1. Henry Simmons – Chief Executive Shifting the paradigm!

2. Vision for change Early diagnosis Post Diagnosis Integrated Care Acute General Health Care Advanced Illness Dementia Friendly Community

3. Lessons from Acute Care Negative paradigm ‒ Don’t get stuck in older persons care ‒ Care of the “elderly” is not that skilled ‒ Why are they here? ‒ I did not sign up for this ‒ We need more dementia specialist units ‒ We are too busy for this New paradigm Caring for older people is Acute Care and it is highly skilled. Dementia, delirium and depression in an over 65 year old person is most common presentation. We all need skills and confidence in dementia care We can provide quality care in situ.

4. Negative paradigm Damaged psychological contract Impacts on : Behaviour Commitment Motivation Morale Engagement Poor standards Stress Denial Dissatisfaction Move the problem Poor outcomes Poor standards Stress Denial Dissatisfaction Move the problem Poor outcomes Leads to: Embracing Engaging Change Leadership Transforming Repairs broken psychological contract ASDN DC Standards PE 10 actions New Paradigm Paradigm shift in Acute Care

5. Specialist dementia care Negative paradigm ‒ Burden ‒ Poor career choice ‒ No investment ‒ Is it needed- generic is ok ‒ Not a priority ‒ No sense of exceptional ‒ Not highly skilled ‒ Not valued ‒ Less quality staff New paradigm Most highly skilled area in health and social care practice Needs best quality staff Exceptional human intervention Exceptional environments An area worth investing in A well supported, challenging and dynamic arena Good career choice

6. Negative paradigm Damaging psychological contract Impacts on : Behaviour Commitment Motivation Morale Engagement High turnover High absence Poor motivation Poor quality Loss of hope Lack of worth Lack of investment High turnover High absence Poor motivation Poor quality Loss of hope Lack of worth Lack of investment Need a new vision New sense of value New commitment Need to work together and repair broken psychological contract Need focus on staff, leadership and investment New Paradigm Paradigm shift in specialist dementia care