Our Approach to Dementia Care
At Advinia Health Care we are committed to continuously improving the quality of our dementia care for the Residents we support.
As a result, person–centred care is at the heart of everything we do.
We understand that people who are living with dementia deserve the very best of care and support. Care must be delivered with compassion whilst promoting choice, dignity and respect.
Meaningful Engagement (ME)
Alongside person-centred care, we prioritise Meaningful Engagement (ME). This means we ensure that all contact between Residents and Colleagues is meaningful.
Person-centred care also requires us to have good, clear and strong communication. This applies throughout our entire organisation and also with the Residents we are supporting, their family and friends and our external partners.
Our approach to dementia care has the following aims:
- Ensuring all Colleagues have the Competence to deliver the best Care.
- Delivering Care with Compassion in everything we do.
- Providing an extensive Meaningful Engagement programme to support wellbeing.
- Supporting a Commitment to ensure all voices are being heard.
- Continuously striving to provide best practice in dementia Care.
- Investing in improving our Communication to support better Care.
- Creating a culture where Colleagues have the Courage to challenge poor quality of Care.
Ensuring all Colleagues have the Competence to deliver the best Care
In order to provide high-quality, person-centred care we must ensure that our Colleagues have the right skills, knowledge and competence.
Consequently, we support the development of our Colleagues through the delivery of a robust blended learning programme, complete with specialist dementia training.
Delivering Care with Compassion
A strengths-based approach is a collaborative process between the person living with dementia and those who support them. We focus on what a person does well and enjoys doing rather than focusing on what are unable to do.
We will not make assumptions that people living with dementia cannot make decisions themselves.
People living with dementia will be given all possible support to make their own decisions using a strengths-based approach.
We will consider the following factors when supporting decision making for those living with dementia:
- Break information down to smaller chunks as necessary.
- Adapting our Communication to the needs of the individual, as appropriate. Using further alternative methods if the initial information does not appear to be understood.
- Using adaptive communication resources such as large print documents, pictures, sign language and easy to read guides to enhance understanding so people can make their own decisions.
- Consider using a translator if the person’s first language is not English.
- Thinking about the best time of day.
- Who is the best person to help to explain things?
- What is the most appropriate way to talk about the decision?
- Being aware of individual needs for sensory assistance such as glasses and hearing aids.
Making decisions in a person’s best interests
If a person living with dementia lacks capacity to make a decision, we will work collaboratively (including the individual living with dementia, family, friends, health care professionals etc.) to do what is in the person’s best interests, taking into account their past wishes, choices and beliefs.
Advanced Care Planning
Individuals will be supported with Advance Care Planning, which will enable them to make decisions about their care treatment and finances. In addition, Colleagues will be supported to understand advanced decisions and relevant legislation.
A positive environment for dementia care
The environment in which people live has an influence on how they feel and behave.
We will endeavour to provide:
A safe environment: Include appropriate dementia friendly design features. Ensure areas are uncluttered inside and out. Provide safe storage, visual and orientation cues. Include design features that reduce infection risks.
A non-institutional environment: Avoid long blank corridors and create areas of interest. Avoid layouts and sizes that lead to overstimulation of senses and introduce small scale homely areas. Create a choice of spaces to spend time in.
Promote engagement with family and friends: Provide spaces for quiet conversations and promote the use of family/friends dining experience. Offer use of social networking technology and provide access to local community.
We will consider lighting and stimulation levels:
Appropriate levels of stimulation: Consider all senses and minimise exposure to stimuli that is not helpful. Provide mobile sensory equipment (as required). Provide areas for purposeful and meaningful activities. Make available and promote the use of appropriate music, consider the need for quiet areas and create sensory gardens.
Optimum lighting and contrast: Maximise natural light and provide uniformity of light. Reduce glare and support independence by creating light pathways at night.
We will also support Residents in the following ways:
Clear orientation: Avoid objects that create confusion over the function of a space. Use internal landmarks such as large clocks, artwork and pictorial display boards.
Support wayfinding: Adopt simple layouts and provide well defined routes with clear and adult signage. Use photographs and memory boxes for Resident rooms.
