Dementia and nutrition

AdoPt A CAre home (AACh) ANd demeNtiA AwAreNeSS: A Sheffield Pilot

andy wallace Commissioning officer for quality, working in adult social Care for sheffield City Council

As Commissioning officer, Andy has to ensure that all care homes and other relevant services are up to date with all legislation linked to care. he developed the ‘Adopt a Care home’ pilot, as he already had links with schools as a School Governor. Andy enjoys his garden and garage, tinkering about on a weekend and confesses to being an active healthy eater.

the prevalence of dementia increases with age. there are approximately 800,000 people currently living with dementia in the uk, with this figure set to double over the next 40 years (1). in 2010, the total number of people with dementia worldwide was estimated to be 35.6 million by the world health organisation (2).

This figure is projected to double every 20 years. The total number of new cases of dementia each year, worldwide, is nearly 7.7 million, implying one new case every four seconds (2). Although dementia mainly affects older people, it is not a normal part of ageing. Dementia is a syndrome, usually of a chronic or progressive nature, caused by a variety of brain illnesses that affect memory, thinking, behaviour and ability to perform everyday activities (2).

In Sheffield, around 6,400 people aged 65 or over are living with some form of dementia. This number is expected to increase to 7,400 by 2020 and to 9,400 by 2030. The biggest increase is likely to be in the numbers of those aged over 85 and that almost a third of those with dementia currently live in care homes in the city, with others living in the community often supported by family carers. People with dementia are more likely to be admitted into long-term care after a hospital stay than returning to their own home.

Sheffield Integrated Commissioning Plan for people with dementia and their carers designed for 2014/15 was to ensure the delivery of excellent health and wellbeing outcomes for people with dementia in Sheffield, maintaining value for money. Effective commissioning and partnership working with key stakeholders are enabling this plan to be achieved.

Understanding dementia and its effects is an important part in understanding, living with and coping with dementia. Schools can play a vital role in the development of dementiafriendly communities. By educating children and young people about dementia, a dementia-friendly generation can be created - a generation that is more aware of dementia and more supportive of people with dementia in the community where they live. And just as importantly, if not more so, by talking to children and young people about dementia, it can reassure them about their fears and misunderstandings and help them to relate to grandparents and other family members who may have dementia.

The Sheffield Dementia Action Alliance oversees the establishment of Sheffield as a dementia-friendly city and provides information about the national work with schools - to establish a dementia aware generation. The Alzheimer Society believes that engaging young people is crucial to the development of dementia-friendly communities. The Society previously funded Dementia4Schools and now runs the project in house. Adopt a Care Home is a fantastic model, improving links between care homes and schools and improving inter-generational relationships.

The Adopt a Care Home (AaCH) pilot intended to involve children in increasing the quality in care homes. It was planned to integrate stronger links with schools and care homes in a geographic area so that schools can ‘adopt’ a care home. The pilot pro-

posed the following work and expected outcomes: • Increase awareness about the older population in Sheffield as many younger children may not have experienced an ‘older’ person’s view. • Help younger people to understand the challenges of dementia and reduce the stigma associated with this. • Assess reading and writing skills of the children by giving them the opportunity to read with the older people and to also write either a ‘life story’ for the older person, or at least write about their experience of meeting older people. • Integrate children within the care home population to enable them to develop and grow by learning about older people’s experiences. This will not only support growth and maturity, but also give clear outcomes around basic skills with integration. • Make the care home that has been adopted a talking point in class and the opportunity for children to reflect. • Offer older people in care homes the opportunity to offer their experience and skills and give something to their community.

A programme for learning was devised in conjunction with the pilot primary school, (Prince Edward Primary) and two care homes in close proximity to the school. This was implemented from September 2014 and qualified teachers delivered the dementia programme. The children were encouraged to walk to their partner care home and ‘walking buses’ made regular trips. There had been many homes in Sheffield showing interest in being involved in the pilot, and it is hoped that there will be a wider ‘Adopt a Care Home’ initiative linked with a local school in the future.

The initiative intended to support the wider outcomes expected from the Care Quality Commission (CQC) and encourage community cohesion. It was anticipated that education and learning would be enriched and, moreover, benefit the quality of provision at the care home. The AaCH initiative aimed to become an integral part of the activity programme within each home. The positive activities included: • Life Story Work Dementia UK Life Story (3) or This is Me (4); • mini autobiographies created by the children for the resident; • reminiscence - involving the children in asking questions and finding answers; • wider learning for the residents - children supporting residents with helpful technology; • intergenerational understanding - allowing the residents to discuss about their life, enabling the child to learn about the past; • eating and drinking together, increasing the residents desire to enjoy the interaction and unknowingly increase what was eaten and drunk; • researching the roles of carers and personnel involved with care homes.

Learning from the programme has been covered in team meetings and in specific 1:1 sessions with the appropriate staff. There is also support via the Dignity Network facilitated by myself as well as an agenda item on the quality visits that I undertake. Questionnaires have also been designed for the school children to assess their awareness of dementia pre- and post-pilot.

An evaluation will be completed with support from Scharr, part of Sheffield University. The outcomes will focus on: 1 that the young people being taught about dementia have a better understanding of dementia and its impacts; 2 that the residents of the care home have a meaningful and positive interaction with young people from the community.

It is anticipated that if the pilot is successful and there is agreement from all relevant stakeholders, that a joint bid for further funding will be submitted to evaluate a city-wide programme for AaCH and Dementia Awareness.

references 1 Dementia 2013. the hidden voice of loneliness - Alzheimer’s society www.alzheimers.org.uk/dementia2013 2 Dementia: a public health priority, world Health Organisation and Alzheimer’s Disease International, 2012 3 thompson r (2011). Using life story work to enhance care. Nursing Older People 23 (8): 16-21 4 this is Me tool, Alzheimer’s society, 2013