1. Workshop PEOPLE WITH DEMENTIA Barbara Sharp Practice Development Manager

2. Alzheimer Scotland Scotland’s only national voluntary sector organisation specialising in the support of people with dementia and their carers

3. Alzheimer Scotland Aim to –  be the national and local voice of people with dementia and their carers  to improve public policies  to provide and secure high quality services

4. Services … Day opportunities Home support Drop-in centres Café (De- café) Link workers and outreach workers Counselling Support groups Training for carers Specific services for specific groups of people – e.g. Younger people, Polish and Ukrainian community support Information 24hr Helpline Clinical Nurse Specialist Welfare rights service Palliative care projects

5. Understanding Dementia Cognitive Impairment Social Psychology Physical Health Disability Personality Environment Biography

6. Approach  Person  Dementia  Environment

8. Croftspar

9. Who Cares? The State of Dementia Care in Scotland 2006 91% of carer respondents had to cope with severe behavioural symptoms such as aggression, personality changes and ‘wandering’

10. Perceptions of behaviour Previous life experience Relationships Personality Expectations Values Attitudes Environment

12. Focus of approaches COMMUNICATION Relationships Identity and self esteem Emotions Orientation and reassurance Stimulation Acceptance Assessment Avoid multiple stimuli Predict and manage ‘stressors’ Prompt/maintain ADL skills Match capacity and pace Discreet, subtle support Analytical Evidence based and ‘Experimental’

13. Involvement and Learning Service users Staff Carers Other services and professionals

14. Partnership working Palliative care - ‘Beyond Barriers’ project Acute care  Clinical nurse specialist  Materials developed jointly - assessment; training; guidance; profiles Volunteer befriending Involvement of carers in training

15. Real life scenarios Miss Anderson has dementia and lives alone. Her sister stays nearby. Miss Anderson has recently taken to going out all day, every day, returning in the early evening obviously fairly exhausted. On inspection of these outings it appears that she has developed a routine of following a set path, frequenting several cafes en route. In each café she buys something to eat and chats to strangers. Her sister is extremely vexed at this situation (as Miss A would never normally have behaved like this and neighbours are phoning her) and she is concerned for her sister’s safety.

16. Real life scenarios David has a frontal lobe dementia and resides in a care home. Staff are finding aspects of his behaviour very difficult to cope with and the family are constantly complaining to them (36 complaints made in one month) about the care he receives. The main difficulty is that he is never still – he walks and walks and walks. Everyone feels frustrated and lost about what to do.

17. Real life scenarios Jenny was referred to our service from another local day care service where staff were finding that 2 staff had to be committed to her support on each visit to assist with mobility, eating and continence problems. Jenny was also described as disruptive and and verbally critical of other service users.

18. Real Life Scenarios Margaret leaves her home and returns with goods from a local shop that she has not paid for. Her ‘shoplifting’ trips become a regular feature (totally out of character) much to the embarrassment of her husband and annoyance of the shopkeeper.

19. Supporting Good Practice Good Practice Learning Culture Support Guidance Policy Process Cont Improvement Standards Audit Involvement Sharing ITP’s Prof. development Recruitment Induction Tools Resources

20. Staff Training ‘ We believe effective induction, training, support and development of staff are key factors in providing job satisfaction and achieving high quality service delivery to people with dementia and their carers’ “I feel doing my SVQ has given me more confidence in what I do and a better understanding of why I do things in a certain way. I think it makes me better at my job. I feel able to challenge things when I think something is wrong” J.A. Day Care Organiser SVQ candidate

21. Key Principles Strong team approach Innovative and motivated staff Tolerance/acceptance Assessment Person centred/relationship approach

22. More than one way to look at things…

23. www.alzscot.org

24. Barbara Sharp Practice Development Manager Alzheimer Scotland 81 Oxford Street Glasgow G5 9EP Phone: 0141 418 3935 Email: bsharp@alzscot.orgbsharp@alzscot.org