Explanation and Introduction to Dementia Care Programme at Oaklodge

Oaklodge Nursing Home has established a now well recognised care programme for Dementia/Challenging Behaviour residents based
on international best practice.

The specialised Dementia care programme offered by Oaklodge Nursing Home to residents has been developed based on international best practice with the help of experts in the field.

• Oaklodge Nursing Home commissioned University College Cork School of Nursing to undertake primary research on international best practice models of care.
• The essence of the approach is based on a much higher staff ratio as is required by residents with Dementia as well as a therapeutic care programme that engages the senses of the resident
  and calms them.
• This reduces agitation and violence and places our residents at ease with their surroundings.
• It comprises of a general care unit and a specialised Dementia/Alzheimer’s care programme and unit.

• Some of the interventions utilised include, one to one care continuous behaviour monitoring every 30 minutes, reality therapy, memory clinics, validation Therapy and reminiscence therapy.
• Through education, information, research and collaboration with others we aim to reduce stigma and promote excellence in all aspects of services for persons with dementia in Oaklodge.
   

Interventions used in programme:

• Instead of treating the person as a collection of symptoms and behaviours to be controlled, Oaklodge Nursing Home aims to see the person with dementia as an individual, rather than focusing on their illness or on abilities they may have lost.

• Each Oaklodge Dementia resident is seen as an individual with unique qualities, abilities, interests, preferences and needs.
• To care for people with dementia. Staff at all levels receive ongoing training
• Offering a wide range of carefully considered activities, and encouraging people with dementia to take part in as many activities as possible.
   

         -                      One to one care
         -                      Continuous behaviour monitoring every 30 minutes
         -                      Reality Therapy
         -                      Memory Clinics
         -                      Validation Therapy
         -                      Reminiscence Therapy
         -                      Higher staff ratios
         -                      Staff training

            -                      Extra management
-                      External Expertise
-                      Orientation cues
-                      Staff experience
-                      One-to-one and one-to-group work
-                      Life Story Programme
-                      Optimal Building Design  

• Dementia Care Programme Resources have also proved to be a great resource for people with dementia. Games such as nostalgia, reminiscing and discover Ireland have encouraged them to look for tasks that they can still enjoy and manage.

• Multi Sensory Tools such as parachute, crayons, hoops (small and large), co-ordination games, rings, shapes and figures, cushion football, plastic balls, bowls (plastic), cards (standard and jumbo size), pencils, shapes and figures, chess and draughts have allowed them to as far as possible maintain existing skills and can give the person pleasure while boosting their confidence.
• Sensory and Physical stimulation such as clay, knitting equipment, mosaic art, shells, magazines for art, collection of art pictures have helped them retain their independence.
   

• Be a warm, calm, reassuring presence and offer support.
• To make a person feel valued and important use positive language. People with dementia are influenced by the language people use around them. Avoid use of ‘negative’ language; such as shouldn’t, can’t or don’t. They may have dementia but they are not children.
• Positive language can make a person feel valued and important.
• Try not to highlight and correct verbal mistakes or directly contradict the person. Focus on the emotions behind their statements rather than the facts or details which may be wrong.
• Don’t take communication deficits personally (the person may not remember your name but will definitely remember kindness).
• The conversation may seem irrational and illogical to you, but make complete sense to them so believe there is sense in it. Once their verbal skills go behaviour is their only form of communication.
• Encourage them to remember what they can without making them feel pressured. Those around the person with memory loss should be flexible and patient and try using frequent reminders while doing things with, rather than for, them.
• Reference points from the past will be used to understand what’s happening now so establish the person’s reality. Their past often holds the key to their current reality. Memories from childhood and early adulthood can be quite clear even as dementia progresses but short term memory becomes transient.
   

Making a home more “dementia-friendly”.

• Colour has a huge impact on a person with dementia. There are many influences on a person’s reality orientation such as colours of walls, floors and objects. Blue, for example, is a restful colour with a calming effect. Strong colours should be used to emphasise what’s important and compensate for any visual impairments as the person’s colour perception may be weakened.
  www.sonasapc.ie
• Contrasting colours can be enormously helpful with identifying objects, especially in the bathroom. A person may have great difficulty identifying a white toilet, sink and bath in a white bathroom. Similarly, in table settings, use plates that have a high contrast with the tablecloth. Pale colours can be used to de-emphasise what’s not important. Floors are especially important. Avoid bold, contrasting patterns, which can be confusing to a person who may have difficulties with depth perception. www.dementia.stir.ac.uk
• If a person with dementia is unsteady on their feet safety measures must be put in place. Handrails in the hall and on the stairs, grab rails in the bathroom and toilet, and a toilet seat riser will help.
• Put up pictures on doors indicating the functions of the various rooms in the house. Pictures help with reality orientation. For example, you might have a picture of a bed on the bedroom door or a dinner table on the dining room door. www.dementia.ie
• When people are stressed or confused accidents are more likely to happen in the home. From time to time it is inevitable that family members and carers will feel tired and irritable. If possible take a few minutes break or else simply breathe deeply and slow down. The person with dementia may pick up on a person's mood from their body language, even if they do not say anything.
  www.dementia.stir.ac.uk
• Check your home for rugs, loose carpets and slippery floors or anything that may cause accidents. These items can affect older people who may be unsteady on their feet. www.sonasapc.ie
• For someone whose memory and sense of danger are impaired fires or heaters can be a danger. Always fit a fixed fire guard while central heating and many electric fires can be regulated with a time switch. www.dementia.ie
   

Places to go for support  www.sonasapc.ie

• Talk to your GP out about the type of dementia involved. The symptoms and effects of Alzheimers is quite different to, for example, vascular dementia.
• Call your local public health nurse and find out what day and respite services are available to you.
• The Alzheimer Society of Ireland is an enormous resource for families which are experiencing Alzheimers, both the person with Alzheimers and the carer. Ireland's leading dementia specific service provider, it has more than 100 services across the country. Contact your local branch of the Alzheimer’s Society or call the Alzheimer National Helpline for support and advice at 1800 341 341.
• Do some research of your own. Websites of organisations such as the Alzheimers Society (check out the UK one too at www.alzheimers.org.uk), the DSIDC (www.dementia.ie), and the Dementia Services Development Centre based at Stirling University (www.dementia.stir.ac.uk) have a large amount of information and resources that can be very helpful. You’ll find lots of ideas there on how to make our home more “dementia-friendly”.
• Go to your local nursing homes. Find out about the various services on offer and if they hold any carers’ support evenings.