Participant Workbook

Transcription

1 Participant Workbook

2 Page 2

3 Contents Welcome... 4 VIPS model... 5 Enriched model of the person... 5 Module 2: Personality descriptions... 6 Module 2: Pain and dementia... 7 Wellbeing and the 5 essential needs... 8 DAPIR cycle... 9 Module 3: Making Marion Comfortable Module 3: Feeling included Module 3: Identity reflection Triggers for wellbeing and illbeing Module 4: The bedroom and bathroom Module 4: The eating experience Module 4: Dementia friendly environments Module 4: Friends, family & community The 5 Cs Module 6: Responsive behaviours Page 3

4 Welcome Welcome! Throughout the DDT modules you will be presented with a range of activities or Learning actions. Some of these are designed to be completed in this DD Workbook while others are interactive tasks that you can complete on-screen. Once you have printed this Workbook you will not need to print the individual Learning actions sheets throughout the modules. To consolidate your learning, we have included a selection of the graphics and models encountered in the DDT modules in this workbook. The table below indicates which Learning actions should be completed in this workbook and which will be completed interactively on-screen. Learning actions: Module 1 Module 2 Module 3 Module 4 Module 5 Module 6 No learning actions VIPS quiz on-screen Brain function match on-screen Brain change match on-screen Personality descriptions - DD Workbook Pain and dementia - DD Workbook Health quiz on-screen Imagining Marion s ideal room on-screen Positive and negative actions on-screen Making Marion comfortable on-screen Marion and Tom s friendship on-screen Making Marion comfortable - DD Workbook Feeling included - DD Workbook Identity reflection - DD Workbook Promoting wellbeing on-screen Signs of wellbeing and illbeing on-screen Identifying wellbeing and illbeing on-screen Bedroom and bathroom - DD Workbook The eating experience - DD Workbook Dementia friendly environments - DD Workbook Friends, family and community - DD Workbook Enhancing Marion s wellbeing on-screen Responsive behaviours - DD Workbook Page 4

5 VIPS model The VIPS model is a simple way of describing the person centred approach to care. Enriched model of the person The Enriched model of the person supports us in looking beyond neurological impairment to consider the importance of personality, life story, physical health, social preferences and the physical environment of the person with dementia. Page 5

6 Module 2: Personality descriptions Task: 1. Think about your own personality. List at least 5 words or phrases below that you think effectively describe your personality. You can select them from the list below or think of your own. 2. What about Marion and Tom? Write down 3 words that describe Marion s personality traits, then Tom s. Choose from the list or think of your own words. Marion s personality Tom s personality Excitable Open Up-tight Down to earth Distrustful Happy Honest Vain Naïve Outgoing Self-centred Easy going Kind Private Charming Conscientious Cruel Intolerant Biased Generous Thoughtful Understanding Critical Negative Ethical Picky Patient Moody Unaffected Good natured Insensitive Thoughtful Sentimental Bossy Reflective Fussy Page 6

7 Module 2: Pain and dementia Pain is a common concern for older people and can be related to a number of different health issues. Pain can be a particularly troubling symptom for the person with dementia as they may not be able to communicate their distress, the location of the pain or request help in managing the symptoms. Changes in mood and behaviour could be related to pain in the person with dementia so it is important that we are alert and responsive to these changes and assess for the possibility of pain accordingly. Task: 1. Watch the video of Marion then list 3 ways she shows signs of pain. 2. List 2 other possible ways a person with dementia might show signs of pain. 3. Think about Marion s arthritis and other physical complaints. How this might affect her mood? 4. From the following list of pain management strategies below, tick the box for all the responses that you think might assist with managing Marion s pain: Analgesia Massage therapy Complete immobilization Position changes Local heat or cold applications Zumba classes Diversional activities Mobilisation Playing tennis Gentle gardening Splinting affected joint Page 7

8 Wellbeing and the 5 essential needs Wellbeing is a fundamental goal of our lives as human beings. We seek to create wellbeing for ourselves and others - and for the person living with dementia. To create a sense of wellbeing we apply the essential needs of Comfort, Attachment, Inclusion, Identity and Occupation. Page 8

9 DAPIR cycle The DAPIR Needs-based Problem Solving Cycle. Was the plan effective and how do we know? What issues should we focus on next? Describe the responsive behaviour Describe the person Describe the Physical and Social Environment Engage, Consult and Communicate the strategy Implement for as long as it takes Reflect, Analyze and look for patterns Visible triggers Invisible triggers Is your plan SMART? Simple Measurable Achievable Relevant Timely Page 9

10 Module 3: Making Marion Comfortable Think back over all the things Marion has mentioned in terms of her personal preferences and what makes her feel comfortable and good about herself. Task: 1. List below your ideas of what might assist in providing for Marion s comfort needs. Page 10

