1. LLT dementia1 Dementia - Update and implications for Later Life Training - 1 st steps

2. LLT dementia2 Session overview Why dementia now ? Sources of information (group activity) The strengthening evidence - summary Implications for LLT programmes Implications for LLT tutors (group activity) Next steps

3. LLT dementia3 Purpose of session To understand the importance of dementia to Later Life Training and tutors To share own knowledge and experience of working with people with dementia To begin to look at issues and topics that (might) affect the delivery of LLT courses To highlight sources of information

4. LLT dementia4 Why dementia and LLT now ? The number of people with dementia is increasing as our population ages To ensure where possible, the inclusion of all (frailer) older people in LLT programmes At last, significant activity in national policy and strategy development Evidence re physical activity and exercise is getting stronger – we have a role to play As a response to tutor and partner requests Our own personal experiences

5. LLT dementia5 Paired activity Pub quiz – what do we know ? Just how important is this ?

6. LLT dementia6 A growing concern Increasing with the ageing population Costs to society are huge A cure may be some 25 -30 years away Causes are not fully understood but lifestyle factors are know to be significant Not a normal part of ageing, it is a disease Everyone experiences dementia differently The New Cancer ?

7. LLT dementia7 Coming to the top of the agenda ? National Strategy (England) to be launched in the New Year Complimentary activity across the UK NICE SCIE Guidance already published (2006) Whole systems approach, not just mental health services Current costs (£17 B) already outstrip CHD, cancer and stroke put together We are now concerned with/about the (increasing) older, older generation French EU presidency gives priority to Alzheimer’s disease

8. LLT dementia8 Stand by your man !” Jack Wooley has Alzheimer’s Disease He is being sprung out of the Willows Nursing Home by Peggy “Where are we going dear ?”

9. LLT dementia9 The Dementia Strategy (England) Three Key components Improving public and professional awareness of dementia Early diagnosis and intervention High quality care and support for people with dementia and their carers

10. LLT dementia10 The potential to contribute e.g. to the Dementia Strategy Key components Improving public and professional awareness of dementia (our professional audiences ?) Early diagnosis and intervention (quality of life, independence and mobility) High quality care and support for people with dementia and their carers (programming + carer support and functioning)

11. LLT dementia11 The potential to contribute: - physical activity and exercise The evidence is getting stronger all the time Prevention (lifestyle factors) Treatment (delay of progression) and care (maintaining independence) Related health/risk factors e.g. stroke, diabetes, falls People with dementia will experience a range of associated benefits (improved mood, sleep, digestion, social inclusion) Physical functioning, quality of life of care-givers

12. LLT dementia12 Falls and dementia Dementia is a risk factor for falls Evidence is emerging but not strong Wraith M (2008) Reduction in falls found for people with dementia from carer-directed home exercise program. Wraith M (2008) Carer-directed home exercise programs maintain quality of life for people with dementia over 12 months. Rapp K (2008) Falls intervention (multifactorial) more effective in those with cognitive impairment Shaw F (2005) Falls intervention (multifactorial) NOT effective in those with cognitive impairment – but little exercise in intervention!

13. LLT dementia13 Exercise and the brain Enhancement of growth factors Increased blood flow Lower loss of corticol volume Activation of attention and memory Structure and function

14. LLT dementia14 Application to delivery of our current programmes Skills, strategies and components that might affect out teaching Individuality – person centre care Working with the carer Challenging behaviours The environmentCommunicationsPerformance Risk assessmentScreening and assessment to exercise Pain

15. LLT dementia15 Application to delivery of our current programmes Skills, strategies and components that might affect out teaching Individuality – person centre care Working with the carer Challenging behaviours The environment Communications Performance Risk assessmentScreening and assessment to exercise Pain

16. LLT dementia16 Communications - guidelines and advice Use the list provided and apply to your teaching of one of the following exercises Walking and turning around (OEP & PSI) Knee bends with support (OEP) Side stepping (PSI) Heel or toe walk (PSI) What are the implications for your teaching and communication strategies ?

17. LLT dementia17 Implications for LLT Tutors 1.Application to delivery of our current programmes – how ? 2.Exercise, physical activity and movement for all people with dementia 3.Awareness raising amongst service providers, commissioners and care givers 4.The health and functioning of care givers

18. LLT dementia18 Next steps Discussions with NAPA and Alzheimer’s Society have begun Further look at emerging evidence Piloting work on awareness raising, physical activity and exercise More detailed proofing of LLT programmes Working towards CPD and other products ?

19. LLT dementia19 Thank you and we would welcome your thoughts, ideas, skills and experience as we move this forward