Issue No. 5, May 2014

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1 Issue No. 5, May 2014 OPAC on TRACK We wanted to update you as to the huge amount of work ongoing in regards to OPAC in Raigmore. We realise it has been a while since we last issued this newsletter, however, we will now commit to publish an update on a quarterly basis. Further updates and related material can be found at our OPAC intranet site which is at: Programme meets challenges head-on Population ageing will continue for the next few decades with the number of people aged over 85 reaching 3.5 million by 2035, accounting for five per cent of the Scotland s population. Similarly, people aged over 65 will account for 23 per cent of the populace. Every four seconds, some is diagnosed with dementia. There is an estimated 44.4 million people across the world with the condition with this number expected to grow to a staggering 75.6 million in the next 15 years. These changing demographics provide a number challenges and opportunities for both the Health and Social Care systems in planning service delivery for older people. The Health Boards from NHS Highland, Western Isles and Forth Valley, along with the School of Midwifery and Health at the University of Stirling recognise that in order to face these challenges head on, a programme of education, research and practice is essential. The University s new Masters in Health and Wellbeing of the Older Person reflects the growing priorities identified for an improved and more responsive level of healthcare for older people. It s a new programme, but it s also an important one, especially at the Postgraduate level, to develop those change agents and build leadership capacity that is required, says Leah Macaden, Lecturer on the programme at the University. As you know, the population demographics have been changing globally and as a result, we need to be looking at the care of the older person that requires specialised expertise. Their needs and problems are different most older people will have more than one medical condition that can impact on each other and really affect their health and wellbeing. I think it s really important for practitioners in health and social care to have that enhanced level of knowledge and skills to look after these people. This Masters programme is designed with that as the key focus. The programme is unique in many different ways. Over the course of their first year, students will undertake three modules covering the complexities of caring for older people, dementia and meaningfully contribute to care delivery through an action research project around care of the older person. Case studies are extensively used to illustrate real-life challenges for older people that require critical engagement from students both with learning materials and assessments. With numbers rising year on year, Leah believes there is an appetite for this type of programme. The programme has been running for two years and we have had an increase in the number of students already 19 compared to 15 in the first year, Leah said. What is also exciting is that the course had multiple pathways. Students can receive their Masters, PG Cert or a PG diploma but can also do stand alone modules, Continued on next page

2 Continued from front page Alzheimer Scotland works throughout the year to raise awareness of dementia. The theme of this year s Scotland s Dementia Awareness Week is Let s talk about dementia and will run from 2-8 June During the annual Dementia Awareness week Alzheimer Scotland will concentrate efforts to reach out to people across Scotland. There s a national conference, Programme meets challenges head on Lorna Harcus, one of the Masters students on Leah s course, has recently finished her dissertation on a unique tool aimed at falls prevention. We had to do our dissertation on improving the health and wellbeing of the older person, said Lorna. I work in the East Ross Community team and through that, I developed an interest in preventing falls. I completed my dissertation on a falls risk assessment tool aimed at falls for people living in the community. I identified that such a tool existed, promoted it to the staff in my team and helped deliver training on how to use it effectively. We are now utilising the tool to assess patients that require it. The tool is a list of criteria that we ask the patients if they have a fear of falling; if they ve fallen more than twice in the last year, or if they have a poor gait and /or impaired balance and because a lot of people see falls as an inevitable part of ageing, a large percentage of people won t actually tell you that they ve had a fall, unless they ve experienced quite significant injury. This tool is designed to pick up people that may not come to which are a bigger attraction for staff working in NHS Highland. They can dip their toe in the water with a taster module and they may wish to research it further. The flexibility is clearly there. I think it is absolutely vital that we train people with contemporary knowledge and skills to help care for the older person and not just in a hospital setting. The care of older people can be very complex and not just because of their health problems; there are economical and social issues that impact on their wellbeing. It is also important that we provide this expertise to all practitioners and not only nurses and doctors. We have an occupational therapist currently on our programme, which is exciting. The programme team consists of Dr Macaden, Dr Annetta Smith and Mrs Elaine Dibden from the Highland Campus and Mrs Julia Scott and Ms. Sandra Menzies from Stirling and they work very closely with the Health Boards and third sector organisations such as Alzheimer Scotland and Sight Action; enhancing the opportunities for the students on the programme for practice, collaboration and networking. Leah continued: Pooling of resources is going to be a very prudent way of using what we have, especially in this economic climate. The programme strengthens interdisciplinary and multi-agency solutions to care delivery through partnership working. This programme is designed to develop new nursing roles, career pathways and nursing leadership in the care of older people. The programme promotes care of older people as an attractive and specialised area of practice with clear career development opportunities for practitioners. Students have gained employment across a range of acute and primary care settings as well as more specialised areas for example, posts supported through the Scottish Government Change Fund to promote and improve services for older people. More recently, the programme Unique tool aimed at falls prevention light until they ve told us they had a fall. Basically, by asking the right questions, we can then complete the paperwork. It actually looks at falling as multifactorial and identifies all the areas from their medication to their blood pressure and if there is anything cognitively that is going on and therefore; by looking at all these factors, this tool will highlight if they should be referred on to their GP for a medication or to a physio or occupational therapist for equipment, for example. What this tool does differently is that it makes it very easy to see where you should be referring people and it makes you aware that it s not just their medication that has to be changed, for example, to help prevent falls, it might be equipment or a patient s environment that is contributing towards it. has been shortlisted for the Student Nursing Times Award 2014 under the Nurse Education Provider of the Year (Post Registration) category, which recognises the credibility and value of the programme at a national level, which we are very excited about. Let s Talk About Dementia: 2-8 th June 2014 events and information stands planned. If you are interested in taking part by holding a local event then please do let us know. There are posters available (including a Gaelic version) to publicise your event which are available from the Alzheimer Scotland Dementia Nurse Consultant Ruth Mantle who can be contacted on or

