Dementia training in Norwich – to reduce the reliance on antipsychotic medication Training to support Care workers in care homes Clare Daly and Penny Levett Started in 2009 – pilot Monthly ish 30 per course Taught 400 approx

Origins In advance of the national strategy Safeguarding issue in West Norfolk Developed in conjunction with CSCI To introduce alternative management techniques rather than over reliance on medication

Training Combines medication and alternatives One day Developed and delivered by specialist staff Off site Interactive! Specialist staff allow for annecodateos and questions to be answered Part of wider PCT initiative Follows national guidance

Pharmacy training Outlines the appropriate use of medication in dementia Looks at Behavioural and Psychological Symptoms of Dementia Looks at treatment with antipsychotics Looks at side effects / cautions Looks at medication management as part of the broader picture in dementia

Non medication training Based on principles of Tom Kitwood ‘Person Centred Care’ overused and misused Go back to PCC roots – looks at the flower and the support these people need to achieve these basics rights If support not there or forth coming - clash

Non medication training Considers full understanding of persons history and how it impacts on current presentation Insight into coping strategies How the past influences their responses to others

Looks at practical application of this Potential restrictive nature of risk assessments Removal of all risk impractical and restricting

Looks at memory How it is stored and how that influences and disorientates

Behaviour Challenging behaviour arises from misinterpretation of intentions and actions Get carers to think about it in a situation that they can relate to

Busy boxes and diaries Appropriate to the person Distraction and enjoyment Allow you to become a detective Can accurately report to GP

Case studies allows learning into practice Allows sharing of good practice Encourages discussion Real life examples

Challenges we have encountered Keenness to change but perceived difficulties Lack of awareness of alternatives to medication Lack of awareness from GPs about alternatives – reliance on mediation Change from ‘prn’ medication to regular medication Culture Resources Time Rules

Future direction Waiting for outcome of a research bid RfBP to take this further

Any questions