Dementia in Care Homes

Lorraine SmithAdvanced Practitioner

Nursing Home Support TeamJuly 23rd 2014

• Two thirds of people living in care homes haveDementia.

• 45% of care home residents have moderatelysevere to very severe cognitive impairment.

The excellent care provided by some homes can make

a huge difference to residents quality of life.

Long term care is aboutliving ones life.

• Primary task of care homes is to provide goodquality care to people living with dementia

• Expectations of the quality of life that can beexperienced by people needs to be higher

• Good care homes have a good atmosphere andwarm relationships among residents, staff and

relatives

What are some of thechallenges

• Provision of meaningful activities andoccupation

• Treating residents with dementia withdignity and respect

• Relationship between care homes andrelatives/friends

• Support from external services variable

What needs to be done to GET IT RIGHT?

Training for care home staff.Improve on Life stories.

An understanding of challenging behaviours.Working closely with the MDT-Not forgetting the

patient and family at the centre of care.Recognising end of life.

Person with DEMENTIA

PERSON with dementia

Inspectors viewsThe CQC found that care homes were not preventing, detecting or properly treating

problems such as dehydration, pneumonia, malnutrition and urinary infections in people with dementia in care homes in 78 out of 151 primary

care trust areas of England (52%). Care home staff are also missing pressure sores, lower respiratory

tract infections and broken bones in residents with serious memory loss, CQC inspectors found.

Care homes and hospitals 'failing people with dementia' –Guardian 12th March 2013

Reasons for Frequent hospital admissions

DehydrationPneumonia

MalnutritionUrinary tract infections

Pressure Sores

ConsequencesIncreased bed days

DisorientationMay inappropriately be diagnosed

with challenging behaviourConfusion

Change of routine.

IMAGINE

You are sat in unfamiliar clothing, beside a bed in a room with 3 other beds and lockers, you think it might be a hospital but it is

strange and unfamiliar...

You cannot recall how you got here ...

You don’t know what is about to happen, but you have a sense of dread...

The smells, noises, sights and people – those who appear ill and those in uniform moving about with purpose – are all puzzling and

unsettling...

You recognise no-one...

You are hungry and thirsty...

Occasionally, you summon the courage to call out to people who walk close by. Many ignore you, those who stop and speak to you

talk quickly in a language you can make no sense of, and then they swiftly depart...

When you get up your movements are unexpectedly slow and laboured...

Finally, when you try to seek a way out of this strange and unfamiliar place, a person in a uniform prevents you leaving…

The more you know about a person the more likely you are to

understand a persons behaviour before it becomes challenging.

LIFE STORIES

My Involvement1. Providing dementia training to care home

staff.2. Support with symptoms in end of life care

3. Advanced Care Planning.4. Life Stories essential part of the

assessment.5. Support with Pain tools.

6. Setting up Nursing home forum.7. Environmental factors.

IT DOESN’T COST LOTS OF MONEY TO DELIVER GOOD CARE AND SHOW

EMPATHY.THIS MAY BE YOUR

PARENTS/FAMILY/FRIENDSWE NEED TO GET IT RIGHT