SCOTLAND

1
SCOTLANDS DEMENTIA STRATEGY

• AND
• PERSONALISATION

2
Scotlands National Dementia Strategy

• The key points from 2010 document

3
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

4
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

5
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

6
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

7
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

8
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
9
Dementia in Scotland

• (Alzheimers Scotland 2007)
• Currently 71,000 in total
• - 60 in community
• - 40 in institutional (long stay) care
• Projected to rise to 127,000 by 2031 (Alzheimers
  Scotland 2010)

10
PERSONALISATION

• AN INTRODUCTION

11
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

12
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)

13
What is Personalisation

• Begins with the person, not the service
• Recognises the persons strengths, preferences,
  networks of support
• Individual is best placed to make decisions about
  their life

14
What is Personalisation

• Accessible information and advice
• Irrespective of whether self funded or publicly
  funded
• Its about giving people choice and control over
  their lives

15
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

16
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)

17
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.

18
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 thats right
  for them

19
Some Common Terms

• Person centred planning
• Person centred care
• Person centred support
• Independent living
• Self directed support

20
Personalisation

• Implementing Personalisation

21
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

22
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

23
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

24
Communication tips

• DONT
• Try to communicate when there are distractions
• Use long complicated sentences (or jargon)
• Talk about doing something long before you do it
• Assume that pronouns 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

25
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

26
FINAL POINT

• The person with dementia cant adapt to us we
  need to adapt our social, clinical and structural
  environment around the person.
• At the very least dont disable the person
  further!

27

• THANK YOU