Concurrent Session 12.00 – 12:45

Session 1 - Listening and Learning from People with Dementia

Elizabeth Norby, NHS Tayside / Queen Margaret University                          

People with dementia who are in acute hospitals may be excluded from efforts to understand and use patients’ experiences to improve care experiences. This holds true for both service improvement and research. Often researchers and practitioners are concerned about consent; underestimate the ability of people to participate and resort to speaking with family members as proxies. This presentation will describe a three stage study using participatory research methods. Knowledge from the study along with findings from a Queen Margaret University’ Listening and Learning to Older People’ project was used to co-design and test, with staff and spiritual care volunteers, tools and processes for collecting feedback. Evaluation of these tools in practice has highlighted a suite of methods and processes that are useful to hear the voices of people living with dementia, that create opportunities for people to share their experiences or gain therapeutic benefit from the interaction. What is heard in such conversations creates opportunities for enlightenment among staff; immediate tailoring of care and care routines to better meet people’s needs and overall consideration by teams of issues facing people with dementia in their care setting. The presentation will share this toolkit, most of which is freely available, so practitioners can consider its implementation into their practice.

Session 2 - Dementia Café Inspires Meaningful Activity

Alan Cook, Sandra Shields & Louise Colquhoun, NHS Greater Glasgow and Clyde

This presentation will discuss the process of identifying the need for the an? improved care experience, leading to the introduction of the project with multi agency and multi-disciplinary support.  A patient centred project, with the emphasis on improving the patient, families, friends and carers experience of an unscheduled admission to hospital in the acute care setting will be described.  An ‘inclusive project’ it was designed to ensure access to the project for everyone. The presentation will identify the outcomes for patients and their families, friends and carers after the introduction of a Dementia café into the acute care setting, with the aims of: reaffirming the value of people with dementia; providing a network for Dementia Champions to collaborate; providing a medium for expert advice in the acute setting for: people living with dementia, family, friends and carers and staff; support volunteers in developing befriending skills; and also to demonstrate the importance of meaningful activity and social inclusion during admission to hospital and on discharge. The presentation will also demonstrate the positive outcomes - service user feedback and audit data will provide evidence of the support required, and share the unexpected outcomes from the Café.  It will give an overview of the planned programme of further spread within NHS Greater Glasgow and Clyde. 

Session 3 - Opening Doors in Care Homes

Fi Thomson & Fiona Alderson, Networks of Wellbeing

This presentation will describe the work one Social Services Dementia Champion has been taking forward with residents of Scott’s Hospital, Care Home in Huntly, Aberdeenshire. The presenter will describe how a firm belief that care home residents are able to give something back to the community and that they have valuable life experiences to share, informed this work.  Although the care provided in Care Homes can be of the highest order, for some residents it does not mitigate against the loss of independence coupled with the sense of being devalued as a person. Running groups in small isolated rural towns can be difficult. With this in mind, work was taken forward with the staff at Scott’s Hospital to develop and run Cognitive Stimulation Therapy (CST) groups that would be open to residents and community members alike.  Opening up the care home in this way allows people to experience the hopeful and cheerful atmosphere of the home in a way that they would not otherwise be able to do. CST is much more than reminiscence and the mix between residential and community adds something to the group.  The project invited people living with dementia to attend our first CST group 12 months ago and this has been a great success. Working in this way has shown residents that they still have a lot to offer their community and has increased their resilience and sense of self-worth, and we hope to further build on this collaborative experience in the future. 

Session 4 - NHS Lothian Rapid Response Team

Karen Ritchie, Angela Hawthorn and Emma Hare, NHS Lothian

The Older Peoples Mental Health Rapid Response Team in NHS Lothian received theCategory Winner Award in the ‘Community Health Nursing’ Category and were also Overall Winnersof the Mental Health Nursing Forum Awards in 2017. The Rapid Response Team (RRT) is a nurse-led service which was established in December 2016 as part of Edinburgh’s Older Peoples Mental Health Service.  RRT promotes care at home to provide an alternative to hospital admission for older people in mental health crisis. They are a hospital based team providing support and care in the community.  They also work closely with the older peoples’ mental health wards to promote and facilitate early discharge. The team has evidenced a significant impact in reducing admissions to hospital and facilitating early discharge for people, including people with cognitive impairment and dementia by providing evidence, rights-based and recovery focused intensive home support. This presentation will detail the work of the team with a focus on the positive impact of the service on people living with dementia and their families and carers.