Respect privacy, dignity and independence: Give opportunities to retain independence and offer to personalise Resident environment. Offer en-suite facilities where possible.
We’ll support wellbeing:
Provide access to nature and outdoors: Provide familiar purposeful outdoor areas, use contrasts to define areas and paths, provide rest areas, consider the natural world in indoor areas
Support nutrition & hydration: Provide a pleasant and stimulating dining area with comfortable chairs. Offer assistive devices and create an outdoor area for enjoying drinks and snacks.
Dignity in dining
We want mealtimes to be a pleasant and stimulating experience and a highlight of the day.
As well as the benefits to Nutrition and Hydration the mealtime experience will be planned taking into consideration the following to create a person-centred and dignified experience.
Nutrition & Hydration
Losing weight is not an inevitable part of living with Dementia and poor Nutrition and Hydration can lead to further symptoms and deterioration of general condition.
Here are just some of things we aim to do to support Residents living with dementia:
- Provide appropriate and dignified support with eating and drinking.
- Offer eating and drinking aids only when necessary.
- Provide hydration stations for Residents to help themselves to a drink.
- Encourage independence around food and drink such as preparing own snacks.
- Provide available and accessible foods for Residents to help themselves.
- Monitor weight loss and fluid intake as appropriate.
- Discover Residents past eating habits and routines and adapt as required.
International Dysphagia Diet Standardisation Initiative (IDDSI)
Advinia will ensure that Residents living with dementia are assessed as required by dieticians and SALT teams. The IDDSI framework has been adopted to support safe care around dysphagia.
An online, bespoke module has been created and rolled out to care and kitchen teams to support learning.
Kitchen teams are supported with ongoing practical IDDSI training.
Care teams are supported with ensuring the understanding of dysphagia and the effects on Residents living with dementia.
Meaningful Engagement Programme
To promote Meaningful Engagement, we have increased our focus on how we can support Residents to live a life with meaning and purpose.
We’ve changed the direction of activities in all Homes. We’ve moved away from the concept of keeping Residents entertained to focusing on supporting and contributing to a Resident’s overall physical and mental wellbeing.
Colleagues will ensure that the time spent with Residents is meaningful and has a positive effect resulting in them feeling valued.
This will be achieved through providing opportunities for meaningful activities on an individual and group basis that are Person-Centred and meaningful to Residents.
Resident Wellbeing & Engagement Programme
Our Resident Wellbeing & Engagement Programme is called S.P.E.C.S, which is an acronym of Social, Physical, Emotional, Cognitive and Sensory.
It has been created to provide a focus on The Four Domains of Activity (Being productive; Self Care; Fun & Entertainment and Rest & Relaxation). These all contribute to a meaningful day
Our wellbeing programme incorporates the Five Steps to Wellbeing (give, keep learning, be active, take notice and connect), which (in line with the Department of Health guidance) contribute to achieving positive wellbeing.
National Activities Providers Association
We are members of the National Activities Providers Association (NAPA) who are recognised as the leading experts in providing activities for older people.
All of our Homes have a subscription to The Daily Sparkle, which is a reminiscence resource that has been specially developed to provide daily stimulation, interest, enjoyment and fun for older people and for people living with dementia.
Our Homes regularly participate in research programmes that aim to improve the lives of people living with dementia.
We have a dedicated support network that aims to ensure Colleagues have the opportunity to develop their skills, knowledge and understanding to ensure Residents live meaningful and engaging lives.
Here are some of the ways we will continue to provide Person-Centred meaningful activities:
- Focusing on getting to know the resident and their history in order to create a Person-Centred support plan.
- Using a dedicated meaningful activities policy – demonstrating our Commitment to supporting meaningful and purposeful activities.
- Providing direction and focus to a ‘whole home’ approach with supporting activities.
- Issuing regular Communication briefings through forums and newsletters – celebrating and sharing meaningful activities across the business.
- Involving Residents in day to day tasks around the Home as appropriate , which are linked to their life history, hobbies and interest.
- Seeking out local community initiatives and opportunities such as intergenerational projects with local colleges, schools and nurseries.
