DEMENTIA

Positive Solutions In Acute Care

Priscilla Taylor
Clinical Nurse Specialist
Benalla & District Memorial Hospital
North East Victoria
 Admission
Stressful
Patient
Carers
Staff
 Raw Deal
Lack of: -
Time
Patience
Resources
Staff confidence
Others Factors

Staff inexperience
Complex needs
Behaviour
Lack of fit
Benalla & District
Memorial Hospital
85 bed rural facility
31 bed Medical Unit
24 bed Mid/Surg/DSU
30 bed Nursing Home
Caring For Dementia Patients

Searching for
solutions
 AIMS

Safe Environment
Anxiety Free
 Where Did We Start?
Total Dementia Bed Days:
Mar 2003 - 109 June 2003 - 180
April 2003 - 166 July 2003 - 221
May 2003 - 192 Aug 2003 - 178
 Where Did We Start? cont.
Average Monthly Bed Days = 175
50% prone to wandering
Jan 05 dementia patients = 26%
of total bed days
 Analysis

Effect on Casemix - funding

44% NOT recognised in diagnosis
 Analysis cont.
Casemix Funding Allocation
Average allocation = $2189
Dementia conditions = $8885
 What Followed
Education
Seminars
Reading

Information Search
Compilation of Resource Folder
 Safe Environment
Installation of Alarm System
 Safe Environment cont.
Hip Protectors Use of Signs
This Is Your
Life Book

Permission granted by
Alzheimers Association of Victoria
 This is your life
Past interests & hobbies
Present skills
Favourite music & TV programs
Special friends and pets
Dos & Donts of
Dealing With
Dementia

Thanks to Bendigo Health for

use of their Communication
with Dementia Clients
Pamphlet.
 Dementia Care Pathway
Directs staff
Tools
Assessments

Thanks to Bendigo Health for use of their Dementia Care Pathway

 Diversional Therapy

MUSIC MUSIC MUSIC

 MUSIC cont.

Emotional wellbeing
Communication
Behaviour Management
Sleep
Other Diversional Therapies
Old movies
Memorabilia
Reminiscences
Craft/games
Touch/tactile/comfort objects
Utilization of previous skills
Old Movies
Memorabilia
Reminiscing
Craft and Memory Games
Tactile Diversion
Utilizing Previous Skills
Strategies For Restless
Hands
IV Line Decoy Part I
IV Line Decoy Part II
Occupying Restless Hands
 The Benefits
Equally valued
Soothe symptoms
Relieve apprehension
Less Staff Stress
Excellent Resource Info
 The Benefits Continue
Dementia pathway & flow charts
Education/Personal development
Support and involvement
Positive feedback
Flexibility of Staff
Allocating workloads
Minimise disruption
 STAFF SATISFACTION SURVEY
There is less aggression
The wandering alarm is the best thing the hospital
has implemented, it gives me confidence to go
about my other nursing tasks knowing that I
will be alerted if a patient with an alarm
attempts to leave
Patients faces light up when you know a bit
about their past and their hobbies
Family members statements of relief,
impressed, reassuring and pleasantly surprised
 STAFF SATISFACTION SURVEY CONT.

Lady with dementia fondly held and

talked to her stuffed toy dog; the man
who spent hours looking at old
magazines; the lady who many times
watched old movies and dancing on
videos; the man who spent ages soaking
stamps off envelopes; the IV site decoy
was pulled, poked and played with but
the IV remained insitu
 STAFF SATISFACTION SURVEY CONT.
If you were asked to look after only the more
ambulant patients with dementia for a full shift,
would you be willing to do so now that we have
these strategies in place?

NO - 1 UNSURE - 3
NO RESPONSE - 2 YES - 12
This Project Is.
Grass roots
Sustainable
Highly successful
Replicable
Everyone benefits
 Acknowledgements
BDMH Board and Management
Jenny Bickerdike, NUM, BDMH
Matt Gill, Discharge Planner, BDMH
Clients and Family members.
Bendigo Health
Alzheimers Association of Victoria