Living with Dementia
In Thanet and East Kent
The Alzheimer's Society has produced a document highlighting opportunities for improving dementia care in care homes. The following is a summary of the key points. If you wish to view the whole document click here. You will need Adobe Acrobat Reader to view this document, which can be downloaded here.
Home from home
A report highlighting opportunities for improving standards of dementia care in care homes.
Summary of key points
Introduction
700,000 people in the
At lease two-thirds of care home residents in the
40% of people with dementia in care homes are not in dementia registered beds.
45% of care home residents have moderately severe to very severe cognitive impairment (Darton et al., 2006).
Dementia care in care homes
The impact of dementia in each individual is profound. Care staff perceive communication problems as one of the biggest challenges in providing good dementia care.
The majority of carers were positive about the dementia care provided to their relatives, but many people reported key problems including poor standards of dignity and respect, dementia becoming a label and a lack of knowledge or skill in how to respond to the symptoms of dementia.
As only 60% of the people with dementia in care homes are in dementia-registered beds, standards of dementia care across the whole sector must be improved to ensure the needs of all residents with dementia are met.
Activities, engagement and occupation.
Opportunities for activity and engagement have a huge impact on quality of life and affect important outcomes including mortality, yet over half of carers felt the person they cared for did not have enough to do during the day in the home.
This supports previous research. For example, a survey of 12 homes found that over a sixhour period the median resident spent less than two minutes in conversation (or other forms of communication) with staff or other residents, outside of care tasks.
People in the later stages of dementia are particularly at risk of isolation and lack of stimulation.
Many people with dementia, particularly those in the later stages, are not able to access outside space.
Involvement of friends and families in the care home
The transition to residential care is a major event for both the family and the new resident. Maintaining good relationships between relatives and the care home, and supporting the ongoing relationship between relatives and the person with dementia, has important benefits for both parties.
The relationship between home and relatives is a problem for many carers:
22% were satisfied with the level of their involvement in decision making.
29% felt they did not receive enough information and updates about thecare and treatment of the person
This relationship is also a difficult one for the care home staff. Good management is important in supporting staff in this area.
Challenges in providing good dementia care
The big challenges identified by care home managers relate to attracting andmotivating staff and ensuring they have the right skills. It is vital to support and motivate care home staff by:
Acknowledging that dementia care is a skilled area of work and valuing, training and rewarding staff accordingly.
Providing a comprehensive training programme that is linked to career and reward structure and supported by ongoing supervision, positive reinforcement of good practice and effective leadership.
Despite government policy making it clear that liaison between dementia specialists and care homes should happen, provision of support to care homes is extremely variable. Liaison work between OPMH teams and care homes can improve care and reduce costs. Many OPMH teams would like to do more of this type of work.
Improved coordination between care homes and hospitals would improve the care provided to people with dementia. There must be greater recognition that care homes are part of the local health care provision.
Alzheimers Society2008