Dementia Awareness in the ED - N Carten
Summary
This on-demand teaching session will provide medical professionals with essential tools and insight into caring for individuals with dementia. Through this session, attendees will gain a deeper understanding of dementia and recognize the importance of communication and person-centered care. The session will also include a brief overview of the prevalence of dementia in Northern Ireland and the associated costs, and discuss physical and psychological barriers that may affect a person's perception of actions and stressors. Additionally, the session will cover assessments and tools, such as the ABP and Score and Borden Pain Score, music therapy, and principles of humour and reconnecting to oneself.
Learning objectives
Learning Objectives for the medical audience:
- Describe the definition and prevalence of dementia in Northern Ireland.
- Explain and demonstrate the principles of Person Centered Care when dealing with dementia.
- Recognize and implement variable communication techniques when communicating with people with dementia.
- Assess the use of music, humor, and prior knowledge in aiding the care of people with dementia.
- Identify physical, neurological, psychological, environmental, and socially influenced factors that impact dementia communication and stress.
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Computer generated transcript
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The following transcript was generated automatically from the content and has not been checked or corrected manually.
Oh, okay. No. Hello, everyone. I hope you can hear me. Okay. See, May um, I'm in office at this sim here, So bear with me. Um so dimension awareness. There's so much to talk about in such a short space obtained. So, um, let's get started. So hopefully we're going to cover a bet about waters dementia, describe the incidents and keep presentations of dementia. Explain the importance off unidentified barriers to effective communication and dementia care, um, identify the principles of person centered dementia care, identify and explained factors and stressors that may affect the perception of actions of people with dementia on. We're going to talk. A little bit of I had some of the molested pee and assessment tools that could be used for people with dementia. So the prevalence in Northern Ireland. So if you can focus on the box with the red surrounding this is just a few statistics off her prevalent dementia as in Northern Ireland. So in 2000 and 14, we had a boat. 19,000 people diagnosed dementia grazing significantly in 2000 and 17 on on estimated 60,000 people with dementia in 2051 on the reference from other statistics there were teamed. Um, the current spanned, um from the Department of Health. Fingers is the dementia costs the whole service 250 million per year on just honing in and the E D department. In 2019, there were 1500 avoidable emergency admissions for people with dementia and Northern Ireland, and that was from freedom of information requests to the health trust. So they find the 39.7% of the total emergency admissions for over 65 years. Um, with dementia, where for avoidable conditions, that's quite a significant, Um, I just people coming into the department unnecessarily. So the World Health Organization, um, quote for dementia is it's but old, nevertheless very pregnant. So what is dementia? It's a syndrome due to disease of the brain, usually of a chronic progressive nature in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capability, A language and judgment consciousness is not impaired on impairments of cognitive function or commonly accompanied, occasionally proceeded by deterioration and emotional control, social behavior or motivation. The syndrome occurs in Alzheimer's disease and cerebral vascular disease, and other conditions, primarily or secondarily, affecting my breathing. So just about a revision about the green, um, on the different areas of the brain. Um, Andi, For most of the this will just be about a revision about the different aspects to frontal lobe the bridal. Except it'll load on the temporal lobe, so the'tr preload the left side of it is associated with verbal memory. Um, on the right side is the visual memory on we're new learning takes place worse mail and taste. The frontal is also where new learning takes piece. I'm planning and organizing, uh, knowledge. Uh, socially appropriate behavior on writing and personality is controlled than the peripheral loop. Uh, the left side is the analytical site. On the right side is your three D center, where your spatial awareness, um, you're acceptable. Low, then, is your visual center, Um, or your typical blindness doesn't necessarily mean, um, but the person is blind. It just means that they're Brean can't interpret the images that they receive. So this is the green working normally, um, as you can see new memories, I'm being sorted and too old memories. Um, for someone who has dementia, it's a completely different experience. As you can see in the Slade, there's a bit of chaos and confusion, Um, on