Alzheimer’s & Dementia

S U P P O R T S E R V I C E S

Sarah ParsonsSenior Nurse Service Modernisation, Adult

Medicine, Darent Valley Hospital

Dementia Buddy Pilot ProjectDementia Buddy Pilot Project

Sarah ParsonsSarah ParsonsSenior Nurse Service Modernisation, Adult Medicine, DVHSenior Nurse Service Modernisation, Adult Medicine, DVH

Ann Aldous-DunnAnn Aldous-DunnDementia Buddy Co-ordinator, ADSSDementia Buddy Co-ordinator, ADSS

March 2013March 2013

BackgroundBackground• Dementia costs the health and social care economy more than Dementia costs the health and social care economy more than

cancer, heart disease and stroke combined (Alzheimer’s Society, cancer, heart disease and stroke combined (Alzheimer’s Society, 2007). 2007).

• In 2010 in West Kent 7,834 people were estimated to have late In 2010 in West Kent 7,834 people were estimated to have late onset dementia.onset dementia.

• By 2013, this is expected to have increased by 13% to 8,837 and By 2013, this is expected to have increased by 13% to 8,837 and by 2023 an estimated 50% increase to 11,692 people. (Kent by 2023 an estimated 50% increase to 11,692 people. (Kent County Council and NHS West Kent, 2010).County Council and NHS West Kent, 2010).

• Intermediate care services did not respond to the needs of Intermediate care services did not respond to the needs of people with dementia, as a consequence individuals with people with dementia, as a consequence individuals with dementia were more likely to be admitted to hospital, and once dementia were more likely to be admitted to hospital, and once there, the length of stay tends to be considerably longer than there, the length of stay tends to be considerably longer than expected. expected.

• DVH Case Mix Analysis 2010DVH Case Mix Analysis 2010 Average length of stay being 34.7 days Average length of stay being 34.7 days ‘‘Non acute’ admissionsNon acute’ admissions Poor outcomePoor outcome

What is a Dementia What is a Dementia Buddy?Buddy?

A trained volunteer who has a good understandingA trained volunteer who has a good understanding

of dementia and knows how to engage positivelyof dementia and knows how to engage positively

with people with dementia to improve their well being.with people with dementia to improve their well being.

The Dementia Buddy The Dementia Buddy SchemeScheme• The Dementia Buddy scheme is a pilot project, initially The Dementia Buddy scheme is a pilot project, initially

running for one year, up to end of June 2013. running for one year, up to end of June 2013.

• It is funded by Kent Adult Social Services It is funded by Kent Adult Social Services

• £30,000 was awarded following a competitive tender £30,000 was awarded following a competitive tender process to the Alzheimer’s & Dementia Support process to the Alzheimer’s & Dementia Support Services (ADSS), a local independent charity.Services (ADSS), a local independent charity.

• The funding for the project was used to create a The funding for the project was used to create a Dementia Buddy co-ordinator post to facilitate the Dementia Buddy co-ordinator post to facilitate the recruitment, training and supervision of 20 Dementia recruitment, training and supervision of 20 Dementia Buddy Volunteers. Buddy Volunteers.

• The volunteers receive full training from the The volunteers receive full training from the Alzheimer’s & Dementia Support Services to become Alzheimer’s & Dementia Support Services to become ‘Dementia Buddies’ for patients with dementia who ‘Dementia Buddies’ for patients with dementia who are admitted to Darent Valley Hospital. are admitted to Darent Valley Hospital.

TrainingTraining• Core induction at Darent Valley Hospital (DVH) which includes Core induction at Darent Valley Hospital (DVH) which includes

infection control, food handling & health & safety issuesinfection control, food handling & health & safety issues

• Adult protection training – Level 1 – Kent County CouncilAdult protection training – Level 1 – Kent County Council

• Mental capacity act training – Level 1 – Kent County CouncilMental capacity act training – Level 1 – Kent County Council

• Dementia and cultural awareness in dementia training – ADSSDementia and cultural awareness in dementia training – ADSS

• Induction – ADSS – Confidentiality, Adult Protection reportingInduction – ADSS – Confidentiality, Adult Protection reporting

• Day to day support, monthly supervision & annual appraisalDay to day support, monthly supervision & annual appraisal

• All volunteers have an enhanced CRB (now known as the All volunteers have an enhanced CRB (now known as the Disclosure, and Barring check) Disclosure, and Barring check)

• Two references taken up and are assessed by the Occupational Two references taken up and are assessed by the Occupational Health team at DVH. Health team at DVH.

Keep basic records

Keep basic records

Encourage and assist with food

and drink

Encourage and assist with food

and drink

Signposting to support

services.

Signposting to support

services.

Provide information and

support to carers

Provide information and

support to carers

Engage in activities to

maintain cognitive

capabilities

Engage in activities to

maintain cognitive

capabilities

Increased social interaction

Increased social interaction

Partnership working with

staff to ensure best outcomes

for patients with dementia

Partnership working with

staff to ensure best outcomes

for patients with dementia

Potential OutcomesPotential Outcomes• Improvement in the overall hospital experience Improvement in the overall hospital experience

for people with dementia for people with dementia

• Improve the sense of well being and dignity Improve the sense of well being and dignity through cognitive stimulation and improvement through cognitive stimulation and improvement in nutrition by assisting with food /drink intakein nutrition by assisting with food /drink intake

• Reduction in Length of Stay by improving Reduction in Length of Stay by improving wellbeing & food/drink intake and maintaining wellbeing & food/drink intake and maintaining cognitive stimulation. cognitive stimulation.

