Ahead of the learning curve

WE’RE on a mission to transform dementia care in the UK. It’s not acceptable for those living with dementia to receive inequitable care opportunities.

Historically, there’s been a reluctance from care providers to welcome people with psychological distress responses, termed by many as ‘challenging behaviour’.

We want to ensure people living with dementia are given a voice and the ability to live a fulfilled life.

Our Dementia Promise ensures that support is tailored to the individual.

We’re moving away from traditional care home approaches, which are often risk-averse and can reduce cognitive function further.

We are currently rolling out three levels of dementia training to all staff across our 23 homes – an initiative we believe is the most comprehensive face-to-face training programme out there.

Our innovative, evidence-based course content is designed to completely re-frame how we think about people living with dementia.

The training model puts people at the very heart of their own care.

By truly understanding the individual’s interests, personality and abilities we can deliver more bespoke, more effective care plans, which have already resulted in significant reductions in distressresponse incidents and in the use of psychotropic medication across the group.

Here are some of the key areas that care providers can focus on to help drive vital change across the sector: n Awareness – remember that sensory changes are commonly experienced by those with dementia. Sensitivity to touch, sound, bright lights or colours can trigger distressresponse behaviour, so think about dialling down overpowering sensory stimulation. n Risk – to achieve truly equitable care for people living with dementia, we need to focus on ‘positive’ risk rather than using blanket risk mitigation. n Language – using positive vocabulary, rather than ‘care speak’ is essential to change. n Meaningful occupation – in our training we ask staff to reflect on how they occupy themselves for fun or to stimulate their brains.

For example, use a soft water flow for showering, as skin can be very sensitive.

Harder jets can feel like needles to someone living with dementia and can cause undue distress.

We must look at adapting all environments to support this, or create smaller, dedicated dementia care settings, such as our Reconnect Communities, which cater to smaller groups with a higher staff ratio.

Suggesting that people remain seated to prevent falls can be very frustrating for someone wanting to move about, so adapt your environment to allow more freedom of movement or organise one-toone activities rather than group tasks which may leave some feeling excluded and frustrated.

For example, using terms like ‘challenging or difficult’ in relation to behaviours is extremely negative, and is often a misrepresentation of the person.

We accept that people with dementia may have certain responses, however, this can be caused by confusion or the way their care is given.

Try to understand what is causing the distress – remain calm, maintain eye contact and give simple instructions to help de-escalate situations.

This helps to reframe the traditional model of care home activities, which doesn’t reflect normal life.

Understanding a person’s likes and dislikes and engaging with them on a personal level helps them to feel valued, understood and ‘normal’.

In our Reconnect Communities we’ve added a laundry and workshop, small kitchens to make a snack and garden areas for planting which people can choose to use as they want.

We have seen vast improvements in confidence and independence by offering meaningful activities and a ‘home from home’ environment which employs positive risk elements. n De-escalation – explore the potential causes of distress – often just put down to a side effect of dementia and can lead to prescribing unnecessary psychotropic medication.

Through group role play, we reflect on how we as carers are often inadvertently the source of the distress – perhaps rushing a task, speaking too loudly, or lacking preparation.

Homing in on tasks such as bathtime routines in training scenarios helps.

For example, ensuring the bathroom is warm, the person remains covered and staying relaxed yourself, helps to alleviate stress and encourage a smoother routine.

Whilst it might seem a big undertaking to challenge and change dementia care practices across the UK, Orchard believes getting the basics right and spreading awareness of what is possible, is one step closer to a positive outcome for all.