1. Vimla Sharma Matron for Care of the Elderly Dementia-- Challenges for Nurses

2. The Alzheimer’s Society Estimates 800,000 people with Dementia in the UK 17,000 are under 65 years of age Use of acute hospital is high ¼ of beds occupied by over 65 years 1/3 of over 90 years olds suffer from Dementia Alzheimer’s Society Predicts – more than 1 million people with Dementia by 2021.

3. Issues Environment on general wards is not ideal Separation from familiar people Change in routine Longer length of stay in hospital Insufficient facilities in community

4. Effects of Dementia Increased dependence Decreased quality of life Decreased autonomy Increased anxiety Low mood (tearful) Sundowning + sleep / wake reversal Irritable / frustration & aggression Wandering, hiding things, purposeless activities Hallucinations

5. Signs & Symptoms of Dementia Short term memory loss Hard to follow conversation Forgetting the names of friends / or everyday objects Losing the thread of what you are saying Problems with thinking and reasoning Feeling anxious, depressed or angry about forgetfulness Confused even when in familiar environment Decline in ability to talk, read or write.

6. Priorities of the Dementia Strategy 1.Good quality early diagnosis and intervention for all 2. Improved quality of care in general hospital 3. Living well with Dementia in care homes 4. Reduced use of antipsychotic medications.

7. Staff need … Compassion and Caring Competence – knowledge, judgement skills and experience Confidence + Courage – quality which fosters trust Comportment – manner, dress and language Conscience – A state of moral awareness Commitment – understanding of what it means to be a professional

8. Training Needs E-learning on Dementia Care E-learning on End of life care 1 day study day on Multidisciplinary at University of Bedfordshire In house training with Partnership from SEPT

9. Essence of Care Excellent communication with patients Privacy and dignity Personal and Oral hygiene – clean spectacles, working hearing aids Nutrition and Hydration - protected meal times - 2 hourly ward rounds - use of volunteers @ mealtimes Prevention of pressure ulcers Continence Safety of patients with mental health needs (wander guard, sensor seating system, use of cot sides and low rise beds) Principals of self care (advocate to enable patients to have control over own health care) Working in partnership with carers / family Record keeping - “this is me” patient profile Improved signage to the toilets and bathrooms

10. Essence of Care Pg 2 Safeguarding of venerable adults – Staff training S.O.V.A Mental Capacity Deprivation of liberty I.M.C.A.S (2007) End of life care Advanced directive Living Wills Pain Control – visual pain score charts Diversional therapy – activity boxes

11. Dementia Task & Finish Group CQUIN Target –all patients over 75 years will be assessed on admission or within 72 hours Plans for appointment of Dementia Specialist Nurse Assessing patients who are at risk of falls or harm Specialising 1 to 1 or cohort – policy for specialising in place

12. THANK YOU for listening Any Questions ???