In this blog post, author Dr Shibley Rahman addresses the urge to recognise the needs of the workforce in dementia education and training by asking a simple, yet poignant, question: what real progress has been made in this direction over the past few years?
The current Prime Minister’s Dementia Challenge 2020 has successfully improved the awareness of dementia (and quality in other areas), but it also did produce a lot of other industrious contributions, such as courses and conferences, not always with a primary aim of educating the workforce.
But – “Knowledge is power.”
A lot has been made of the finding that people living with dementia are “core users” of the NHS and social care. And it has been said “dementia is everybody’s business”. But these tropes are too easy to trot out. Rather, the needs of people with dementia and their care partners often go unaddressed, despite much effort being publicly pumped into ‘dementia awareness’.
Just before Christmas last year, as a full time carer of a family relative with dementia, I had reason to experience at close quarters an English hospital admission. Although I am loath to extrapolate from what was essentially an anecdotal experience, I found the mismatch between reality and political rhetoric quite revealing. Continue reading
Moving into residential care is not an easy decision. Some people won’t even consider the idea, whereas others might just accept it as an inevitable step. In this blog post, Colleen Doyle, co-author with Gail Roberts of Moving into Residential Care: A Practical Guide for Older People and Their Families, shares her personal experience and gives some advice on what to do when a loved one might be moving into a care home.
“No care home is perfect, so people need to work out what is most important to the individual and focus on how to achieve that”
Moving into residential aged care is a step that is dreaded by many older people. My parents were born in the 1920s and were part of the generation that valued stoicism as an approach to many of the challenges that life brought. Before I was born, my parents spent many years living in remote Australia while my father worked along the railway line that snaked its way through the central deserts of Australia. My mother coped with caring for my two older siblings while living in the desert. My father was by necessity a great inventor whose creative solutions enabled them to live independently when support services were non-existent. When he came to the end of his life he, like many people, let it be known that under no circumstances whatsoever would he consider moving into a nursing home. For someone who had spent most of his life in control and fending for his family, the thought of being at the mercy of health services was too much to bear. In fact he faced his terminal cancer at home, being cared for by a wonderful palliative care team, and spent his last week of life in a palliative care unit of the local country hospital. When my mother was faced with the same challenges at the end of her life ten years later, she acknowledged that care at home was not an option and asked her children to ‘find me a good home’, a task that was very daunting even for those of us who had worked in aged care for a long time.
Both circumstances are commonly faced by families and older people who have all to work out what is the best solution for providing good quality of life, when people’s health may also be deteriorating and services may not match what an individual wants. Families need help to choose the right services for their older relative in a time when there seems to be very little that will satisfy all the needs of the individual. Sometimes if the older person is having to move unexpectedly, the rush in decision making can make the situation even more stressful. Very often the emotional response to residential care is very negative. In our book we emphasise that allowing the older person themselves to have control and lead decision making as much as possible will assist them to adjust to the move. We have found that there is information available, including for example checklists to help with choosing residential care. However the checklists are generic, and what needs to be considered are the main priorities of the individual – not only what their health care needs are but what gives them purpose or meaning in their life. No care home is perfect, so people need to work out what is most important to the individual and focus on how to achieve that. The coping styles of individuals will contribute to how long it takes to adjust to their changed circumstances. One of my mother’s favorite responses to her own chronic pain was ‘it will pass’. Being able to let go, and focusing on the positives in the moment can help older adults to get through difficult days. Older people have a lifetime of experience, diverse backgrounds and varied family supports, all of which will impact on how they approach moving into residential care.
We hope that this book will provide valuable advice to help older people and their families and friends who are considering a move to residential care. Our book brings together the latest research on what helps and what does not help during a move to residential care, advises where to find some of the latest resources that are available on the internet, and describes some stories from people who recently experienced the move. Everyone has different life experiences and circumstances, but we share the common goal of having the best quality of life possible, no matter where we live.
Colleen Doyle is Professor of Aged Care at Australian Catholic University and Honorary Research Fellow at the National Ageing Research Institute. She is the co-author with Gail Roberts of Moving Into Residential Care: A Practical Guide for Older People and Their Families, Jessica Kingsley Publishers, December 2017
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With a key theme for every week of the year, this resource contains extended multi-sensory reminiscence group session plans for older adults.
Written by experienced occupational therapists, it provides detailed session plans for running successful and therapeutically-valuable activities within group sessions, from remembering school days to celebrating the natural wonders of the British Isles. Each plan has been developed to be suitable for people with a variety of abilities, including for those with dementia, and help to support memory, sensory function, confidence, communication, connection, as well as overall physical and emotional wellbeing.
These group session plans are taken from Sophie Jopling and Sarah Mousley’s new resource, The Multi-Sensory Reminiscence Activity Book: 52 Weekly Group Session Plans for Working with Older Adults.
Sophie Jopling and Sarah Mousley are State Registered Occupational Therapists and together they run their own independent OT business, Kent Occupational Therapy.
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Take any health and cultural issues into account
Age related health problems such as the onset of dementia, hearing loss, speech problems and the effects of medications can complicate understanding and the ability to communicate. Be aware of any difficulties individuals may have and take these into account. Make adjustments to any activities to allow for different mental and physical abilities. Even in today’s enlightened age many older adults, and, indeed, young people, have difficulty reading and writing. Find out all you can about the person you are supporting and adjust your communication methods to suit. This includes learning about their cultural background and what is or is not acceptable to them when communicating. For example, in some cultures it is disrespectful for younger people to make direct eye contact with an older person. In this instance it may be prudent to sit slightly to one side, keeping your eyes lowered but so the person can see your expressions, rather than facing the older person when talking.