Download Mary Heritage Assistant Director of Quality

Welcome to the RCSLT’s webinar:
Dementia and the
role of the SLT
8th July 2014
#Dementia
Welcome
Derek Munn
Director of Policy and
Public Affairs, RCSLT
Panellists:
Mary Heritage
Sasha Wade
Assistant Director of
Quality and
Professional Lead for Allied
Health Professions in
Derbyshire Community
Health Services NHS Trust
Service Improvement Lead for
Dementia , Kingston
Hospital NHS Foundation
Trust
Housekeeping
 Send in chat messages at any time by
using the Chat button
 Send in questions by using the Q&A button.
 This event is being recorded. See here for recordings:
www.rcslt.org/news/webinars/rcslt_webinars
 Vicky Harris is on hand to help!
Today’s session
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Dementia in context
Outcomes decision-makers are looking for
The RCSLT Dementia Position Paper 2014
How SLTs can fit in the care pathway
Person-centred care
The RCSLT Dementia Campaign & resources
Questions
Dementia: an overview
with reference to RCSLT’s
dementia position paper
Mary Heritage
Assistant Director of Quality
and Professional Lead for Allied Health
Professions, Derbyshire Community
Health Services NHS Trust
Did you know…?
665,000
(From RCSLT’s Dementia
position paper 2014)
What is dementia?
 A set of symptoms, including memory loss,
mood changes and problems with
communication and reasoning
 These symptoms occur when the brain is
affected by certain diseases, including
Alzheimer's disease and the damage
caused by vascular changes
 Each person is unique and will experience
dementia in his or her own way
There are over 100 different forms of
dementia. Alzheimer’s disease is the
most common form of dementia….
 Alzheimer’s disease (AD)
62%
 Vascular dementia (VaD)
17%
 Mixed dementia (AD and
VaD) 10%
(Alzheimer’s Society)
 Dementia with Lewy bodies
4%
 Fronto temporal dementia
(FTD) 2%
 Other dementias 3%
What ultimate outcomes do decisionmakers want?
The four priority areas for the Department of Health
around dementia are:
1.
Good quality early diagnosis and intervention for all Two thirds of people with dementia never receive a
diagnosis
2.
Improved quality of care in general hospitals - 40% of
people in hospital have dementia
3.
Living well with dementia in care homes - Two thirds
of people in care homes have dementia; dependency
is increasing; over half are poorly occupied;
behavioural disturbances are highly prevalent
4.
Reduced use of antipsychotic medication – c.180,000
people with dementia are treated with antipsychotic
drugs. In only about one third of these cases are the
drugs having a beneficial effect and there are 1800
excess deaths per year as a result of their prescription
Quality outcomes for people with
dementia: building on the work of the
National Dementia Strategy
Department of Health, 2010
What ultimate outcomes do decision-makers
want?
Key outcomes from Scotland’s National Dementia Strategy: 2013-16:
1.
More people with dementia living a good quality of life at home for longer
2.
Dementia-enabled and dementia-friendly local communities, that contribute to greater awareness
of dementia and reduce stigma
3.
Timely, accurate diagnosis of dementia
4.
Better post-diagnostic support for people with dementia and their families
5.
More people with dementia and their families and carers being involved as equal partners in care
throughout the journey of the illness
6.
Better respect and promotion of rights in all setting, together with improved compliance with the
legal requirements in respect in respect of treatment
7.
People with dementia in hospitals or other institutional settings always being treated with dignity
and respect
Scotland’s National Dementia Strategy:
2013-16
How can speech and language
therapy help?
RCSLT published its Dementia Position
Paper to address these issues
 Speech and language therapy services should be adequately resourced to
provide quality care for people with dementia
 Communication and swallowing are the responsibility of the whole team.
The role of the speech and language therapist is to empower and educate
others, as well as providing direct specialist input as appropriate
 Early speech and language therapy intervention is crucial so that people
with dementia and their carers have their needs met in a timely way.
 Read the RCSLT Dementia Position Paper:
www.rcslt.org/members/publications/publications2/dementia_position_p
aper2014
In a multi-disciplinary team, SLTs are
well placed to deliver the following
outcomes…
1. Diagnosis:
- Analysis of associated language
disorders to inform differential
diagnosis
- Specialist assessment of any
eating, drinking and swallowing
problems
- Assessment of individual’s capacity
to consent to treatment and care
2. Care:
- Providing programmes to
maximise and maintain function
-Providing an optimum
environment for communication
and eating and drinking
- Enhancing function in the later
stages of the condition
3. Living well:
- assisting interpersonal relationships
between individuals and carers
- acting as advocate for people with
communication disorder
- supporting the person with dementia
with interactions in their community
4. Helping the person with dementia
and carers by providing:
- support that enables carers to care –
support that maximises knowledge, skill,
self-efficacy and quality of life, and
minimises depression and anxiety
- management strategies for people
experiencing eating and swallowing
difficulties
- specialist input to clinical networks for
policy development, risk management,
ethical decision-making, research and audit
The risks of not providing speech and language
therapy...
