Staff training - & related issues what (needs to) change? James Churchill Chief Executive Association for Real Change 1

Staff training - what (needs to) change? Look around and start where you are at now Learn from what others have done 2

Staff training - what (needs to) change? What does ‘growing older’ mean? 1.Looking from a physical viewpoint 2.Looking from a social viewpoint 3.Looking from a psychological viewpoint 3

Percentage of people with Down’s syndrome affected by Alzheimer’s Disease (McQuillan, Kaisy et al 2003) Age in yearspercentage rate % % % % on average 5% of the general population aged 65 will have dementia and this increases with age. 4

Downs Syndrome Congenital heart defects Gastrointestinal problems Visual & hearing disorders (related to old age) Infections, Decreased longevity Fragile X syndrome Mitral vale prolapse, Musculoskeletal problems Early Menopause, Epilepsy Prader-Willi Syndrome Obesity related Diabetes Obesity related Heart Conditions 5

Do staff know about these conditions? Can they identify them? Would they know what to do to help people who suffer from the? NB Danger of Staff and carers perception of what is ‘normal’ for this group of people? 6

A clear body of specialist extra knowledge Not just knowledge, but competence is needed in staff group Majority of people are living in the community with older parents - complex situations need imaginative solutions 7

8 How should services respond? Marie, aged 60, has lived with her mother all her life. Her mother is now in her 80’s and has become too frail to cope at home any more, despite intensive efforts from the local Social Services home support team. Both Marie and her mother have moved into a residential home for older people, together. The joint placement was a success. A couple of years later Marie’s mother died and Marie has stayed on in the residential home. Cally Ward Preparing for a Positive Future ARC 1998

GOLD programme (Growing Older with Learning Disability) media>articles Today & Tomorrow (October 2002) A charter of rights for older people with learning disabilities and for older family carers. 9

What does this mean for staff training? Who needs to be trained? -more than just care home staff How can the training be made easily available? More than just a ‘common core’ - extra knowledge is needed - staff must see the bigger picture to offer real support 10

How does your society regard older people? Residential care the option of ‘last resort’ People being ‘put away’ in a home Going into a care home is like having one foot in the grave Funders see generic services as cheaper and of acceptable standard - so why create something special (and more expensive) ? 11

Checklist for Commissioners Do you buy the following? Values & Visions Person Centred Approach incorporating age related needs Lifestyle planning in later life Staff competent to meet age related needs Optimising the physical environment Planning for future needs Optimising health –Promoting Physical/emotional well-being – Managing complex health problems 12 Of course they (say they) do!! Cally Ward, Preparing for a Positive Future ARC

Small ‘units’ of knowledge - easy to learn Relates directly to national qualifications Can develop specialist knowledge Available from entry level to 1st year of degree course 13

Unit 035 Help service user to manage dementia Aims of unit: This unit enables workers to understand the common symptoms associated with dementia, & their effects on service users. It considers the vulnerability of people with learning disabilities to developing early dementia, & to the possibilities of misdiagnosis. The unit covers ways in which the health & social life of people who are developing dementia can be optimised, & identifies sources of specialist support & advice which may be needed. Application to service user group/setting: This unit is applicable where service users are developing, or are at risk of developing, dementia. This may occur in any service setting. 14

Unit 035 Help service user to manage dementia Learning outcomes: The learner should be able to: 1Understand the different kinds of dementia, and their likely effects on the individual 2Understand the greater prevalence and earlier onset of Alzheimers disease amongst people with Downs Syndrome 3Understand the circumstances in which a misdiagnosis of Alzheimers disease may occur 4Identify ways of optimising the health of people developing, or at risk of developing, dementia 15

Unit 035 Help service user to manage dementia Learning outcomes: 5 Understand the importance of encouraging and supporting the social contacts of people who are developing dementia 6Understand the importance of maintaining accurate records and noting any changes in an individual’s condition 7 Identify individuals & organisations who can provide specialist medical care, information & support in relation to dementia 8 Understand the possible social impact of dementia for the service user 16

Some other specialist LDAF units Managing the health care and support needs of older people Providing palliative care For more information visit 17

3 main statements of presentation 1Build services for older people with disability round the needs of the individual & think through what that means - are our commissioners and providers really up for it? 2Know what staff need to know in order to do their job well & find a way of delivering that knowledge 3Keep asking people who use the services and their carers what they think of the service & act on their responses. 18