NHS hospitals wind back the clock for dementia care

NHS hospitals are going back to the future to help patients with dementia by decorating their wards, rooms and corridors in 1940s and 1950s style – creating a calming, familiar environment which can help jog memories, reduce anxiety and distress | via NHS England

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Providing the best care for people with dementia and with their families is a key priority for NHS England. With the dementia diagnoses rate among older people at a record high, the Long Term Plan puts in place the building blocks for an effective and compassionate older people’s health service.

Hospitals across the country have revamped their dementia ward decor, with innovations ranging from a ‘memories pub’ to 1950s style ‘reminiscence rooms’ and even a cinema booth where patients can watch old films.

With support from local charities and staff bringing in donations, hospitals like Airedale Hospital in West Yorkshire are going the extra mile to provide a stimulating environment for patients with dementia. In Ward six, patients can relax in a ‘butterfly tea room’ complete with shop front wall mural and vintage memorabilia including a red telephone box. These items from bygone eras can give patients conversational cues and help them talk about the memories they still retain.

Full story: NHS hospitals go back to the future for dementia care | NHS England

Improved asthma and dementia care from community pharmacists under new quality scheme

Most community pharmacies in England are now providing improved asthma and dementia care |  NHS England 

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Thousands of community pharmacists took up incentives to offer new patient services, such as providing asthma checks and undertaking training to become more dementia aware, as part of a programme to improve care.

The uptake figures from NHS England show that 97 per cent (11,410) of community pharmacies are now signed up to the Quality Payments Scheme, which provides an incentive to deliver new clinical services in a bid to encourage more people to use their local pharmacist.

An assessment of the new scheme shows that since April 2017, 70,000 pharmacy staff have become ‘Dementia Friends’ in order to offer greater awareness regarding the needs of people with dementia. ​

NHS England issued guidance in December 2016 on how community pharmacies could qualify for the scheme, which ran between December 2016 and March 2018, and is currently considering how best to implement the successes of this scheme over the long-term.

Full story at NHS England

Dementia-friendly public toilets

Many older adults avoid travelling and social interaction because of the scarcity of public toilets or their inaccessibility. Furthermore, where public toilets are provided, poor design and signage can preclude independent use, particularly for people living with dementia | The Lancet

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Image source: Martin Sotirov – Flickr // CC BY 2.0

In general, there is a gap between current public toilet provision and toilet design appropriate for individuals living with dementia, who might have behavioural change, poor level of motivation, loss of mobility and manual dexterity, or abnormalities in visual information processing. In response to research and anecdotal evidence, many guidelines are available to inform and improve the design and independent usability of toilet facilities for people living with dementia. Examples include the use of familiar or automatic flush systems, non-reflective surfaces, good lighting, contrast between doors and surroundings and between the toilet and toilet seat, sinks that do not resemble urinals, well labelled taps and soap dispensers, and the careful placing of mirrors.

However, as highlighted by a substantial amount of anecdotal evidence, the absence of simple and clear way-out signs negates any positive influence of a well designed toilet facility. Such an omission can result in distress, anxiety, embarrassment, and reluctance to use the toilet in the future. Common examples reported to investigators include instances of people having to enter opposite sex toilet facilities to guide their partners out, or going through the wrong door and into undesired or incorrect locations. A fire exit sign showing someone running with a directional arrow is also easily misunderstood as an exit sign, which can result in misdirection with people ending up outside the building and, in some cases, wandering on to a road. Similarly, doors that are both a fire exit and the route back to a public area can cause confusion, and might elicit a reluctance to open them, primarily because of the fear of setting off a fire alarm.

Full reference: Tales, A. et al. (2017) Dementia-friendly public toilets. The Lancet Vol. 390 (no. 10094) pp. 552–553

Dementia-Friendly Hospital Design

We report the findings of a knowledge synthesis research project on the topic of dementia-friendly acute care (D-FAC) design | The Gerontologist

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This exploratory project systematically mapped what is known about D-FAC physical design in hospitals. We discuss our challenges in locating reportable evidence and the implications of such design for maximizing independent function while ensuring safety and harm reduction in older people living with dementia.

A total of 28 primary studies plus expert reviewers’ narratives on the impact of design and architectural features on independent function of hospitalized older people with dementia were included and evaluated. Items were mapped to key design elements to describe a D-FAC environment. This scoping review project confirms the limited nature of available acute care design evidence on maximizing function.

Physical design influences the usability and activity undertaken in a health care space and ultimately affects patient outcomes. Achieving safe quality hospital care for older people living with dementia is particularly challenging. Evidence of design principle effectiveness is needed that can be applied to general medical and surgical units where the bulk of older persons with and without dementia are treated.

Full reference: Parke, B. et al. (2017) A Scoping Literature Review of Dementia-Friendly Hospital Design. The Gerontologist. Vol. 57 (No. 4) pp. e62-e74.

Dementia-friendly housing charter

Housing organisations urged to unite against dementia | Azheimers UK

The charity Alzheimer’s UK has published the Dementia-friendly housing charter to help housing organisations better understand dementia and how housing, its design and supporting services can help improve and maintain the wellbeing of people affected by the disease.

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Image source: http://www.alzheimers.org.uk

Research from the leading dementia charity has previously found that 85 per cent of people want to stay living at home for as long as possible when diagnosed with dementia, but that a third of the general public would not know where to find information about how to make their home and living environment suitable.

The charter, developed in partnership with Housing & Care 21, is the latest innovation from Alzheimer’s Society’s Dementia Friendly Communities programme, which aims to ensure people affected by dementia feel understood and included in all aspects of community life.

The publication can be downloaded here

Exploring the impact of dementia-friendly ward environments on the provision of care

Brooke, J. & Semlyen, J. Dementia. Jan 2017 ; p. 1471301216689402

Dementia-friendly wards are recent developments to improve care for patients with dementia in acute hospitals. This qualitative study used focus groups to understand the impact of dementia friendly ward environments on nurses experiences of caring for acutely unwell patients with dementia. Qualified nurses and health care assistants working in an acute NHS Trust in England discussed their perceptions and experiences of working in a dementia-friendly ward environment.

Four themes developed from the thematic analysis:

  1. ‘It doesn’t look like a hospital’: A changed environment,
  2. ‘More options to provide person-centred care’: No one size fits all,
  3. ‘Before you could not see the patients’: A constant nurse presence and
  4. ‘The ward remains the same’: Resistance to change. Recommendations and implementations for practice are discussed.

Read the abstract here

The impact of dementia-friendly ward environments on the provision of care

Brooke, J  & Semlyen, J. Exploring the impact of dementia-friendly ward environments on the provision of care: A qualitative thematic analysis | Dementiapublished online: January 19, 2017

Dementia-friendly wards are recent developments to improve care for patients with dementia in acute hospitals. This qualitative study used focus groups to understand the impact of dementia friendly ward environments on nurses experiences of caring for acutely unwell patients with dementia.

Qualified nurses and health care assistants working in an acute NHS Trust in England discussed their perceptions and experiences of working in a dementia-friendly ward environment. Four themes developed from the thematic analysis:

  • (1) ‘It doesn’t look like a hospital’: A changed environment,
  • (2) ‘More options to provide person-centred care’: No one size fits all,
  • (3) ‘Before you could not see the patients’: A constant nurse presence and
  • (4) ‘The ward remains the same’: Resistance to change.

Recommendations and implementations for practice are discussed.

Read the full paper at Sage Journals