Decreased quality of life
and quality of relationships
Increased level of
dependence at an earlier stage
Delay in diagnosis and/or
incorrect diagnosis
Exclusion from decisionmaking and service-planning
Barriers to accessing
other professionals
Avoidable death due to
malnutrition, choking &
aspiration pneumonia
How SLTs can help people
living with dementia
Sasha Wade
Service Improvement Lead
for Dementia at Kingston
Hospital NHS Foundation
Trust
How SLTs Can Help
People Living with Dementia
Sasha Wade, SLT
Service Improvement Lead for Dementia
Kingston Hospital NHS Foundation Trust
Ways We Can Help
 RCSLT
Dementia Position Statement
 helping
to inform differential diagnosis
 optimising communication and
swallowing
 training
 research and development
My Experience
 Context:
Acute Care
Dementia Education
 Promoting Person-Centred Care
 Supporting Carers
 Advocacy
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Dementia Education
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Varies depending on
time/audience/needs
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Recognition/Understanding
Communication
 Can include training on
behaviours that challenge
 Provide practical examples
Feeding/Swallowing/Mealtime
Promotion
 E.g. Dining Companion Program
Emphasis on SLT role in
dementia care
Person-Centred Care
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Importance of unique wishes
and needs of the individual’s
care
Examples
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Forget Me Not Scheme
This is Me
Dementia Champions
Environmental Modifications
Therapeutic Activities Program
A team effort
A Closer Look: Signage
A Closer Look:
Important Things About Me
A Closer Look:
Therapeutic Activities Program
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Education Component
Daily 1:1 and group activities
Communication based
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reminiscence therapy
singing for the brain
group reading
finish that line
familiar, interesting, functionappropriate activities
Activities How-To Guide
Supporting Carers
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Person with dementia +
carers are a package unit
Examples of experience
supporting carers
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training re: compensatory
strategies, function appropriate
activities
behaviour
management/communication
support
advanced care planning (e.g. re:
swallowing decline)
Carer’s passport in acute care
Dementia navigation support
Advocacy
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Dementia Action Alliance
Dementia Friends
Barbara’s Story
Dementia Awareness Week
The RCSLT Dementia
Campaign
Derek Munn
Director of Policy and
Public Affairs, RCSLT
Key Objectives/ Asks
• We are calling for budget holders to review their provision of
speech and language therapy for people with dementia to ensure
their communication and swallowing needs are met
• We are calling for primary care services and care homes to have
appropriate access to speech and language therapy services to
support people with dementia
• We are calling for the relevant health professionals, care home and
home care staff to understand the impact of communication
difficulties on dementia patients and their carers
• We are calling for the relevant health professionals, care home,
agency and home care staff to be able to identify the early signs of
eating, drinking and swallowing difficulties and know when to
refer to speech and language therapy, so that people with
dementia can meet their nutritional needs safely and appropriately
Audience
Local decision
makers in
hospitals
Decision makers
in care homes/
care home
providers
Other health
professionals
Politicians
General
Public
Hubs and Champions
THEME
Diagnosis
GRASSROOTS ACTIVITY
FOCUS
Local Influencing:
meetings, letters, presentations.
Enabling your CCG to meet its
locally-set target for diagnosis
Positive PR
Celebrating successes of patients
staying out of hospital
Events
A joint event between an RCSLT
Hub and Patient Opinion or
regional Dementia Action Alliance
highlighting SLTs role in improving
communication outcomes for
patients.
Dysphagia
Communication
+
Local Influencing:
meetings, letters, presentations.
*GV Dementia campaign a key way to promote campaigning in Hubs! *
Who can do what?
Activity
Purpose
Who can be involved?
Services actively
encouraging and
participating in a review of
SLT services for people with
dementia.
To highlight gaps in
provision and open
opportunities for
new/enhanced services.
Adult services, acute and
community.
Basic training around
communication and
swallowing difficulties for all
professionals involved in
caring for people with
dementia.
To improve the care of
dementia patients and build
appreciation amongst
professionals of the role of
an SLT in dementia care.
Adult services.
Awareness raising events,
displays and news stories.
To increase professional,
political and public
understanding of the role of
SLTs in dementia care.
All SLTs and all SLT
students!
SLT students?
Campaign Resources
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Local Activity Menu of campaign ideas
Leaflet for awareness raising
Briefing for decision makers
Dementia and SLT awareness poster
Available at www.givingvoiceuk.org/dementia
Find out more…
RCSLT dementia campaign: http://givingvoiceuk.org/dementia/
RCSLT dementia campaign:
www.rcslt.org/members/publications/publications2/dementia_position_pape
r2014
Dementia resources:
www.rcslt.org/members/clinicial_areas/dementia
Dementia position paper:
www.rcslt.org/members/publications/publications2/dementia_position_pape
r2014
ANY QUESTIONS?
More
‘Did you know?’
facts