Harrogate and District NHS Foundation Trust Dementia Event

Carol Giblin is Community & HR Coordinator at Carefound Home Care in Harrogate and, as a member of Harrogate and District NHS Foundation Trust, recently attended the Medicine for Members Event at Harrogate District Hospital where the topic of dementia and how the staff at the Harrogate Trust care for patients with the condition.

Carol provides some highlights below:

Dementia Forward

“Jill Quinn opened and spoke about Dementia Forward, the statistics relating to the population developing dementia and how as the population lives longer the risks increase and the number of people being diagnosed rises considerably. Dementia Forward support individuals pre-diagnosis, through to end of life and continue to offer support to friends and relatives who have lost their loved one to dementia. Dementia Forward have an Admiral Nurse who is the only Admiral Nurse in North Yorkshire and is funded by Dementia UK in a similar way to a MacMillan nurse.”

The Butterfly Scheme

“Harrogate and District NHS Foundation Trust relaunched the Butterfly Scheme in November 2015 which is a taught system of whole-team hospital dementia care, working in partnership with family carers; the patient (or carer) opts into the scheme in order to receive that care.”

Dementia Friends

“The Trust now has approximately 100 Dementia Friends. These are mainly front-line staff including doctors and nurses in A&E and porters. The staff on the dementia ward are encouraged to become Dementia Friends and to use the Butterfly Scheme and the Trust is also working on colour coded signage to become more dementia friendly. There are a number of the team who are currently undertaking a degree in dementia studies. The ward has also started to use tools and provide activities to make an individual’s stay in hospital less anxious and enable patients and staff to engage e.g. activity boxes, adult appropriate colouring books and quizzes, age appropriate music CD’s, and visiting patients is open and not restricted to certain times.”

The Wards

“The Acute Assessment Unit is trying to mirror the dementia ward as this area of the hospital is definitely the wrong environment for a person with dementia. If the paramedics are notified that a person has dementia this can be radioed ahead and a quieter bay and a Dementia Friend staff team may be available to reduce stress to the individual.”

“Dr Jane Paisley is the consultant on the Byland and Jervaulx wards and frailty ward. There are also CATT (Clinical Assessment and Triage Treatment) rooms. The frailty based service could be for a person who is 60 years old and who has suffered a serious stroke, however an 85 year old patient who is relatively fit and mobile would be admitted to the most relevant ward for the reason he / she was there.”

“Falls and UTI’s are the most common reasons why patients are admitted to the frailty wards and the patient often has other conditions such as dementia / alzheimer’s disease and families get really fed up with having to give the information in admissions, CATT then Byland because often the patient is unable remember why they are there – this is why the Butterfly Scheme is so useful.”

Hospital Discharge

“The area where there still are communication issues is when a patient has been discharged to a residential care home / nursing home as the teams have assessed the person as not safe to return home to live independently and the family find out or are notified after the event. Dr Jane Paisley is very sorry when she hears this and she hopes this can be improved – the main obstacle is the nursing team have to act quickly when a provider says they can provide care or a place and this may not be available in two days’ time.”

Dementia Screening Programme

“The dementia screening programme in place for the Harrogate and Ripon and rural areas was also covered. This involves the GP surgeries and the Memory Clinic – these services pick up 78% of people with a suspected dementia.”

Delirium

Delirium (acute confusion) was also discussed which can be caused by a change in medication, type of medication e.g. Tramadol, Codamol and certain pain relieving patches. Other factors include UTI’s and dehydration. This can be very frightening to the patient as well as the family, care and medical teams. On Byland Ward 40% – 45% of patients may have delirium – they will demonstrate agitated, frenetic behaviour, may be suspicious of everyone, and may be experiencing hallucinations. Some of these issues can be reduced by the patient having a picture of their family or pet or objects of interest, this can provide a lead to open dialogue and immediately reduce stress.

Care at Home in Harrogate

After the meeting there was FAQ time where I spoke with the team about our home care service at Carefound Home Care rated outstanding by the Care Quality Commission (CQC). I highlighted that we not only offer visiting hourly home care but also a full-time live-in care service which provides a genuine alternative to residential care homes in Harrogate.