1. Alzheimer’s & Dementia S U P P O R T S E R V I C E S Sarah Parsons Senior Nurse Service Modernisation, Adult Medicine, Darent Valley Hospital

2. Dementia Buddy Pilot Project Sarah Parsons Senior Nurse Service Modernisation, Adult Medicine, DVH Ann Aldous-Dunn Dementia Buddy Co-ordinator, ADSS March 2013

3. Background Dementia costs the health and social care economy more than cancer, heart disease and stroke combined (Alzheimer’s Society, 2007). Dementia costs the health and social care economy more than cancer, heart disease and stroke combined (Alzheimer’s Society, 2007). In 2010 in West Kent 7,834 people were estimated to have late onset dementia. In 2010 in West Kent 7,834 people were estimated to have late onset dementia. By 2013, this is expected to have increased by 13% to 8,837 and by 2023 an estimated 50% increase to 11,692 people. (Kent County Council and NHS West Kent, 2010). By 2013, this is expected to have increased by 13% to 8,837 and by 2023 an estimated 50% increase to 11,692 people. (Kent County Council and NHS West Kent, 2010). Intermediate care services did not respond to the needs of people with dementia, as a consequence individuals with dementia were more likely to be admitted to hospital, and once there, the length of stay tends to be considerably longer than expected. Intermediate care services did not respond to the needs of people with dementia, as a consequence individuals with dementia were more likely to be admitted to hospital, and once there, the length of stay tends to be considerably longer than expected. DVH Case Mix Analysis 2010 DVH Case Mix Analysis 2010  Average length of stay being 34.7 days  ‘Non acute’ admissions  Poor outcome

4. What is a Dementia Buddy? A trained volunteer who has a good understanding of dementia and knows how to engage positively with people with dementia to improve their well being.

5. The Dementia Buddy Scheme The Dementia Buddy scheme is a pilot project, initially running for one year, up to end of June 2013. The Dementia Buddy scheme is a pilot project, initially running for one year, up to end of June 2013. It is funded by Kent Adult Social Services It is funded by Kent Adult Social Services £30,000 was awarded following a competitive tender process to the Alzheimer’s & Dementia Support Services (ADSS), a local independent charity. £30,000 was awarded following a competitive tender process to the Alzheimer’s & Dementia Support Services (ADSS), a local independent charity. The funding for the project was used to create a Dementia Buddy co-ordinator post to facilitate the recruitment, training and supervision of 20 Dementia Buddy Volunteers. The funding for the project was used to create a Dementia Buddy co-ordinator post to facilitate the recruitment, training and supervision of 20 Dementia Buddy Volunteers. The volunteers receive full training from the Alzheimer’s & Dementia Support Services to become ‘Dementia Buddies’ for patients with dementia who are admitted to Darent Valley Hospital. The volunteers receive full training from the Alzheimer’s & Dementia Support Services to become ‘Dementia Buddies’ for patients with dementia who are admitted to Darent Valley Hospital.

6. Training Core induction at Darent Valley Hospital (DVH) which includes infection control, food handling & health & safety issues Core induction at Darent Valley Hospital (DVH) which includes infection control, food handling & health & safety issues Adult protection training – Level 1 – Kent County Council Adult protection training – Level 1 – Kent County Council Mental capacity act training – Level 1 – Kent County Council Mental capacity act training – Level 1 – Kent County Council Dementia and cultural awareness in dementia training – ADSS Dementia and cultural awareness in dementia training – ADSS Induction – ADSS – Confidentiality, Adult Protection reporting Induction – ADSS – Confidentiality, Adult Protection reporting Day to day support, monthly supervision & annual appraisal Day to day support, monthly supervision & annual appraisal All volunteers have an enhanced CRB (now known as the Disclosure, and Barring check) All volunteers have an enhanced CRB (now known as the Disclosure, and Barring check) Two references taken up and are assessed by the Occupational Health team at DVH. Two references taken up and are assessed by the Occupational Health team at DVH.