the person. It doesn't look extremely happy. They don't for ST it. So dementia is really a weight term used on relative term, used to describe ah weight, range of symptoms and your memory loss and mental to play. So there are many different types of dementia on. Unfortunately, on this occasion, there's not enough time to cover all of these. But it is important for us to know what type of dementia that someone has coming into the D department. Um, because it can help us predict or understand the challenge is the person May fees medication issues on allies is to communicate better. I don't understand their behavior. So what are my essentials and your essential? So if you think about it, shouldn't drink sleep, personal hygiene, communication, warmth, conference identity and rule, um, laughter, music, pets and family. So these are just a few. And I'm sure many of you right there can think of over, um, essentials that are important to you. Um, so for the person coming into E. D. With dementia, these area quickly is important to them. So it's all about perception. Um, many of you seeing the person and the picture night. Um, we'll have different views on what you see. Um uh, gentleman, A meal figure. Um, my father, Grandfather, lots of different things. So it's just be mindful at each of us will perceive you know people differently. So person centered care. So think about the person behind the disease. Really, really important. Um, their lifelong habits, their preferences, they're coping methods, longstanding personality of personal history, their life experiences on their personal strengths and abilities. And many of this information can be, you know, gained from relatives and families that will attend with, um, family members who have a diagnosis of dementia. So understanding and respecting the person was dementia. Tell Ping them feeling valued what's in their name, what they like to be called respecting their cultural values on acting with cortisol at all times respecting the privacy, um, on their dignity, helping the person feel go to bite them sales offering simple, uncomplicated choices. I'm maintaining respect at all times, So communication is so important. Um, I've just broken a dine and variable and nonviable, so we concentrate on the variable communication. Simple terms. Clear, precise information, actively listening to the person. Repeat rather than refreeze, ask open and closed questions you can. Some changes. Written information. Um, as long as a person with dementia doesn't have any visual impairments. Um, peace yourself that you can be understood. Be mindful of your tuna voice on week for the answer, and you're known variable involves your eye. Contact your proximity, your body language, your facial expression, your smile on your piece on obviously touch where appropriate. Um, the level that you speak to someone on the possession that you're in on the use of music art on dance on 7% off communication is picked up Um, nonverbally. So it's just important to be mindful that people with dementia they're not incompetent. They can tell very quickly if you're not listening to them. Um, so it's just to be mindful of those skills and the art of communication. Avoid. You are wrong messages so really important. If someone is agitated that you don't say no, you're not going to work today. No, you can't visit your father. He's day it. No, this is your home night. No, that isn't yours. Put it back. No, we just talked about that. Stop banging the table. Do not reason. Do not hard. You do not be confrontational. Remind them they forgot. Do not question their recent memory. And do not take it personally. So music. So this lady on the left shows the Brianna dressed on the Briones reaction to music on the right on. There has been lots of researched on, um, with regards to music on people who have dementia and the benefits that has shown, um and shortly assure you of a deal highlighting that, um, I also was able to get in touch with, ah, charitable organization that was able to send, um, cause my e d four MP three players. Um, Andi, they send me different Gene Ra's of music so that we could child this and see if we could use it. For patients that have dementia in the e d environment. So essential skills that are required for working with people who have dementia humor. They always say laughter is the best medicine. Um, being flexible in your approach, um, you know, thinking about memories, their identity and the rule, um, behind the person you know they were a mother or father. They had a rule on a job in life, their love for their hobbies, music or dance. Remain cam with someone who has dementia on. Obviously look after yourself in the process, so barriers to effective communication or things that might add to the stress of the person living with dementia. So your physical, your neurological, psychological, environmental on be malignant social psychology. So the physical is your neurological changes, hunger and first feeling on where medication, sensory difficulties, the desire to exercise it cracks. Yeah, I'm peeing. So what about PM? So there's