COLLABORATION: Empowering clinical practice in dementia care Danielle Kennedy Aged Care Nurse Practitioner PGNA Conference September 13th 2019

Discussion points Ageing Australia: Service availability and access Changes and challenges The remote, rural & regional perspective Service availability and access Promoting collaboration Empowering local staff There are significant changes and challenges projected with an Ageing Australia Severe behavioural change associated with dementia Mental health in the older person Age Service awareness Service access and accessibility RACF Home care packages Fragmentation of services Carer impact Collaborative practice …..Are we meeting the needs of our clients?

REMOTE, RURAL & REGIONAL: Murrumbidgee Local Health District

Brodaty, Draper & Lee (2003)

Severe BPSD “Ronald, is an 89 gentleman, who was recently admitted into RAC. He had a suspected dementia (no formal diagnosis) with associated behaviours of concern (exit-seeking, sexually inappropriate and intrusive behaviours, disturbed sleep-wake cycle and verbal and physical aggression). His behavioural change was ongoing with increasing episodes of physical aggression and he was entering and propositioning female residents”. 

The evolution of BPSD Empowering local clinicians

Getting to the real referral What is Dementia? Dementia is an organic brain syndrome that is characterized by loss of intellectual ability. Many definitions of dementia exist , most include impairment of cognition, social and occupational functioning, and impairment in performance in activities of daily living. Dementia is a progressive syndrome with persistent dysfunction in intellectual ability, affecting thinking, memory, language, understanding, praxis (performance of an action), gnosia (faculty of perceiving and recognising), executive functioning (planning and decision making), communication and calculation. Disturbances of mood and alterations in demeanour often accompany the intellectual deterioration. COLLABORATIVE PRACTICE

The collaborative approach: Enhancers Barriers Transparency Understanding Effective communication Interdisciplinary relationships Service awareness/access Ineffective communication Models of care Organisational silos

Points of referral Local management RANZGP, 2013

The collaborative approach in BPSD MDT Role clarification Communication Agreements and plans Knowledge and skills Link workers Quality improvement ELDAC, 2019