Session 5 - Quality and Excellence in Specialist Dementia Care

Lorraine Haining, NHS Dumfries and Galloway

This presentation will describe the significant progress made in systematically taking forward a range of improvements in a number of areas as part of the Quality and Excellence in Dementia Care work programme in NHS Dumfries and Galloway.  The team are able to evidence a range of improvements across a number of areas, including: the implementation and impact of training in keeping with the Promoting Excellence framework; Dementia Care Mapping to evidence improvements in practice to enhance the experience of people living with dementia at an advanced stage of their journey; development of stress and distress care planning and interventions; and many more positive initiatives not detailed here. The team also have robust plans for future improvements and impact evaluation. Linda McDougal and Claire Gabriel from NHS Dumfries and Galloway received the Category Winner Awardin the ‘Dementia Care and Support Category’ at the 2017 Mental Health Nursing Forum Awards in recognition of the success of this work.

Session 6 - End of Life Care in an Acute Mental Health Assessment Ward

Linda McDougal, NHS Dumfries and Galloway

This presentation will describe work in developing practice to improve end of life care for people with dementia in a specialist dementia unit. The background to the work was that the ward supported an increased number of people with dementia who displayed ongoing severe and unmanageable distress when nearing the end of their life, despite the best efforts of the nursing and medical team to alleviate this. Working with colleagues within palliative care, and families and carers, the team developed a framework to aid the decision making process surrounding end of life care which is inclusive of the needs and wishes of all – the person with dementia and their families and carers. Linda McDougal, Donna Tran, Dr Fraser Gibb, from the Cree Ward team in NHS Dumfries and Galloway received a Highly Commended Award in the ‘Dementia Care and Support Category’ at the 2017 Mental Health Nursing Forum Awards in recognition of the success of this work.

Concurrent Sessions 13.30 – 14.15

Session 7 - Improving Patient & Carer Experience through the Triangle of Care

Jacki Ishmael, NHS Dumfries and Galloway and Karen Martin, Carers Trust

There are currently an estimated 759,000 adult carers and 29,000 young carers in Scotland and, by 2037, it is estimated there will be over one million (National Carers Organisations, 2016). This presentation considers the use of the Triangle of Care: A Guide to Best Practice in Mental Health Care in Scotland (2010) which was launched with the aim to meaningfully create a partnership approach involving carers in service user’s care and treatment. Through the Quality and Excellence in Specialist Dementia Care change programme it was agreed to use the Triangle of Care (to implement a successful carer pathway in dementia services). Initially developed for adult wards, the pathway demonstrated improved outcomes for patients, carers and staff by facilitating more effective carer engagement. The presentation describes how self-assessment has now been undertaken in both units providing specialist dementia care in NHS Dumfries and Galloway with baseline measures and an action plan in place. This has led to the development of a pathway which includes; a driver diagram, carer checklist, carer’s letter of invitation to meet with staff, carer Information sheet and information from carer pack. It provides clear carer engagement objectives giving the opportunity to signpost carers to non - statutory carer support services (including Alzheimer Scotland, The Dumfries & Galloway Carers Centre). The session will outline how staff are being supported in the implementation of the pathway.

Session 8 – Please note there are 2 presentations in this session

Patients now PIC their Vascular Access

Nicola Wyllie and Sandra Shields, NHS Greater Glasgow and Clyde

This presentation will outline a patient centred project with the emphasis on improving the patient experience. The Vascular Access service identified improved outcomes for patients with dementia by increasing the service to provide a bedside service.   The aim was to provide a bedside service which inserts a Percutaneous Indwelling Catheter (PIC) device from which bloods can be taken, IV therapies can be given and which can remain in place for the duration of the person’s treatment.   The aim of the work is to: reduced multiple Peripheral Venous Cannulae (PVC) insertion; reduce the pain and distress associated with cannulation; ensure reliable venous access via a device from which bloods can be taken, and IV therapies can be given through and which can remain in place for duration of treatment. The presentation will discuss how this has improved experiences for people with dementia in an acute hospital setting requiring this intervention, including the involvement of families and carers to reduce peoples’ anxiety.  It will also demonstrate the positive outcomes and how the project has been spread to other areas, including an overview of audit data and a planned program of further dissemination in NHS Greater Glasgow and Clyde.