lots of research right there that suggests 80% of older people have chronic pain. So that is the older population that don't have a diagnosis with dementia. So you figure in them, you know, evidence that people with dementia than are less likely to receive regular analgesia. It has a huge impact on those people, so anyone with dementia who requires analgesia should receive this regularly. I'm not as a PRN, um, and then the use of appropriate pain assessment tools that are used right there. So the ABP and score is one that I wasn't particularly familiar with. I was more familiar with the Bolden peon score. Um, and this is really useful to assess someone who has a cognitive impairment. Um, allergy. You have something there that is a visual, too, that can give you information to go to your doctor and say, Look, I believe this person is actually sore. Let's give them something relief. So that's the A BP and score, but also the board and pee and score is equally as effective. And I know when I came here to start, I I have mentioned ELISA. But, you know, looking at these chose to be used in the department. So I think that those have gone to governance and hopefully we'll have some sort of feedback soon are being able to use these p and scores. So feeling lost An insecure boredom? No. Only anxious, fearful, um, or the task is too difficult environmental. So the temperature, sensory overload, sensory deprivation, comfort lighting, knowing the way tension in the environment on the actual belt environment. And if you look at the E d environment, this is certainly not unenviable. That is conducive to patients who have dementia. But if you spot the many potential stressors For someone who has dementia, there's lots of things there that would certainly frighten someone who's got to mention the noise and the sensory overload. There is only two abundance in the picture, so challenging behavior or a perfectly normal reaction to stress. So again, you know, communication as she's really, really important. Um, if you're not listening to the person and you're going to miss interpret what they're trying to say or do, um, if you're not understanding them, you have to take into consideration the environmental factors and a busy department. The change of environment, um, that my colleague had a little tea earlier where the uh individual had developed a Z delirium was a result of a change of environment. Um, physical health and PM um can also have a huge impact on people not treating others as they wish to be treated on. But the perception where we see ourselves is not maybe what other people see so reconnecting with yourself. So this is just a video that I'd like to show on a plate. Just a bit of information about the benefit of music. It's just a once a year, we'll get it set up. It's like I get some years. You know what I tried? Side wouldn't work for me. Much is like trying for two years. What I tried, besides, wouldn't work. Work's mean the introduce the I pox and the family told me that things that you like it was amazing. Once you put the eye started, started for that person with this maze. Okay, I'm seeing her over. Are you doing that? Is Charlie having seizures? That's my mother was always, you know, loving single, you know, occasionally come out with the song. No matter where I was a child, I used to walk us down to shoot me and my brother stopping too soon laying that was jumping. Swimming around medicine. Uh, that's for that's the nice music. You're just one in the Bible. You have that for you before. See every, you know, maybe the crest on responses on almost under lives. Yeah, my watch. You know, you talk, it is to give a cleaning. No. Uh oh. Oh, oh. He that's up. His face assumes expressions. I don't, Right. Yeah. He starts to, um, to see drunkard move his arms on TV. I weigh toxicology bone know I introduce the music. Um, this is actually it's okay. What school? Use it quickly. Yeah, let me take a minute for one second. Okay. This the actual three questions. Okay. I'm going to give it back to you. You think this stuff start between the It's taken off normally unable, Can't see the insulin questions. Just great, Henry. Yeah, you like the I got you like the music. Your hearing? Yeah. Tell me about your music. Well, I don't know. I don't know. Do you like music? Yeah. I'm crazy about new You pretty good with you. You sound you Did you play music when you were Well, did you like music when you were young? This big dances. Thank you. What was your favorite music when you were young? Whoa. Well, tell tell we want one. I want your favorite cap. Follow a song. Oh, oh, you know No miss the whole breads. Remeron. You free? Oh, so in some sense is restored himself. Yes, members who is on? But it's your cracks. That's his identity. A while to power field. What does music do you do to you? Way world, You come in. You saying do you believe it again? You know, you know, you've been low dream long, kid. So you just say it's beautiful, beautiful woman. It's a significant for you to something else because of Matchbox, I think two eyes bringing since 60. That who are