Getting to Know Me: Supporting a Culture of Person-Centred Care

A blog piece from Susan Holland, Dementia Nurse Consultant at NHS Ayrshire and Arran who also works with us here @uwshealth and @AlzScotCPP. This was written for the Alzheimer’s Scotland Blog “Let’s Talk about Dementia” which I have contributed to previously. Another appropriate message for #DAW2018 in Scotland. Blogging is so much easier when others do the work for you !! Thanks, Susan.

Let's Talk about Dementia

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Improving outcomes for people with dementia within acute care settings has long been recognised as a commitment by the Scottish Government. Yet, with the recent launch of Scotland’s National Dementia Strategy (2017-2020) (Scottish Government, 2017), there is recognition that although significant progress has been made over the last ten years, wide variations in dementia care and treatment remain evident across Scotland.

People with dementia are estimated to occupy approximately 25% of acute hospital beds (Alzheimer Research UK, 2018) and are known to have longer lengths of stay and poorer outcomes than people who do not have dementia. With a growing ageing population and incidence of dementia, there is no doubt that acute hospital settings require ongoing support to meet current and future dementia care needs.

Person-centredness is at the heart of high-quality dementia care provision. This involves knowing the person and tailoring care to meet their personal abilities, needs, likes…

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What’s on During Scotland’s Dementia Awareness Week

Starting tomorrow, 4th June 2018, it is Scottish Dementia Awareness Week 2018. Alzheimer Scotland has online information about Dementia Awareness Week 2018. In their blog Let’s Talk About Dementia you will find out about what the Society is doing online during this week. The Alzheimer Scotland Centre for Policy and Practice (ASCPP), which is based […]

via Scottish Dementia Awareness Week 2018 — When The Fog Lifts

Supporting People in Later Life to Get Online is Now Essential

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Good news this week that more than twice as many people over 75 use the internet as they did in 2011. But despite this rapid increase, millions of people in later life are not online. The UK Office of National Statistics released figures this week that showed 4.8 million people over the age of 55 are not online – making up 91% of all ‘non-users’. As a result, they are at risk of missing out on essential services as these continue to move online, and companies increasingly offer online-only deals.

The problem, of course, is that those not online are people with the lowest levels of wealth, health and education. In other words the very people most likely to benefit from crossing the digital divide and getting online.

A report by the Centre for Better Ageing and the digital charity the Good Things Foundation released this week urges the government, companies and organisations to ensure that the most vulnerable people don’t get locked out of essential services and benefits particularly since a number of people may be digitally excluded for many years to come. As the report concludes;

“It is easy to think that with the increasing digitisation of society everyone will eventually be online, and so the digital divide will simply fade away. In fact, the opposite is true. As our services and interactions become ever more digitised, the digital divide between the most and least advantaged in society will grow and may become amplified across the life course.We need to take action now to prevent this gap between the digital haves and have-nots from becoming entrenched.”

To access the full report and the Centre’s views of “The digital age: new approaches to supporting people in later life get online” Click Here

I owe my followers an apology. I have missed two weeks in a row for the very first time! Found myself subject to #DigitalExclusion in Crete.

News for Nurses’ Day #ThisNurse

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Not Enough Healthcare Staff Here Either!

Well a return to some of the topics that I repeatedly go on about in this blog. So this week saw the release of a groundbreaking paper from Finland (which has very similar staffing levels in their hospitals to UK hospitals), which revealed that having an excessive daily nurse workload increases the risk of patient safety incidents and deaths. The chances of a patient safety incident increased by up to about 30% if nurses’ workload went above what is considered “optimal” levels and the odds of a patient dying increased by about 40%!! As we approach a growing crisis in the UK around nurse numbers, nursing vacancies and difficulties recruiting to the profession this only adds to the call to make nursing a more attractive profession an to introduce safe staffing levels. Not a new message, especially not in my Blog. It is time politicians started listening. This is not going to solve itself while we undervalue all nurses and allied healthcare professionals. If you want to find out more see the Nursing Times and this is the link to the study on BMJ Open .

I am also a big fan of the National Institute of Health Research (NIHR) Signals have created a My Signals page for Nurses. In the My Signals resources service users, in this case nurses, tell you what research is important to them and why they feel others need to know about it. So go take a look by clicking this link. You can find out more about all of  NIHR Signals by clicking here!

Finally tomorrow, Saturday 12th my is International Nurses Day!   There are a list of UK events on the Nurses’ Day page and you can follow #ThisNurse on Twitter.

A Bad Week All Round

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Some weeks are bad weeks but this week could rank as one of the worst for bad news about the NHS and its relationship with older people in a long time.

