and mentoring package on developing Circles of Support for people with dementia to complement the development of the new Dementia Advisor Services that are starting in Hampshire in October 2012.
Aim of Circles of Support is to reduce the need for paid support and promote social inclusion and feelings of connectedness to communities.
People with dementia will:
lead the lives they want to lead and be in the driving seat of key decisions about their support
The project is about establishing sustainable dementia friendly communities across the county of Hampshire, reaching as full a range of different communities as possible. This is a county wide project covering all five of the Clinical Commissioning Groups in Hampshire.
The project will support the delivery of a number of the key priority areas for the Innovations Fund, namely: Dementia Friendly Communities; Improving diagnosis; Community based care; and Carers.
This project will provide support to carers of people with dementia in 21 General
It is important to put a preventative and early intervention service in a familiar place where people can be easily engaged face to face without feeling a sense of stigma.
This project will deliver the Department of Health approved ‘Understanding Dementia’ training course to educate carers about dementia from first diagnosis through the dementia journey.
The training course is facilitated by a Carer Support Worker together with a volunteer carer and is delivered over 5 x 3 hour sessions held weekly.
This project will develop Dementia Friendly Communities across Dorset, Bournemouth and Poole, increasing public awareness of dementia and assisting people with dementia to remain independent and to have choice and control over their lives.
The emphasis will be on making best use of the facilities and organisations which already exist in communities. Additionally, links will be formed with local health and social care services.
Co-produced dementia training and awareness sessions
Business sign-up
Dementia Action Alliance
workers to raise dementia awareness, identify co-ordinators, & highlight DFC benefits
Evaluation by BUDI
This project aims to dedicate a ward area with an outside area and tailor the environment to improve the wellbeing and enhance the recovery of people with dementia whilst at Frimley Park Hospital.
The project is designed to use the Kings Fund Enhancing the Healing Environment
Assessment Tools to identify the areas for improvement needed in the elderly care wards.
Using 5 domains (Legibility, Orientation, Wayfinding, Familiarity and Meaningful Activity) we will redesign one of the ward areas for people with dementia
This project aims to ensure that staff working in University Hospital Southampton are dementia aware and have the appropriate skills to meet the needs of people with dementia. This project seeks to improve the acute hospital experience for people with dementia and their family.
Better workforce understanding & quality of environment; introduction of person-centred care and 'THIS IS ME' training; reduce antipsychotics; improve experience & pathways strengthen health & social care interface.
All patients admitted who have a diagnosis of dementia are contacted by Rachel and a service offered. This consists of information on services for carers, support during the discharge process and any other issues that arise during the stay, e.g. a carer fed back to Rachel that the care of their relative had been sub optimal and the person’s dementia needs had not been addressed. Rachel followed this up immediately and has been working with the team on their approach to people with dementia. She is about to be joined by a colleague working 2 days per week to support her, Pippa Elson.
Multiple improvement initiatives across training, signposting and support for people with dementia and their carers.
Movement for the Mind is a physical activities group for people with dementia and their families/carers.
People with dementia and carers gain emotional support. Maintain physical fitness. Resolves isolation for people with dementia and their carers.
To provide more visible and formal support for carers of patients with delirium/dementia admitted to acute hospital through:
• setting up onsite carer cafes at hospital canteens to provide a portal for mutual support, information giving and service signposting
• opening up basic dementia awareness training to carers
• use allied services such as Alzheimer's Society, Age UK and Carer Support Wiltshire
To be evaluated. The aim of the project is to improve carer feedback and experience
A 4 day modular dementia care training programme mapped to the QCF DEM Unit 501 with a gap of 3-4 weeks between each session. Pilot programme for 10 residential/nursing homes initially with plan to roll out to all 35 residential care homes and 10 nursing homes in Southampton. Programme includes:
•Understanding current policy, practice guidance and research in dementia care
•Leading practice which promotes the wellbeing of the individual with dementia
•Working in partnership with carers
•Symptoms and approaches to supporting staff to deliver person centred care
Residents receive better person centred dementia care.
Monthly cafes that are part educational and part social. Each café has a different topic that is delivered by consultants, GPs, CPNs, social workers or the third sector. It is repeated annually. There are also social events for carers, cared for and extended family and friends.