11 Module 3: Feeling included Task: 1. Think about the residents in your facility. Choose a resident who asks questions a lot or who hovers around staff. What needs might be driving this responsive behaviour? 2. Think about the potential underlying causes. Write some suggestions below about strategies or approaches you could use that might address the resident s needs and assist with reducing this particular responsive behaviour. Page 11

12 Module 3: Identity reflection The need to know who one is, in feeling and thought. To have a sense of a past. Often given to us by others. Even though memory loss may rob a person of their name, their identity can be held by others. (Kitwood, T. (1997). Dementia Reconsidered: The person comes first. Open University Press, Buckingham, UK, p 83 How do you know who you are? What do you do that signals to others that you are you? Think about clothing, speech, your name, actions, people you mix with. Task: 1. Think about all the information Marion has given us about her life and personality so far. List below the things that make up her sense of identity. 2. Choose one of your residents and review their file by going through their social history or life story. What can you find that tells you about their identity or sense of who they are? 3. What do they need from people around them to feel good about themselves or feel like their old self? Page 12

13 Page 13 Triggers for wellbeing and illbeing

14 Module 4: The bedroom and bathroom All staff play a key role in respecting and facilitating resident privacy. The bedroom and bathroom are the most personal and private areas of our homes, and in an aged care home they are also where other people come to assist with the most intimate aspects of care, including hygiene and toileting needs. Choose an activity from the list below related to your role; Hygiene care Dressing and grooming Clinical care (medication as appropriate) Cleaning resident rooms Providing food / snacks / drinks in a resident s room Maintenance and repairs Task: Thinking about encounters in the bedroom and bathroom, respond to the following. 1. Describe what you do during any one encounter (give a brief step by step account) 2. Describe any reactions during such encounters that would be considered responsive behaviours. 3. Make suggestions about how you might change the encounter to try to reduce or eliminate these responsive behaviours. Page 14

15 Module 4: The eating experience Meals have been described as the single most consistently effective health promoting activity we can offer our residents. Failure to eat well has been identified as the single greatest threat to a resident s physical and emotional health. Task: Read the PDF The Eating Experience. Think about how meal service is conducted in your facility and write responses to the following. 1. List three ways you could improve the dining experience for residents in your facility. 2. List three important actions to take when assisting a resident to eat their meal. 3. Tick the box for all the responses you think might indicate that one of your residents would benefit from a finger food menu; Regular refusal of a full plate of food Picking individual items off the plate Eating full meal Refusal to sit down for more than a few minutes at a time Weight loss Request for second servings Taking food from another resident s plate Page 15

16 Module 4: Dementia friendly environments There are many elements to consider when creating dementia friendly social and physical environments. These include colour differentiation, cues and signage, quiet and private spaces, garden areas and public spaces. Task: 1. What positive features of the environment are shown in this picture? Line of sight to interesting areas Handrails that contrast the wall Unpatterned flooring All of the above 2. Thinking about dementia friendly, enabling environments, compare and contrast the features of these two hallways. Record your ideas. 3. Identify at least three elements that need to be changed in these environments to improve them for people with dementia. Page 16

17 4. Which one of these is the better sign for a person with dementia? Why? Page 17

18 Module 4: Friends, family & community Task: Think about Marion s experience of family visits. Record your responses to the following; 1. When Marion forgets that her family have visited the best practice response I can make is to What are some other strategies that you could use to assist Marion in recalling details of family members and family visits? 3. List three ways to improve the family s experience of visiting Marion. 4. What kinds of community activities could you engage Marion in and why do you think these would appeal? Page 18

19 The 5 Cs Tools to Tackle Responsive Behaviour The 5Cs: Page 19

20 Module 6: Responsive behaviours Let s explore Marion and Tom s relationship further by applying the DAPIR cycle. Respond to each of the items below. Task: For each scenario, list all the actions that could be identified as a responsive behaviour. 1. Use objective language to DESCRIBE each individual behaviour. Drawing on what you have learned about the Enriched Model of the Person (neurological impairment, personality, physical health, life-story, social preferences) and the influence of the physical environment, list all the factors that might be relevant to each behaviour. 2. For both scenarios, ANALYZE the invisible or internal triggers or causes that you think might be motivating Marion and Tom s behaviour (memories, thoughts, feelings, sensations and the five fundamental needs). There is often more than one trigger or cause for a responsive behaviour. What patterns are you seeing in Marion and Tom s behaviour? 3. Now focus on the visible or external factors. Can you identify any visible or external triggers or causes that could be motivating Marion and Tom? Page 20

21 Module 6: Responsive behaviours 4. How could you meet Marion and Tom s needs in order to maintain their sense of wellbeing while also ensuring that the needs of other residents are also met? PLAN how you would do this by listing at least three strategies to address the responsive behaviour you have identified in each scenario. 5. How will you IMPLEMENT this plan? What issues will you consider when implementing the plan? Think about whom you will be communicating with. How would you ensure that all the staff involved in delivering care are consistent in their approach? Who will you talk to in order to ensure implementation is successful? What specialists or other people will you involve? Page 21