you are? What? Well, um, so I be interested to hear your thoughts on that video. Um, so just to finish up, um, the Northern Trust has just recently released this up, so it's called the clear dementia. Care up. Um, it's follow really useful resources for family, for healthcare professionals. Um, and it was devised by one of the psychologists, Dr Francis Stuffy, and her team. Um, so it's hopefully you'll find it helpful. And hopefully you'll feel inspired, um, Tioga to patients with dementia and the department in a different light and a positive, uh, perception on. But that's all do our best to try and look after these people as best we can. What's he? Well, thanks so much. And like Well, that was a great talk. Um, we'll just use any questions coming up. Um, one thing that I'm really came that we drove home today is just this idea, but pee in your life, which you've talked on really, really well for us. So and, you know, these patients might not have for pain relief initially important that we are kind, proactive and trying to assess if they are peeing and peeing and so that and score until it's quite helpful. But And please, please, just because your paces agitated on got diagnosed dementia, you know, think. Please think about Jesus as you touch him. And so just there's another questions coming up here for, you know, cool. Um, yes. Um, I just says yes. Absolutely. That's remember that there's a person behind the disease. Colon was asked on any practical tips for 80 stuff to help those You're agitated or wandering when they're in the eating Any other week, pearls of wisdom that you can share with us. Um, I always find music powerful too. I I have to say in the number of times that I have worked with, um I use my Spotify at night. Um, Andi, I tend to ask them what their favorite music is on. I put it on, um, on. I walk with him when we have time. Um, and it seems to settle. Um um, you know, the other thing is, is touch used appropriately, Um, just helps them fading, you know, about more secure. Um, so it's just being mindful that, you know, they're out of their own environment. Um, you know, offering them drinks. You know, it's really, really important eating as a warm environment on just, you know, simple drinks where they don't get dehydrated with can cause, you know, more agitation. And, you know, Emily had mentioned earlier by delirium, and, you know, you think it of your three days is Well, you know, your depression, your delirium, your dementia s So it's it's just blocking and being mindful of those sorts of things. I'm trying to find out, you know, from family what they did something that you have in common with, Um maybe what they did in their past. I remember one time I had a lady who was really, really distinct distressed family commended visit, and I said to him, What did she do? You know, what was your occupation previously? And she was a tape just for a law firm. So we had a nolde keyboard that wasn't being used in the department on I said the keyboard in front of her on. It was unbelievable. The change in her behavior with simple keyboard. So it's kind of trying to record on on things personal, isn't it? To them and just trying to use those sorts of tools that you can pull up on dry. A smart as you can, but, you know, music as a powerful tool. And I really would be very interested to see how you know the MP three players will go down and eat day just to see effort will help, you know, block out as to say earlier, You know, the number of stressors that are needy department people with P. And so maybe all those sorts of things might be helpful. Watch the space. We may do better research and see what happens. Thank you, Nicole. Yeah, absolutely. And I think the other thing we're just kind of king to touch on and keep come back today is, you know, to use family and, um, you know, work Have thinking about, um, visitors. Another asked, but if you got some things I did, I just get in the family member that they knew really well to come in and set with, um, one makes out wondering, but to you means you've got something else setting there didn't provide the one the one for you on can make sure could be the off it for the patient as well and can say like a sore. Or, you know, I think. And she's Thursday or seeds. Some food or doesn't like that are kind of keep us, keep us posted soup and try, I guess, which is for all of us to try and get away, you know, if not mine sale of see and relatives Better Virgin, actually, for the script, patients in particular, they can be real, really useful asset for us to to use. There's a few comments to get up. I didn't know that by their knuckles, so I think, and probably have a look about because it looks like it might be quite helpful on a lot of people. Just send thanks to Talk Column thinks that I'm a great singer apartment four years old here, my son in books call upon you manage it will mention think that's nothing to get too excited about. My son, right? So it's on. The other question is the course, or thanks very much. That was really, really good talk and wouldn't move on. I Then let me just stop.