Carers and cared for are better educated and able to ask some questions that they might not ask elsewhere. Reduces social isolation.
Working alongside the dementia friendly communities project to lead a volunteer project/programme of trained dementia champions within Test Valley, Winchester, Eastleigh and the New Forest
Sustainability of dementia awareness, reaching rural communities, roll out of dementia friends program, enabling community to be dementia friendly.
Educating staff, including nurses, in care homes on good nutritional care for those with dementia. Working with Burdett Trust.
Improved physical health in care home environment
Bournemouth University, Department of Health and Social Care
Dr Jane Murphy
Contact Email: jmurphy@bournemouth.ac.uk
This study reviewed the use of sensory approaches used in nursing homes and the attitudes of care staff. Details of equipment used and strategies undertaken were documented.
Free downloadable guide based on results findings giving advice on how to implement sensory approaches. Free exhibition as part of the Inside Out festival at Somerset House, London demonstrating design features.
Working with memory groups, Churches Together Isle of Wight and Age UK IW as part of Dementia Friendly Communities. A service of 30 minutes in the afternoon with hymns chosen by memory group members.
65 people enjoyed the service
Alzheimer's' Society to provide five new groups; 3 art groups, 1 reminiscence group and 1 walking group.
Engages people living with dementia and provides support for carers.
Circulation of boxes containing reminiscence objects around residential homes for people with dementia in Bournemouth. Funding provided to Coda music to deliver music based outreach and circulate themed music boxes to residential homes for people with dementia in Bournemouth.
Improved quality of life for people receiving services
Specialist accreditation of residential homes in Bournemouth who wish to become known as "best practice" homes for people with Dementia. Bournemouth Council is supporting these homes to upskill staff to ensure environments are appropriate and stimulating.
Better quality residential care for people with dementia, list of dementia specialist homes in Bournemouth
Public Health England (Public Health England) has collaborated with voluntary and community sector organisations to develop a toolkit for commissioners. The toolkit aims to support commissioners to ensure equitable dementia care, taking into account characteristics such as ethnicity, age and disability. Public Health England Wessex has contributed a chapter on building a dementia equity data profile.
Evaluation of trained volunteers helping older people at mealtimes in five acute hospital departments; almost all patients are confused with delirium and/or dementia.
Improved mealtime care for hospital patients with dementia
Wessex CLAHRC/University Hospital Southampton NHS Foundation Trust
Helen Roberts
Contact Email: hcr@soton.ac.uk
Training nurses to measure the grip strength of older inpatients (low grip is associated with cognitive impairment and decline) and identify those at risk of poor healthcare outcomes.
Improved identification of older inpatients with frailty and cognitive impairment and increased staff awareness on acute wards.
Wessex CLAHRC/University Hospital Southampton NHS Foundation Trust
Helen Roberts
Contact Email: hcr@soton.ac.uk
A peer support group for people with dementia and carers. An opportunity to talk in a relaxed environment and receive 1:1 face to face support and the opportunity to meet local health professionals
Peer support replaces social isolation and anxiety.
To provide a social setting for peer support and advice
Signposting and social service
To provide musical 'trigger' points for people living with dementia and their carers.
To provide musical 'trigger' points for people living with dementia and their carers.
One to one ongoing support for people with dementia, carers and wider family and friends. Patient centred approach to support with individualised goals and outcomes.
An acute medical ward for the elderly received funding from the Kings Fund to redesign and decorate the whole ward. The new design was specifically to create a calming, appealing environment with emphasis on 'dementia friendly' features.
Less falls occurred on that particular ward. Patients and families were very positive about the environment.
Changes to the ward to support elderly, visually impaired and dementia. Using guidelines from college or occupational therapy to improve signage, use of colour to improve orientation. Changes to bathrooms to increase independence - colour, traditional taps, sink plugs.
Almost complete Improved orientation and increase independence. Expert to improve safety.
Cafes empower carers and people with dementia and provide access to information, support, advice, education and a place where individuals can voice their needs in a safe and supportive environment without prejudice. Also the cafes provide an opportunity to build a social network. The cafes are built and developed to meet the needs expressed by carers and people with dementia in the community.