 “Have you Asked for Help?”

Pamela Burns and Sandra Shields, NHS Greater Glasgow and Clyde

This presentation will describe a patient centred project with the emphasis on improving the patient, families, friends and carers experience with the Radiology outpatient service within NHS Greater Glasgow and Clyde (NHS GGC). It is an inclusive project that ensures person centred care for everyone.  The project aims to ensure what matters to the patient is delivered seamlessly during their outpatient appointment.  This presentation will identify the outcomes for Patients and their families, friends and carers after the introduction of a project that invites service users to ask for help. It was driven by an identified need to: develop person centred care for everyone; offer a service that is responsive to what matters to patients, family, friends and carers during the time in our department; ensure robust communication tools in place to ensure help is given when it is asked for or identified. The presentation will discuss the process of identifying the need for the improved care experience, education of staff and the introduction of a pilot project.  It will also demonstrate the positive outcomes, service user feedback, audit data-  and how the project has been spread to other areas in NHS GG&C.

Session 9 - Using the Promoting Excellence Framework to Improve the Care Provided in Specialist Dementia Units

Gillian Grubb, NHS Fife

This presentation will outline work taken forward in NHS Fife in implementing the Promoting Excellence Framework to improve the care and treatment provided to people living with dementia and their families and carers. This work has ensured all staff working in specialist dementia units are trained to a minimum of the 'skilled level' of the Promoting Excellence Frameworkwith the aim of further improving care and partnership working with relatives and carers. The programme developed and delivered resulted in an innovative programme of education, using a range of methods, which will be described. The presentation will also detail evidence of the positive impact of the training and a range of subsequent improvements in practice as a result. Gillian Grubb and Kerry Lowe from NHS Fife received a Highly Commended Award in the 'Innovations in Education Category' at the 2017 Mental Health Forum Awards for their work in this area.

The presentation will also describe the approach taken to disseminating specific training in supporting people living with dementia experiencing stress and distress.

Session 10 - Positive and Individualised Culture of Care: What it looks like in one care home setting

Cheryl Henderson and Anna Rose, Elder Care Homes

This presentation will give an overview of a number of incremental changes and improvements that are being embedded in practice to enhance the lives of residents living in the care home.  It will also discuss how staff are supported to appreciate the individuality and spirituality of residents both in theory and practice. The presentation will detail how small changes are having an impact including: changing culture, language and attitudes; looking at the whole person - including their life history and the areas that make them a unique individual; expanding how choices are made by or for the person. The Dementia Champions in the Care Home have also taken forward training in a number of areas including, delirium training and use of 4AT tool; development of use of Promoting Excellence Framework and palliative care training. The presentation will also outline wider work that has improved outcomes, including the support of family members.

Session 11 - Music in the Emergency Department

Helen Skinner, and Lucinda Gorrie, NHS Fife

The emergency department (ED) atmosphere is frequently intense and stressful. Merely entering the ED can often cause feelings of fear, anxiety, uncertainty, and helplessness. For people living with dementia this can be particularly heightened. Diversion techniques are generally necessary to promote relaxation during this seemingly endless period of time. This makes the ED a prime environment to test the effect of music to facilitate this.  Current theory suggests that the use of music complements scientific treatment by distracting people’s attention away from stressful procedures. This in turn decreases anxiety and improves outcomes. Music is a useful adjunct to nursing, a profession that has a long-standing history of bringing a holistic perspective to patient care. This presentation will describe a project undertaken by two dementia champions to introduce music into the ED for patients with a diagnosis of dementia. A MP3 device was loaded with a variety of musical genres and provided to the ED along with headphones and a mini speaker. When people with dementia were admitted to the ED displaying stressed and distressed behaviour, the music was offered as a first line intervention to alleviate agitation. The impact of the music was measured using a simple evaluation tool. The result of using music in this way was hugely beneficial and many patients experienced a positive reaction to the music, reducing stressed and distressed behaviour.