On the 21st February 2016, the BBC reported that a drug to slow down the progression of Alzheimer’s disease is being trialled on patients in the early stages of the disease.
American-based pharmaceutical company Eli Lilly is testing the drug Solanezumab, which aims to cut the rate of the dementia’s progression by about a third.
Diane Grey, from Plymouth, is one of the patients involved in the trial; and preliminary results are expected to be published in December.
This is really good news!
However, we all need to support others in our families and in the community cope with this and other dementia conditions in our daily lives.
We have the ability as a well-equipped organisation to allocate the appropriate care worker to people with dementia using our rostering software; that is, allocate those workers who have been trained appropriately and have shown in practice their ability and interest, and more importantly that they have the compassionate qualities to support these vulnerable individuals.
During our training we convey that the aim of person-centred care is to ensure that the person being cared for is an equal partner with health and social care professionals and care workers in risk assessing, identifying options, care planning and delivering the most appropriate package of care for that individual; and this practice must cross organisational boundaries, ideally supported by shared policies and procedures.
Our care workers are taught that person-centred care is treatment or care which takes into account the person’s individual needs and preferences. It views each patient or service user as a unique individual and with a unique set of needs and requirements and a rich past. In person-centred care the person being cared for is placed at the centre of care and everything is done around them. In particular, their opinion on all aspects of care is sought out and their decisions and choices are respected. In this way person-centred care supports and respects the autonomy, dignity and independence of the person.
Sunshine Care internal dementia training is delivered through DVD, powerpoint and class discussion sessions, which cover:
• The different types of dementia.
• Recognising the symptoms of dementia.
• How healthcare professionals should communicate dementia diagnosis.
• How we communicate with someone with dementia.
• The Mental Capacity Act and Deprivation of Liberty Safeguards.
Our care workers know that, with the permission of the person with dementia, carers and relatives should normally have the opportunity to be involved in decisions about care and treatment. Where there are no carers or family the person with dementia may want to have an advocate or other representative to support them. Our holistic care assessments do not just look at a person with dementia in narrow terms of the dementia itself, but also look at their physical and medical condition and the psychological and social aspects of their life and health.
Our risk management audit processes include checklists on our practice with regard to:
• Nutritional standards risk assessments.
• Falls prevention; (people with dementia are at greater risk of falls and injury).
• Training and embedded learning in medication administration practice. (All our care workers are taught and supervised to administer medication in strict accordance to the four categories described in Plymouth City Council’s medication policy).
• Pressure ulcer risk assessment and treatment process.
• Use of bed-rails, cot-sides and cocoons.
• General use of restraint.
• Protecting service user’s money and all aspects of POVA and POCA.
Where a person with dementia does not have the mental capacity to understand what is being asked of them this does not prevent their care being person-centred; indeed, it is more important than ever that the care is delivered in a person-centred way. Where they cannot understand the choices then our Field Care Coordinators will conduct an initial assessment of their mental capacity. Where it is shown that they may lack capacity to make choices, then decisions may be made for them but these must be in their best interests and must restrict their rights and basic freedoms as little as possible.
Where a decision is about more important matters, and particularly in end-of-life matters, our assessment process is clear and accountable and requires input from staff across the range of organisations or agencies involved in providing support for a person. In such cases it should include family and carers; and referral is made to an independent mental capacity advocate (IMCA).
The provision of good-quality information in a format that can be understood by the person with dementia and their carers and family is essential in the delivery of person-centred care. In person-centred care it is essential that the person at the centre of care is asked for their consent and agreement at every stage. They can only give that consent and reach informed decisions about their own care if they are provided with sufficient information and can understand the issues.
In the care of people with dementia it is important for the carers and family to also be given enough information to help the person with dementia to make decisions, particularly in the later stage of the condition. To this end, we have just developed a web-based care “information and support hub” that will be accessible to care workers and service users and their carers, families and advocates. This information and support hub has a members only area where Sunshine Care policies and procedures, training DVD’s, handouts, links to other relevant organisations, and a discussion and feedback forum can be viewed and participated in. This hub has been produced to enable us to actively seek participation by our customers and all relevant people in the various aspects of our care delivery practice.
The dementia-related handouts we have produced for care workers, and the people we support, include the following:
*Different types of dementia; *How people with dementia see the world; *Recognising the signs and symptoms of dementia; *Dealing with dementia and depression; *Making choices about care;*Stress and dementia; *Decision-making and independence; *Managing personal finances; *Independent advocacy; *Lasting power of attorney; *Dehydration; *Malnutrition; and * Therapies for people with dementia.