User feedback indicates that the cafes are generally meeting their needs
Funded through Community Dementia Funding in Southampton. Offering people with dementia the opportunity to access outdoor activities & connect with nature. Partnership with community farms and Age Concern Hampshire providing sessions with support in a group environment.
Greater confidence, wellbeing and improved physical and emotional health
Trained counsellors can offer the time and space to meet on a regular basis in a safe and confidential environment. Free sessions which support the individual to cope and can reduce levels of anxiety, isolation and stress.
Greater emotional support for people with dementia throughout their dementia journey
Staff from Southampton City Council (SCC) Quality and Safeguarding team attended Skills for Care, Dignity in Care workshops. SCC commissioned workshops for residential and nursing care providers to attend. A dignity in care quality audit tool was designed and used in provider of care services, including services providing care to people with dementia.
50+ Dignity Champions have committed to the project. Quality Network groups meet to discuss the positive works and improvements made within their services. All Dignity Champions ensured that the National Dignity Action day was promoted and delivered in their services.
Commenced in 2012 as a pilot to audit residential care services commissioned by Southampton City Council. This was to identify improvements, recommendations and develop an action plan to improve the quality of care and to prevent services going into a safeguarding process. Training needs of staff and management identified, including a 4 day dementia course. This is all free to provider services, is ongoing and now carried out in nursing homes as well.
Dementia awareness and improvement of care delivery in residential care services. Training has enabled care and management staff to have a better understanding of the needs of people with different types of dementia, from diagnosis to end of life.
People with early stage dementia come to a memory group every week to take part in activities and discussions. This stimulates the mind as well as provides a safe place and a social group.
Reduces isolation and depression, people remain more positive, feeling engaged and valued. Also results in less time spent in care and provides an opportunity for carer respite.
By training carers in suitable Cognitive Stimulation Therapy (CST) activities and using local libraries as a place to access resources carers can provide CST at home as well as having a "mutual place" for discussion and quality time with the cared for person.
Carers can feel more empowered to provide therapy, providing more enrichment and stimulation for people with dementia.
Part of Isle of Wight Dementia Friendly Communities. Clearly signposted sections with a range of books for all ages about dementia. The library service has waived late fees for people with dementia. Training for all library staff. Future training in libraries for carers in CST and monthly pack of activities.
Education and support
Training for GP practice nurses, who become dementia champions. Focus on, understanding dementia types, communication, challenging behaviour, nutrition, carer involvement/support. Dementia screening and educating practice staff.
Training runs December 2014 - March 2015
Volunteer led project that supports people with a form of dementia to continue normal activity for them. Could be home based or outside of the home.
Increased physical movement and social engagement. Respite for carers.
To support research, especially dementia research in care homes. An online toolkit to aid researchers and care homes, building a network of research ready care homes across Wessex.
To encourage and support dementia research in care homes
Carer respite / social activity. People with Dementia invited to 'hosts' home for as many sessions a week as wish, to socialise with other people with dementia
Increased quality of life, maintain social skills, carer respite.
Small team of RMN's whom provide intensive support / training to a core group of nursing/residential homes in East Dorset. Training such as challenging behaviour, medication management, care planning, Deprivation of Liberty Safeguards, help with CHC applications, advice to GP surgeries, patient care planning to avoid unnecessary admission to hospital
Reduced hospital admissions, Improved training for care homes/community hospitals, better care for patients in care homes/community hospitals
To provide information for carers about dementia, legal issues, coping strategies. A 4 week course, 1 day a week for 2 hours per session. Very informative sessions
A peer support and activity group for veterans with a diagnosis of dementia in Winchester and Andover. "What's in your kitbag?"
Peer support , reminiscence and reduces social isolation.
To provide 1st contact support for people living with dementia and their carers
To help by sign posting and provide support
Family carers involved in dementia awareness training in residential and nursing care homes across Hampshire
Changes in care practice and understanding
In year five of a supporting role to help Southampton City Council Care Homes develop better care practice and leadership.
Development of better person centred dementia care
Collaboration between charitable sectors and NHS following the development of the memory assessment service in Dorset. Previously Age UK Memory Advisory Service - Now Alzheimer's Society Memory Advisory Service
Referrers to forward referrals for new presentations of memory problems through the Alzheimer's Memory Assessment Service.
