Teaching dementia care in Sweden An example from Silviahemmet

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Teaching dementia care in Sweden An example
from Silviahemmet

• Dr Wilhelmina Hoffman MD

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Her Majesty the Queen of Sweden
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Silviahemmet

• 1996 - opening on Valentine's day
• Education for assistant nurses ( licensed
  practical nurses) in dementia care
• Day care unit initially for practice
• 2000 Teaching for Learning and Learning for
  Teaching
• in Care of Elderly with Dementia - Thesis by
  M. Skog
• 2001 34 Silvia sisters in Sweden

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Silvia sister assistant nurse withspecial
education in dementia care

• Picture

• Since 2004
• the education in co-operation with Sophiahemmet
  University College
• A two year part-time education over internet
• Students from all over Sweden

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Silvia sister Examination Day8th of June 2006
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SilviahemmetDay care and Education unit
Drottningholm, Stockholm
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The Swedish perspective of dementia

• Inhabitants 8.9 millions
• Dementia cases 140. 000
• Dementia new cases 21.000/ year
• Alzheimer's disease 66
• Cost / year 40 billion (sek)
• County council Primary care/ memory wards
• Municipality Home help, care settings

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Quality in care (from a Swedish survey, 2001)

• Clear leadership
• Educated staff
• Common care philosophy

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Palliative care philosophy

• A chronic and incurable disease
• (an early, often long phase then a late phase,
  often shorter)
• An active total care
• including control and relieve of different
  symptoms as well as problems of psychic, social
  or existential character
• Obtain quality of life
• for the patient and the family

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Palliative care philosophy-the four cornerstones-

• Control of symptoms
• Teamwork
• Family support
• Communication and relation
• Silviahemmet quality assure the care through the
  four cornerstones for each patient

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Communication and relation
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Alzheimers disease the progression
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(MMSE)
Mild
25
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Moderate
15
10
Severe
5
Terminal
0
1 2 3 4 5 6 7 8 9
Time ( year)
Feldman and Gracon 1996
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The dementia journey
hallucination

• Our aim is to educate in the best dementia care -
  to make the long journey safe and secure for the
  patient and the family
• - wherever the train stops

depression
aggressiveness
incontinence
delusion
apraxia
confusion
wandering
agnosia
spasm
etc.
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Education in practical dementia care

• Demographic picture, epidemiology
• Normal ageing
• Different dementia diseases
• Symptoms during dementia progression - how to
  interpret and treat
• (cognitive, psychiatric, behavioural, physical
  symptoms)
• Medication
• Nutrition
• Incontinence
• Family support
• Teamwork
• Communication relation
• Tactile care
• Technical devices
• The good environment
• Ethical issues
• Existential issues

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Examples of educations at Silviahemmet

• Team one week and follow up 6/year
• Seminars one day ( different professions,
  different themes ) 6-8/year
• Family education one day
  6/year
• Care worker one day 8-12/year
• Nurses - dementia care two days
  2/year
• Education in supervising for assistant nurses
• 5 days 2/year

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Examples of educations from Silviahemmet

• Educations in different care settings (on demand)
• Supervising in Home Help Service (project one
  year)
• Education of teachers Silviahem instructors (
  Japan )

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When follow up - what do the student say?

• - I have learned to respect the person with
  dementia
• - I have better tools than before
• - I feel proud of my work now
• - I think my work is more stimulating now
• - I am more secure and work is more fun
• - I want to learn more!

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Can education change the care situation - what do
we see?

• In Home help services
• In Day care
• In Care settings
• Concerning the patient, the family, medication,
  teamwork etc.

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Ongoing work for the future

• New education material different themes
• A book in practical dementia care for care
  staff
• Hopefully a Silvia sister education for nurses
• ( and physicians )
• Hopefully a National dementia service centre!

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Thank You for listening!