7. Partnership working with staff to ensure best outcomes for patients with dementia Increased social interaction Engage in activities to maintain cognitive capabilities Provide information and support to carers Signposting to support services. Encourage and assist with food and drink Keep basic records

8. Potential Outcomes Improvement in the overall hospital experience for people with dementia Improvement in the overall hospital experience for people with dementia Improve the sense of well being and dignity through cognitive stimulation and improvement in nutrition by assisting with food /drink intake Improve the sense of well being and dignity through cognitive stimulation and improvement in nutrition by assisting with food /drink intake Reduction in Length of Stay by improving wellbeing & food/drink intake and maintaining cognitive stimulation. Reduction in Length of Stay by improving wellbeing & food/drink intake and maintaining cognitive stimulation. Reduction in the number of 28 day emergency re- admissions by ensuring that the Carers/person with Dementia feel more supported and therefore more able to cope after leaving hospital, particularly with access to support services. Reduction in the number of 28 day emergency re- admissions by ensuring that the Carers/person with Dementia feel more supported and therefore more able to cope after leaving hospital, particularly with access to support services.

9. Increase in number of patients with dementia returning to own homes rather than admission to hospital or placement in Care Home. Increase in number of patients with dementia returning to own homes rather than admission to hospital or placement in Care Home.  This will be achieved by giving early support to the person with dementia and their carer with information about local services such as short breaks & care at home services Reduction in cost to Acute Trust of requiring, one to one nursing, of ‘at risk’ patients with dementia Reduction in cost to Acute Trust of requiring, one to one nursing, of ‘at risk’ patients with dementia

10. Scope of Project Initially the project has been piloted on Ebony Ward, the Elderly Care Ward, at Darent Valley Hospital with up to four buddies in situ (dependent on availability) between 10:00am until 2:00pm, Monday to Friday

11. Implementation The Dementia Buddy Co-ordinator was recruited and took up post in June 2012. The Dementia Buddy Co-ordinator was recruited and took up post in June 2012. The post is managed by ADSS but is based at Darent Valley Hospital with additional management support from the Hospital’s Dementia Project Lead. The post is managed by ADSS but is based at Darent Valley Hospital with additional management support from the Hospital’s Dementia Project Lead. Agreement for pathways, protocols and documentation which both the ADSS and DVH were happy to use for the project. Agreement for pathways, protocols and documentation which both the ADSS and DVH were happy to use for the project. A monthly project steering group was implemented to monitor progress and evaluate the impact of the project, with membership consisting of representatives from the hospital, ADSS and Kent Adult Social Services Commissioning. A monthly project steering group was implemented to monitor progress and evaluate the impact of the project, with membership consisting of representatives from the hospital, ADSS and Kent Adult Social Services Commissioning.

12. Baseline information was collected to enable the evaluation process of both qualitative and quantative data Baseline information was collected to enable the evaluation process of both qualitative and quantative data This consisted of:  An observational audit using the Observational Person, Interactions and Environment (PIE) Method for Hospital Audit of Dementia created by Bradford Teaching Hospitals NHS Foundation Trust  Satisfaction surveys requesting feedback from ward staff, dementia buddies, patients and/or carers/relatives  Data specific to Ebony Ward including Length of Stay, incident reports/falls, complaints, 1:1 at risk nursing requirements, and discharge destination/outcome; Readmission rates.  Aim to repeat same data analysis for interim review 6 months after implementation

13. Going Live! First Buddy in place on Ebony Ward in August First Buddy in place on Ebony Ward in August Media Launch on 26 October Media Launch on 26 October

14. Progress so far Currently 14 volunteer dementia buddies are in place on Ebony Ward having completed the relevant processes & training. Currently 14 volunteer dementia buddies are in place on Ebony Ward having completed the relevant processes & training. Recently (February 2013) the Buddy Service was extended to Maple Ward (Orthopaedics) with 3 volunteers in place Recently (February 2013) the Buddy Service was extended to Maple Ward (Orthopaedics) with 3 volunteers in place 12 more buddies are at various stages within the recruitment pathway 12 more buddies are at various stages within the recruitment pathway Making a total of 26 buddies Making a total of 26 buddies 14 new applications received 14 new applications received 3 potential recruits would like to work weekends once the service has expanded to 7 days per week 3 potential recruits would like to work weekends once the service has expanded to 7 days per week

15. Future Plans Dementia Challenge funding: Dementia Challenge funding:  Dementia Specialist Practitioner  Environmental changes: Signage Signage Pilot Colour Scheme in bays (Ebony) Pilot Colour Scheme in bays (Ebony) Pictures relating to colours Pictures relating to colours Bed spreads Bed spreads Curtains Curtains Toilet Seats Toilet Seats Charitable Funds: Charitable Funds:  Picture books/memory boxes  Reminiscence corridor  MP3  Sensory Garden Laundry Laundry Expansion of Dementia Buddy Scheme Expansion of Dementia Buddy Scheme