Project to improve the environment for female patients with dementia via the creation of a themed "diner", "beauty/hair salon" and independent "kitchenette". The project has the following aims:
•To improve socialisation
•To maintain self care skills
•To improve diet and fluid intake
•To increase assessment opportunities
•To reduce aggression associated with inactivity and frustration
The project has received £5k grant from the Quality Improvement Team and launched on 21st October 2014
I am currently undertaking a 6 month secondment as a dementia champion to the education department. This is very valuable and should be made more available so that nurses and ward staff who are caring for people with dementia on a daily basis have a better understanding of dementia and of the services available, therefore improving care for patients.
Enhanced strategic awareness of services within and outside of the trust, using this knowledge to improve experiences for patients that I care for and ensure high quality of care which is safe and effective.
•Understanding dementia courses are delivered to carers and the cared for
•GP Dementia Clinics offer private face to face time with the carer within the surgery providing practical/emotional support, benefits advice and access to free counselling.
Both of these services are currently being delivered in North Hampshire CCG but could be commissioned throughout Hampshire.
Improved knowledge and education for carers and the cared for.
Princess Royal Trust for Carers in Hampshire
Contact Email: info@carercentre.com
It is evidenced and accepted that the contact with living beings and nature evokes calmness and a sense of wellbeing in people. Biophilia - or the 'love of life' - hypothesis has been tested and researched in a range of settings. It supports the theory that people with damaged or compromised attachment relationships, such as can be present in people with a dementia, can particularly benefit from the relations with companion animals because of the lack of judgement and the perceived empathy. Unconditional positive regard, empathy and understanding are at the heart of person centred practice and are enhanced by the presence of animals (Wilson, 1984). Animals, and specifically dogs, can act as a social support and stimulate conversation, particularly when situations are mildly stressful and the person with dementia finds 'small talk' difficult to follow (Kruger et al.,2006).
In 2009, Alzheimer's Support introduced 'Therapy Dogs' into their day care settings. The two whippets are very placid animals and are present at the day clubs, moving freely in the space as they would in a family home. They also have designated sofas where club members often join them to simply sit with them or to brush their fur. The effect the project has had - and continues to have - on members is captured and illustrated in photography.
Day Club members interact with the two therapy dogs almost from the point of their arrival on the premises in the morning. The dogs function as a 'welcome party' which visibly diminishes the person's anxiety and acts as a 'reminder' of the pleasant feeling the club's activities can evoke. If we consider a person with dementia more as a 'feeling' being rather than a rationally 'thinking' one (Sheard, 2015), the tactile sensation of casually stroking the dogs will cause positive sensations on multiple sensory levels. In many cases, the day club activities succeed in peeling back the layers of confusion the dementia puts upon a person and uncovers the underlying personality and lets it shine through. The presence of the dogs and interaction with them accelerates the process and helps members to settle into the club. It could also be observed that, when club members are confused about where they are going when they are being picked up by their transport for the day club, pictures of the dogs seem to 'remind' them and reduce their stress and anxiety. The photographic records of club members interacting with the dogs demonstrates a high rate of positive expressions, of calmness as well as animated activity.
As an additional beneficial phenomenon, test results have shown that persons accompanied by animals are consistently described as friendlier and less threatening (Lockwood, 1983). This leads to club members and particularly first time visitors to react more calmly and become more trusting in stressful situations.
The resulting photography is shared with carers and relatives and also used widely to promote Alzheimer's Support services and to demonstrate the results achieved in day care settings. The positive effect of the dogs was particularly considered when the organisation won the GlaxoSmithKline Impact Award in 2015.
Free weekly art, music, drama and dance sessions for people experiencing mild memory loss and early stage dementia, and their companions. They are led by arts facilitators trained to understand the challenges people face as symptoms of the various types of dementia set in, their communication needs, existing skills and how best to access them.
to create and report on a regional model to integrate the use of arts into the Well Pathway for Dementia, so that it becomes natural for GPs and diagnosticians, both before and after diagnosis to recommend patients to arts (& exercise etc.) activity
to show how patients can be directed to arts activity to help override symptoms etc.
Strategic Clinical Networks exist to bring about complex change across complex pathways of care. We developed the Dementia Timeline as a visual representation of dementia projects in place in Wessex. This repository will serve as a resource for individuals and organisations collaborating to improve dementia care in Wessex.