Firstly we had the revelation that 450,000 women aged between 68-71 had not been invited to routine breast cancer screening due to a computer error, that has been traced back to 2009!. Public Health England has said that it was not aware of a national problem with the screening programme until January 2018, which seems a bit worrying when they were aware at the same time that screening uptake amongst older women was falling. Watch out for the public inquiry and subsequent report particularly since NHS “everywhere else” didn’t have the same problem. Most people are probably unaware that a full review of the NHS breast screening programme was undertaken in 2012. So if you are affected by this systems failure in any way it’s worth looking at THIS REPORT and making your own mind up about the impact that it may have had on you or your loved one. My concern is that if this had been any other group would it have been noticed sooner and acted upon earlier?

As if that wasn’t bad enough a report released today (May 4th. 2018) is probably worse and even more significant. The annual report for 2017 of the Learning Disabilities Mortality Review (LeDeR) was released today and did make the national news. Their findings are very worrying and point to problems with institutional discrimination across services dealing with people with learning disabilities to the extent that life expectancy at birth if you have a learning disability is 19.7 years lower than for people without learning disabilities. Equally disturbing is that more than a third of deaths of people with learning disabilities were potentially amenable to health care interventions. Again much more will be said about this in the coming days and months so it’s worth taking a look at the primary source, which you can see and download from THIS SITE.

I haven’t even mentioned the dementia care ward at Glan Clwyd Hospital, in Denbighshire which closed in 2013 and it’s culture of “institutional abuse”. Too sad to go there but if you want to know more see this BBC Wales  TIMELINE

Can Scotland Help? @WeNurses #70nursebloggers

It came to my attention this week that Professor Jane Cummings,  The Chief Nursing Officer for England has called on nursing, midwifery and care staff to help mark the 70th anniversary of the NHS by encouraging more nurses and midwives to blog in order to showcase the fantastic contribution that the profession has made to healthcare over the years. Rather than looking backwards, I thought I’d say something about what is going in Scotland that might inspire our nursing and health and social care colleagues in England. So here goes!

Realistic Medicine was initially discussed as a way forward for the NHS in Scotland by the Cheif Medical Officer Dr Cath Calderwood in 2016. It has become an NHS’ vision for introducing the concept of “realistic medicine” concept and is designed to make sure that by 2025 anyone providing healthcare in Scotland will take a realistic medicine approach. NHS Inform states

 Realistic medicine puts the person receiving health and social care at the centre of decisions made about their care. It encourages health and care workers to find out what matters most to you so that the care of your condition fits your needs and situation. Realistic medicine recognises that a one size fits all approach to health and social care is not the most effective path for the patient or the NHS.

Realistic medicine is not just about doctors. It applies to all professionals who use their skills and knowledge to help people maintain their health and prevent and treat illness. This includes nurses of course, but also pharmacists, physios, OT’s, social work and everyone else. The Chief Medical Officer’s third annual report was published last week but if you want to know more about this approach and its impact you can read this and download the 2018 summary from here

One of the features that is really useful for all nurses and healthcare professionals is the idea of encouraging people to ask 5 questions about their treatment. The 5 questions are given in the image below.

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So a challenge to our nursing colleagues elsewhere spread the word and start encouraging your patients to use the 5 questions.

The second initiative is less uniquely Scottish but it has certainly been having an impact and that’s called “What Matters to You”  This Scotland-wide campaign encourages and supports meaningful conversations between people who provide health and social care and the people, families and carers who receive their care. ‘What Matters to You?’ day started in Norway in 2014 and has been growing internationally since. This year ‘What matters to you?’ day falls on the 6th June 2018, so there is still plenty of time to get involved. Of course, asking “What matters to you?” isn’t a question for just one day its a question that we should ask everyone. As Scotland’s Chief Nursing Officer, Fiona McQueen has said,

“The one thing I think that would transform the care that we deliver to people is to listen…… really listen; not just hear what suits us. We need to listen to staff who deliver care and make changes that support them to provide real excellence; but in particular, we need to listen to people who use our services. When we focus on what truly matters to the person and have that ‘what matters to you?’ conversation, that is what will make all the difference”

For a bit of inspiration about personalising healthcare to include what matters, see Why is it important to ask what matters? and  @PersonCntrdSco and if you are on Twitter look for #wmty18

Frailty Resources

age-2785015_960_720Apologies to my MSc in Gerontology students first; because a number of them have just finished their Frailty in Older People Module. So this is too late to help them with their assignment. However, it’s still useful to know its here.

The journal “Age and Ageing” have released a Virtual Edition called “Frailty” that covers many of the main issues in Frailty,  including describing the condition conceptually, reporting its epidemiology, contrasting different options for clinical assessment, detailing the adverse outcomes of frailty in older subjects and some insights into what interventions might improve outcomes for frail older people (and their carers). They have made them available on-line. To have a look at what you can access and to learn a bit more about this important topic CLICK HERE.

Looking forward to next Thursday when Atul Gwande is joining a QI Connect Webinar hosted by Healthcare Improvement Scotland. If you don’t know who Atul Gwande is the I would have a look and listen to these. The Reith Lectures 2014

If you want to join the webinar go to https://www.eventbrite.co.uk/e/qi-connect-atul-gawande-tickets-42419687427