• Reduction in the number of 28 day emergency Reduction in the number of 28 day emergency re-admissions by ensuring that the Carers/person re-admissions by ensuring that the Carers/person with Dementia feel more supported and therefore with Dementia feel more supported and therefore more able to cope after leaving hospital, more able to cope after leaving hospital, particularly with access to support services.particularly with access to support services.

• Increase in number of patients with Increase in number of patients with dementia returning to own homes rather dementia returning to own homes rather than admission to hospital or placement in than admission to hospital or placement in Care Home. Care Home.

This will be achieved by giving early This will be achieved by giving early

support to the person with dementia and support to the person with dementia and their carer with information about local their carer with information about local services such as short breaks & care at services such as short breaks & care at home serviceshome services

• Reduction in cost to Acute Trust of Reduction in cost to Acute Trust of requiring, one to one nursing, of ‘at risk’ requiring, one to one nursing, of ‘at risk’ patients with dementia patients with dementia

Scope of ProjectScope of Project

Initially the project has been pilotedInitially the project has been piloted

on Ebony Ward, the Elderly Care Ward, aton Ebony Ward, the Elderly Care Ward, at

Darent Valley Hospital with up to fourDarent Valley Hospital with up to four

buddies in situ (dependent on availability)buddies in situ (dependent on availability)

between 10:00am until 2:00pm, Monday between 10:00am until 2:00pm, Monday toto

FridayFriday

ImplementationImplementation• The Dementia Buddy Co-ordinator was recruited The Dementia Buddy Co-ordinator was recruited

and took up post in June 2012. and took up post in June 2012.

• The post is managed by ADSS but is based at The post is managed by ADSS but is based at Darent Valley Hospital with additional Darent Valley Hospital with additional management support from the Hospital’s management support from the Hospital’s Dementia Project Lead.Dementia Project Lead.

• Agreement for pathways, protocols and Agreement for pathways, protocols and documentation which both the ADSS and DVH documentation which both the ADSS and DVH were happy to use for the project.were happy to use for the project.

• A monthly project steering group was A monthly project steering group was implemented to monitor progress and evaluate implemented to monitor progress and evaluate the impact of the project, with membership the impact of the project, with membership consisting of representatives from the hospital, consisting of representatives from the hospital, ADSS and Kent Adult Social Services ADSS and Kent Adult Social Services Commissioning.Commissioning.

• Baseline information was collected to enable the Baseline information was collected to enable the evaluation process of both qualitative and evaluation process of both qualitative and quantative data quantative data This consisted of:This consisted of:

An observational auditAn observational audit using the Observational Person, using the Observational Person, Interactions and Environment (PIE) Method for Hospital Interactions and Environment (PIE) Method for Hospital Audit of Dementia created by Bradford Teaching Hospitals Audit of Dementia created by Bradford Teaching Hospitals NHS Foundation TrustNHS Foundation Trust

Satisfaction surveysSatisfaction surveys requesting feedback from ward requesting feedback from ward staff, dementia buddies, patients and/or carers/relativesstaff, dementia buddies, patients and/or carers/relatives

Data specific to Ebony WardData specific to Ebony Ward including Length of Stay, including Length of Stay, incident reports/falls, complaints, 1:1 at risk nursing incident reports/falls, complaints, 1:1 at risk nursing requirements, and discharge destination/outcome; requirements, and discharge destination/outcome; Readmission rates.Readmission rates.

Aim to Aim to repeat same data analysisrepeat same data analysis for interim review 6 for interim review 6 months after implementationmonths after implementation

Going Live!Going Live!

• First Buddy in First Buddy in place on Ebony place on Ebony Ward in AugustWard in August

• Media Launch on Media Launch on 26 October26 October

Progress so farProgress so far• Currently 14 volunteer dementia buddies are in place Currently 14 volunteer dementia buddies are in place

on Ebony Ward having completed the relevant on Ebony Ward having completed the relevant processes & training.processes & training.

• Recently (February 2013) the Buddy Service was Recently (February 2013) the Buddy Service was extended to Maple Ward (Orthopaedics) with 3 extended to Maple Ward (Orthopaedics) with 3 volunteers in placevolunteers in place

• 12 more buddies are at various stages within the 12 more buddies are at various stages within the recruitment pathway recruitment pathway

• Making a total of 26 buddies Making a total of 26 buddies

• 14 new applications received14 new applications received

• 3 potential recruits would like to work weekends once 3 potential recruits would like to work weekends once the service has expanded to 7 days per weekthe service has expanded to 7 days per week

Future PlansFuture Plans• Dementia Dementia

Challenge funding:Challenge funding:

Dementia Specialist Dementia Specialist PractitionerPractitioner

Environmental changes:Environmental changes: SignageSignage Pilot Colour Scheme in bays Pilot Colour Scheme in bays

(Ebony)(Ebony) Pictures relating to coloursPictures relating to colours Bed spreadsBed spreads CurtainsCurtains Toilet SeatsToilet Seats

• Charitable Funds:Charitable Funds:

Picture books/memory Picture books/memory boxesboxes

Reminiscence corridorReminiscence corridor

MP3 MP3

Sensory GardenSensory Garden

• LaundryLaundry

• Expansion of Expansion of Dementia Buddy Dementia Buddy SchemeScheme