Our background in providing dementia care
Aster Care has been providing 24 hour support to people with long-term health care conditions in the community for many years. After establishing a reputation for good communication and the delivery of high quality care, we were approached by the local mental health services to support service users whose dementia caused them to display very challenging needs. To accept care packages of this kind requires critical thinking and planning by the management team, and should not be taken on with any hint of arrogance. This is what we learned very quickly:-
- Staff absence/turnover has the potential to rise due to physical attacks which can lead to staff leaving the organisation, and ultimately from the care industry.
- There is an increased risk of reportable incidents due to, a) staff being harmed and, b) service users causing harm to themselves or members of the public.
- There can be an increased number of safeguarding incidents due to staff being accused of abuse ( appropriately or falsely).
So why provide care to this group of people? Because these can be the most rewarding people to look after! We have both loved and learned how to do it better over the years, changing our practices to reduce staff turnover and injury, and to avoid a return to institutional care so the person can eventually die at home.
The history of our dementia training
Over the years, the management team at Aster Care has undertaken different dementia training courses with previous employers and so our approach was formed by what we had been taught. We used an external training company to provide modular dementia training which we believed had been sufficient up until this point. However, after being approached to support a lady with frontal lobe dementia discharged under section 117 of the Mental Health Act 1983 – and whose care had failed with two other care providers, we knew we needed to look at how we would support this lady to prevent our own organisation from failing too. We tried a new approach that we then embedded into future practice for all service users being discharged from health care institutions back home:-
- Send staff to the specialist unit to carry out shifts at the establishment to get familiar with the person before they came home
- Attend case conferences to learn about what had worked and what hadn’t in the establishment, or with other providers
- Participate in home trial visits
- Hold our own team briefings prior to commencing the care
- Staff to complete the current dementia training
- Produce person-centred care plans to to avoid generalisations and assumptions about the disease
- Produce training plans for staff, for each individual service user, to ensure all aspects of the care and behaviours would be covered prior to working alone
What else was developed?
- It did not go into sufficient detail about the different types of dementia, focusing mainly on Alzheimer’s (most common), when we were dealing with people experiencing frontal lobe and Lewy Body; two of the less common dementias.
- Our dementia training, and all the training the management team had received prior, failed to focus fully on the challenging behaviours that could be seen and the techniques staff would need to manage these.
- Introduction to dementia
- Types of dementia;
-
- Alzheimer’s
- Vascular Dementia
- Fronto-Temporal Dementia (FTD)
- Dementia with Lewy Bodies
- Korsakoffs Syndrome
- Mild Cognitive Impairment
- Illustration of the brain and symptoms linked to area damage
- Understanding and managing the behaviours of dementia
- Local support groups in Portsmouth
- Resources accessible from Aster Care
Where are we now?
One of the biggest challenges we face in domiciliary care, second to recruitment, is being able to successfully deliver face to face training courses. In recent years, online training courses have become the norm, with staff logging in on their laptops or mobile phones to complete a range of online training. If staff are not working in service user’s home, they have planned for a day off. Even though all training is paid, working on a ‘day off’ is not always a good idea! Our answer was to adapt our booklet Dementia: A Practical Guide for Staff into its own module and produce an assessment paper that would ask questions to draw out the answers we thought were the key areas we wanted staff to understand.
We believe the move to relying on our own training and assessment will better equip staff to understand how to manage and respond to the challenging behaviours they will see, preventing more incidents, reducing staff turnover, and will produce better outcomes for those with complex or advanced dementia. All new staff joining the organisation will be asked to complete our training to ensure consistency throughout our service.
To find out about how we care for people with dementia,
CLICK THE BUTTON