3 Dignity: A Tale of Two Wards Raigmore Hospital will once again hold dignity and awareness sessions aimed at improving staff understanding of good practice. The training focuses on a DVD named Dignity: A Tale of Two wards which uses dramatic portrayal of examples of positive and negative examples of care on hospital wards, during a key piece of research by Cardiff University. By watching the DVD, staff can reflect on their own practices and actions, particularly when it falls short of an acceptable standard. The DVD examines how we behave towards a person can either have a positive or negative impact upon his/her experience within the care sector. Staff who use terms of endearment, such as dear, think they are being nice to the patient, however; when they see this on screen they realise how patronising it sounds. Other examples of patronising language shown are; speaking more slowly than is necessary, and we don t want you falling, which is belittling. It is the little things that make all the difference when it comes to good practice. Listening to a patient and their relatives, taking their concerns seriously, by taking the time to explain things and ensure understanding, can convey empathy and reassurance. National Dementia Strategy ( ) The training was delivered throughout NHS Highland for the second time from November 2013 until January this year, having previously taken place last spring. It was successfully received by over 350 staff and Muriel hopes the more open format will be as successful Posters have been sent to all the clinical areas/ departments of the hospital and the staff have been invited to attend when they can. Feedback from the previous sessions has been positive, with the training being called informative and thought provoking. The dignity and awareness sessions will run in Raigmore Hospital through April, May and June Key Actions to deliver improvements in care The Scottish Government made a commitment in the National Dementia Strategy ( ) to develop and deliver a three year programme to support all NHS Boards to use the 10 Key Actions to deliver improvements in care for individuals with dementia admitted to acute hospitals. The 10 Key Actions are: There is a structure in place to drive and monitor improvements Promote a rights-based antidiscriminatory culture System to evidence the impact of changes against patient experience and outcomes Workforce is developed against the Promoting Excellence Framework Care is delivered within a safe and therapeutic environment Admissions and discharges are prepared and planned for Person-centred assessment and care planning is embedded Evidence-based screening and assessment tools are used Work as equal partners with families, friends and carers Minimise and response appropriately to stress and distress It is recognised that a number of existing programmes are already focused on aspects of this work, including the Person Centred Care, the Older People in Acute Hospitals, the Patient Safety and Releasing Time to Care programmes. Work is underway within NHS Highland to ensure our ongoing work is aligned with the 10 Key Actions and delivered via collaborative working between existing improvement programmes and associated national agencies. For further information please contact Ruth Mantle, Alzheimer Scotland dementia nurse consultant o n o r o n

4 A one-woman play based on a true story about dementia has landed a spot at this year s Edinburgh Fringe Festival. Penned by NHS Highland service improvement lead for residential care, care homes and day care, Jackie Hodges, Tell me your secrets and I ll shout them out focuses on the married life of George and Ella and the shift in their relationship upon his diagnosis of dementia. As Ella, played by Jackie Goode, slowly gains a power in their relationship she never had before this illness, she begins to reflect on her own abuse of that power and is saddened and shocked by her behaviour. It is based on a true story and began life several years ago with a brief performance at Edinburgh Traverse theatre new writer s project, said Jackie. It drifted for a while but the reworked version was accepted as part of the latest Scottish Mental Health Arts Festival. We ve had three other performances across Highland, the latest of which was last week in Gairloch and we ve had some very good feedback, Jackie lands Fringe spot with play on dementia especially from carers, many of whom have noted that they are often not asked the questions that really matter. Jackie is well placed to write on such a topic, having spent many years working within social work and the care profession. She has also written short plays and stories on her experiences of working with older people. Jackie added: I certainly drew on my experiences when I was writing the play and it has evolved along with our understanding of dementia over the last 15 years. This play looks at the changing nature of relationships and offers a behind the scenes look at an outwardly ordinary couple s life. I was motivated to tell the story after working with a couple in Edinburgh as their social worker. Spending time with them was a huge learning curve for me at the beginning of my career and I took a lot from the assumptions I made at that time. Every four seconds, someone is diagnosed with dementia and the number of people living with the condition worldwide is expected to reach a staggering 75.6 million in the next 15 years. It is vitally important we begin to educate the wider population about the condition and major lessons are learned. What is still relevant today is that we need to actively listen to the people who use services and their carers. They are critical in influencing future provision and ensuing it is fit for purpose. The one hour long show will run from the 1 st of August until the 9 th at the Space UK theatre in Edinburgh. Tickets go on sale from 5 th June and are priced at 7.50 or 5.50 for concessions. For more information or to book your tickets, phone or contact

5 Getting to Know Me form New document aimed at enhancing care and support Alzheimer Scotland nurse and AHP consultants have created a document called the Getting to Know Me form which aims to provide personal information about any patients with a cognitive impairment, communication impairment or learning difficulty. Endorsed by the Scottish Government, the document will help enhance the care and support given while a person is in an unfamiliar environment by giving out information from the patient s perspective. Ruth Mantle, Alzheimer Scotland dementia nurse consultant said: This form was initially developed for use in acute general hospital settings and should be completed at the earliest point of admission. It should be completed by the person and or their main carer, or person who knows them best. Information such as the patient s name; things that are important to them; information that will help staff to get to know the patient; the patient s spiritual and cultural needs and beliefs and their food and drink preferences all contribute to help staff continue to deliver high standards of care and also help the patient feel relaxed in a new environment. Ruth added: Once completed, the form should be kept in a place that is accessible to those who are providing the main care or support to the person. The form can also be used as an important prompt for staff to initiate contact with the main carer. For further information on how to order the Getting to Know Me form, please contact Ruth Mantle on o r o n