SCOTLAND’S DEMENTIA STRATEGY
ANDPERSONALISATION
Scotland’s National Dementia Strategy
The key points from 2010 document
Dementia Strategy
Published in June 2010, it focuses on two key areas: Providing better support and information to people with
dementia and their carers after diagnosis Providing better support and care in hospitals (including
finding alternatives to admission and improved planning for discharge)
Why? Because they will bring immediate benefits to people with
dementia and their carers and improve efficiency and quality of the care system
Dementia Strategy
A further eight priorities for improving care pathway for people with dementia and their carers are identified:
Common standards of care for dementia A definitive skills and knowledge framework for dementia Transformational change involving all health and care sectors Improved management and outcome information Continued work on diagnosis Better response to challenging behaviour Accelerated implementation of Dementia Integrated Care
Pathway Continued action to support dementia research
Dementia Strategy
The strategy is designed to tackle five key challenges: The fear of dementia that means people delay in coming
forward for diagnosis Poor or non-existent information and support after diagnosis
for those with dementia and their carers Poor outcomes in general healthcare services A lack of dignity and respect for people with dementia and
their carers Inadequate support for family members and those who care for
people with dementia
Dementia Strategy
Action already taken: Alzheimer Scotland have 19 Dementia Advisers in 18 local
authorities They fund three Dementia Nurse posts in NHS Lothian, NHS
Borders and NHS Ayrshire and Arran – and have launched a £1.5 million appeal to place a nurse in all 14 health boards
Dementia has been established as a national clinical priority by the Scottish Government
New self-directed support legislation introduced to enable more people with dementia to have control of their care funds
The Scottish Dementia Forum, including people with dementia and carers, has been created and meets regularly
Dementia Strategy
The next steps The first annual report on the progress of the strategy will be
published in June 2011 by the Dementia Strategy Implementation and Monitoring Group
This Strategy has long-term objectives, but there is an immediate focus on action over the next 3 years
A revision of the Dementia Strategy is due to be completed by June 2013
Dementia: By NHS Board Scottish Borders
Dumfries &
Galloway
Fife Forth Valley
Lothian
_65 37 48 115 93 255
65-74 328 477 909 709 1775
75-84 657 942 1854 1358 3693
85+ 686 902 1738 1232 3494
No people
with dementia
1708 2369 4616 3392 9217
Population of area
106764 147765 349429 279480 778367
Est. % with
dementia
1.6% 1.6% 1.3% 1.2% 1.2%
Dementia in Scotland
0
20000
40000
60000
80000
100000
120000
2007 2012 2017 2022 2027 2031
males
females
total
(Alzheimer’s Scotland 2007)
Currently 71,000 in total - 60% in community- 40% in institutional (long stay) care
Projected to rise to 127,000 by 2031 (Alzheimer’s Scotland 2010)
PERSONALISATION
AN INTRODUCTION
Starting with the Person
Personalisation means thinking about public services and social care in an entirely different way – starting with the person rather than the service. It will require the combined transformation of adult care.
Julie Jones, Chief Executive, SCIE
What support do people with dementia need?
Information about their illness and what's available The tools to become active in their own planning and
decision making Control enabling them to take decisions when they
have capacity to make decisions and plan ahead Knowledge of the allocated budget to their care Ability to control their budget to meet their personal
needs and understanding the options available to them (e.g. self directed support, direct payments purchasing services or personal assistants)
What is Personalisation
Begins with the person, not the service Recognises the person’s strengths,
preferences, networks of support Individual is best placed to make decisions
about their life
What is Personalisation
Accessible information and advice Irrespective of whether self funded or publicly
funded It’s about giving people choice and control
over their lives
What Personalisation is NOT
A completely new idea Just about giving people individual
budgets Only for people eligible for Council
funding Or those needing traditional services
only
What Personalisation is NOT
“Importantly, the ability to make choices about how people live their lives should not be restricted to those who live in their own homes. It is about better support, more tailored to individual choices and preferences in all care settings”
(DH, 2008a,p5)
What it does mean
Finding new collaborative ways of working and developing local partnerships, which produce a range of services for people to choose from and opportunities for social inclusion
Tailoring support to meet individual needs Recognising and supporting carers in their
role, while enabling them to maintain a life beyond their caring responsibilities.
What it does mean
Access to universal community services and resources – a total system response
Early intervention and prevention so that people are supported early on and in a way that’s right for them
Some Common Terms
Person centred planning Person centred care Person centred support Independent living Self directed support
Personalisation
Implementing Personalisation
The experience of dementia
Consider Trying to make sense of an increasingly unfamiliar world Unable to access memory Being disorientated – time, place, person Unable to respond to emotional demands Unable to verbalise your needs Loss of strengths – weaknesses come to the fore Loss of identity and control over your life Being ignored, talked over or treated as stupid Loss of coping skills
Implementing Personalisation - Environment
Does it make sense to the person Does it lack crucial information Signs and cues Areas of importance not highlighted Inappropriate lighting Too much noise and conflicting stimuli Patterned carpet and shiny flooring Mirrors
Communication tips
REMEMBER – challenging behaviours are not always a problem for the person with dementia
For the person with dementia – their behaviour often makes perfect sense to them
Due to communication difficulties the behaviour of people with dementia should be seen as an expression of need
Communication tips
DON’T Try to communicate when there are distractions Use long complicated sentences (or jargon) Talk about doing something long before you do it Assume that pronoun’s like he, she or it will be clear to the
person Keep repeating something if you are misunderstood Use gestures that could be seen as threatening Assume that the person does not understand
Communication tips
DO: Seek out a quiet area Identify yourself by name Speak slowly and clearly – no need to shout Ensure that only one person speaks at a time Use other cues and gestures to maximise understanding Give time and remain unhurried Listen and give the person your full attention
FINAL POINT
The person with dementia can’t adapt to us – we need to adapt our social, clinical and structural
environment around the person.
At the very least – don’t disable the person further!
THANK YOU