Understanding Dementia

Trying to understand those who suffer from dementia’s reality is the first step in making a difference to those in care’s lives, says Hall & Prior’s Behaviour and Cognition Clinical Nurse, Katie Conciatore.

I

t was something of an accident the first time I truly connected with a resident with dementia.

I was a brand new graduate registered nurse who ended up working an unintentional double shift in my aged care facility. The facility had several sections so I had taken handover for the afternoon shift, sat at the main desk and was going through care plans when I first met her. She was a new admission and had come in from hospital following a fall. I hadn’t been present for her admission but had heard of her during the handover. As I sat at the desk that was higher than my head, for safety purposes, I became aware of a dragging noise, a plunk then scrape. By the time I looked up, there she was, she lifted her face above the high nurse’s station and beyond her bruised purple and blue face was a pair or striking blue eyes staring at me. As a young registered nurse, my aim for my career was to eventually end up in paediatrics. I hadn’t exactly planned on coming into aged care and yet here I was, with a bruised 78-year old woman staring at me. She quickly whispered that we needed to get a move on, I looked down at my paperwork and in that second, curiosity got the better of me and it resulted in my making a decision that would change my career path. The woman had dementia, she was a frail falls risk who needed assistance with personal care and could at times be “resistive”. She was the mother of four sons and by their account, she was not someone you forced to “ask you twice” to do something. But on this night, the night of our initial encounter, she was hungry and wanted my assistance to steal some crumpets from the kitchen. I went along as she, very slowly, made her way down the hallway, pausing at every opening in the wall, even if it was just a sink, to check if our parents were there, ready to catch us. We finally made it to the kitchen area and she heckled me as I made us buttery toast and tea, apparently I smeared butter instead of spreading it.

Story continues overleaf.

This encounter may seem small, however it led me to explore, who this woman was, what her story was and in the process, I was moved into a dementia specific locked unit and the rest is history. As a registered nurse, of course it was my duty to ensure that all of my residents were healthy but the true satisfaction I gained from the role came from making them happy. Finding out their routines, personal preferences and uncovering the small changes that we as care staff could implement that would make them smile, laugh or even just not be uncertain. Several years later I came across a quote from a carer, “rather than trying to bring the person living with dementia back to reality, why not try to enter their reality?” This is the point of view I hope to facilitate throughout Hall & Prior.

HELPING HAND NSW resident Margaret enjoys helping fold the laundry.

What is dementia?

Dementia is a neurodegenerative syndrome and it describes a collection of conditions that impair a person’s thinking, judgement, memory and ability to perform daily tasks. In 2021, there are an estimated 472,000 Australians living with dementia. More than two-thirds (68.1%) of aged care residents have moderate to severe cognitive impairment. Therefore, the need to provide care and the opportunity to connect to the residents of Hall &Prior who have a cognitive impairment is vital. In the last six months, Hall & Prior has held extensive training sessions delivered across all sites on Responsive Behaviours, a module on dementia, and how to assess and care plan responsive behaviours to ensure the wellbeing of all. Dementia-friendly environmental audits have been conducted across many sites throughout NSW in order to improve the ability for people with dementia to engage in their surroundings and reduce stress caused by over or under stimulation. A good environment can, almost by itself, reduce confusion and agitation, improve wayfinding and encourage social interaction. Simple changes like colour blocking walls, introducing signage to assist people with dementia with wayfinding and personalisation of rooms can have a significant impact. In NSW Hall & Prior homes we’ve introduced modifications to Caroline Chisholm’s bathrooms, Grafton’s door signs and Sirius Cove’s labels.

Garden upgrades have been completed in Bexley, Caroline Chisholm and Sirius Cove and Montana are working on garden programs to promote growth and nature within the facilities. Gardens designed specifically to support people with dementia provide therapeutic activities designed to

maximise retained cognitive and physical abilities and lessen responsive behaviours. Recently Grafton has made additional resource purchases focusing on promoting their residents with cognitive impairment to participate in daily activities to promote purpose and meaning. At the end of November last year, training sessions with lifestyle officers were completed, focusing on incorporating everyday tasks into the lives of people with dementia and sensory stimulation. Sensory stimulation plays a major part in helping communication for people with dementia while helping reduce agitation, sleep disturbances and unmet needs.

Liaison with organisations such as Dementia Services Australia, Anglicare Emotional Wellbeing and Support Program and The Older Person Mental Health Team have increased resulting in more multidisciplinary care plans being created. The 2021 staff educational needs survey outlined many requests for further dementia training, plans for weekly sessions throughout 2022 are currently being finalised. The hope for Hall & Prior over the next year, and the many after that, is to continue to create opportunities to not only keep our residents with dementia healthy but also happy, engaged and empowered.

CREATIVE SOLUTIONS Introducing colourful signage to bedroom doors helps dementia sufferers navigate more easily.

To find out more about caring for those with dementia, visit hallprior.com.au