- Homes will be encouraged to participate in national campaigns such as Postcards of Kindness and internal initiatives such as Advinia in Bloom and Advinia Virtual Tours.
Commitment to ensure all voices are being heard
Living with Dementia often means people are isolated from society and the local community.
We aim to support involvement wherever possible by:
- Involve family and friends as much as possible.
- Encourage Residents to retain links with the local community.
- Support visits to local events
- Be aware of specific groups, clubs and activities in the area supporting people living with dementia.
- Work closely with local professionals to provide quality of Care.
- Carry out family/friends/visitor surveys and respond to feedback.
- See families as Care partners who contribute to the wellbeing and individuality of Residents.
- Support families and provide guidance and information so that they can maintain positive loving relationships with people living with dementia.
- Develop dementia cafes and information hubs to support and link with the local community as well as supporting family and friends.
LGBTQ and dementia
Around 5-7% of the population are LGBTQ. In many Health and Care settings, LGBTQ people’s identities are hidden and perhaps even more likely in dementia Care, where people may become less able to communicate what is important to them.
We are committed to ensuring that every person living with dementia is treated as an individual. However, we also recognise that many people – including Residents, Colleagues, Families etc – may feel uncomfortable talking about minority sexual orientation and / or gender identity.
We will support Residents and families by:
- Supporting opening up those difficult conversations.
- Recognising that some Residents have lived through a time of prejudice and it may not have been safe for them to be open about their sexuality or gender identity.
- Understanding Residents and their support network may fear being judged and so hold back details around their life story that would enhance their person centred care plan.
- Recognising that LGBTQ people may no longer be in touch with biological family, so Care and support may be limited or be unacceptable to them.
- Being aware that memory problems may make it harder for people to remember what they have told others about their sexual orientation or gender identity.
- Understanding that specific medication such as hormone therapy may be necessary to avoid health complications and this should be reviewed regularly
Improving Communication in dementia Care
Electronic Care Planning
All Advinia Homes are in the process of implementing electronic care monitoring and planning. The software promotes a Person-Centred approach to each Resident and means more quality time can be spent by Colleagues with Residents.
The software we use is from Person Centred Software, this is the most widely-used digital care system in the UK.
Colleagues will have a hand-held device to evidence all Care and support provided. Plus all of the Home Management Team will have access to the web-based monitor part of the system to enable them to monitor care and support provided to Residents.
All support plans are built and held electronically on the system. They are available to Carers to view on the handset at all times. Also, handovers are completed via the system.
RADAR is used to electronically report all incidents within our Homes and also to complete audits which are part of the Quality Assurance Framework for Advinia.
The following are all embedded within RADAR. However, it is incident reporting and auditing which are its main functions:
- The Quality Assurance Framework
- Policies and Procedures Library
- Maintenance checks
- Internal email system
My Life TV
All Homes have a subscription for My Life TV, which is a video on demand TV channel specially created for people living with dementia.
Using technology devices such as Alexa can help to promote independence and provide entertainment for those who are living with dementia.
Digital Assistance can also play a vital role in providing music therapy, which is known to be beneficial for enhancing mental wellbeing.
The voice-activated nature of a Digital Assistant make the features very useful for those living with dementia and can provide access to unlimited audio books as well as telling the time, dates, weather and news.
Considering spiritual and cultural needs
Colleagues will respect the spiritual and cultural needs of those who are approaching the end of their life. We’ll ensure that needs are met through providing appropriate opportunities and links to the local community. In addition, we will adapt communication to meet the individual needs of the Resident.
We will engage with the Resident, their families and carers in a warm and empathetic manner, involving all individuals at all times.
End of Life Care for a person living with dementia
When a person living with dementia is approaching the end of their life it can be a very difficult time for them and the people around them.
We will provide dignified and compassionate end of life care that respects the Resident’s previously expressed wishes.
In addition, Colleagues will support the resident with planning ahead (sometimes called advance care planning), including their feelings, wishes and choices.
We’ll discuss how the Resident would like to be cared for in the final months of their life. In addition, we’ll cover where the Resident would like to be cared for, and who the Resident would like to be with them.