1. Aim The aim of this poster is to highlight examples of projects that we have been developing over the past couple of years and how, in the past year, they have really started to become embedded in the minds of our community. Some of these initiatives have helped change the experience of people with dementia in the acute hospital and others have changed the views of the community as to how people with dementia can be cared for in a different way. Alan Murdoch Dementia Services Nurse Manager Grantfield, Lerwick ZE1 0NT Telephone 01595744322 Email alan.murdoch@nhs.net Introduction There has been a lot of positive work taking place in Shetland since the Dementia Champions programme began. The initial focus was within our acute hospital and predated the introduction of the 10 Care Actions. Our first Champions focussed on making small changes within their own workplace to support their colleagues to deliver care to people with dementia when in their care. Over the past year we have developed support in the hospital but have also focussed on changes that can be seen to benefit people with dementia in the community too, with the intention of keeping the person with dementia in their own home whenever possible and avoiding unnecessary admissions to hospital. This can be seen through our integrated partnership working between colleagues in health, social care, Alzheimer Scotland, housing as well as the person with dementia and their family and carers and the community as a whole to help people live well with their diagnosis. 4.Redesigning housing for people with dementia One of our Champions in Social Care has been working closely with the Local Authority Housing Department to develop a new model of care for people with dementia who would previously required residential care. A three bedroom flat in King Erik House extra care housing has been adapted to create a dementia friendly design with extensive use of telecare. The flat has three ladies living in it with dementia who were either in residential care or in the acute hospital awaiting a placement in residential care. The social care team has been adapted by this Champion to be able to provide care to these ladies when required without being intrusive. This has allowed them to retain a good degree of independence and regain skills that were being lost in the previous care settings. This model is now being looked at with a view to developing further. 5.Working in Partnership We have been working on a number of projects in the community setting to try to avoid people with dementia being unnecessarily admitted to hospital. We have developed Anticipatory Care Plans (ACP) which the person with dementia and/or their carers are encouraged to complete. This plan then remains with them and they can take it with them if they are admitted to hospital or other care settings to help the team better plan their care and discharge planning. The intention is to have this available as an electronic version that would be able to be accessed by health and social care staff if the person presents in an unscheduled way. This has resulted in several hospital admissions being avoided when the person has presented out of hours as those attending have been able to see the ACP and understand the person’s needs better enabling them to contact more appropriate support other than a hospital admission. Our social care team have changed some of their work patterns in some episodes of end of life care in order to keep the person in their own home rather than be taken into care. They have been able to work in partnership with the family using Direct Payments to enable the family to purchase some care to complement that being delivered by the care team and the family. Again these changes have been made possible by our Dementia Champion who manages this part of the service being able to focus on delivering a person centred approach.. 10 Dementia Care Actions in Hospital and Beyond Five Key Examples of Improvements in Care 1.Introduction of Getting To Know Me for people with dementia in our surgical Ward One of our first Dementia Champions initially introduced the This is Me document for all patients in the older person’s ward where she worked. Once Getting to Know Me was developed this replaced it. This proved to be popular with staff, patients and family and t has recently been introduced for people with a diagnosis of dementia in our surgical ward and nursing staff are finding it is helping them to have a closer working relationship between them, the person with dementia and their family/carers. It is expected that the medical ward will introduce it early in 2015. 2.Development of a “Memory Book” in the A&E Department Our Champions in this department wanted to find a way to minimise any distress for people with dementia when they presented in A&E. After some discussion they decided to develop a folder with old pictures of Shetland from the Museum archives. The nursing staff have been able to use the photographs in it to initiate discussion and better engage with people with dementia and found that looking through the folder helps to reduce anxiety for the person. This folder has also proven to be popular with older people in general while they are waiting in the department to be seen. 3.Dementia Experiential Training for Community Nurses Two Community Nurses who have just completed the Champions programme have been developing a programme for their colleagues based on their experience on the programme. They have taken the materials from the session that allowed them to experience how it feels to have dementia and are intending using these to develop awareness with their colleagues and help understand why a person with dementia may present with stress and distress. They hope to then extend these sessions to hospital colleagues. King Erik House extra care housing, Lerwick, Shetland.