Sharing best practice for delivering excellence in nutrition and dignity in dementia care. 1

Transcription

1 Sharing best practice for delivering excellence in nutrition and dignity in dementia care 1

2 Partnership project Started January 2014 Council Service users/ carers BU Care homes Dorset LEP 2

3 Overview of afternoon Welcome by Jane Murphy Dame Christine Beasley, Burdett Trust for Nursing Hilda Hayo, Chief Admiral Nurse, Dementia UK Overview of the key research findings Panel discussion Networking Training film viewing Next steps 3

4 Social #nutridignityindementia 4

5 Dame Christine Beasley 5

6 @nutri_dementia #nutridignityindementia 6

7 Hilda Hayo 7

8 Working with People Living with Dementia Hilda Hayo Chief Admiral Nurse/CEO 8

9 What are the issues? Growing numbers of people with dementia Majority live in their own homes Growing number of family members providing care estimated to save the nation 17.4 billion Patchy services and postcode lottery High multiple health and social care needs Multi morbidity 9

10 A potted history of Admiral Nursing Family experience Hosts Specialist dementia nurses Family focus 10

11 3 Tier Dementia Pathway Tier 3 Admiral Nurses Tier 2 Dementia Skilled Tier 1 Dementia Awareness 11

12 Dementia Pathway Pre diagnosis Diagnosis Living with dementia End of life Grief and bereavement Supporting families affected by dementia through the trajectory of dementia 12

13 What does an Admiral Nurse do? Family & relationship centred approach Work in partnership Specialist assessment & intervention Promote and implement best practice Provide supportive education Provide bio psychosocial support for the family Liaison with other professionals and organisations Work in consultancy and supervisory role 13

14 Some nutritional issues encountered Under nutrition Reluctance to eat Obsessions Overeating Dental and oral issues Swallowing issues 14

15 Recommendations from Nutrition and Dementia Review (ADI, 2014) More research into: supplementation; MIND diet; Vitamin E; fortification Clear, consistent and independent advice Nutritional standards of care for dementia 15

16 Nutritional standards of care for dementia Weight and nutritional status assessed Dietary advice from a dietician to all families affected by dementia. Under nutrition: dietician and OT assessment. Natural food fortification to be tried first but then oral nutritional supplementation. Staff training in hospitals and care homes re: nutrition 16

17 Diet and Brain Health Fish oils: heart disease, arthritis, cancer, cognitive function Vitamins especially B vits and antioxidants Flavonoids: antioxidant properties, protect against cell damage No one food / nutrient likely to reduce risk of developing AD/ Dementia need a mixture

18 The MIND Diet Developed to help Improve brain function and reduce risk of Dementia Combination of the Mediterranean diet and diet to reduce blood pressure (DASH diet) Which key foods most important? American study, 960 older people, spanned 9 years ( ) 52% reduction in Dementia, slower mental decline

19 MIND Diet brain healthy foods Green leafy & colourful veg Nuts & berries - blueberries, strawberries etc Beans, lentils, soya Wholegrains Fish Poultry Olive oil 5 unhealthy foods Red meats Butter and margarines Cheese Pastries and sweets Fried and fast foods

20 Should you follow the MIND Diet? Maybe hard to follow it rigidly Even those who followed it partly obtained some benefit Making your diet more MIND like easier to follow long term Diet important, but only one aspect of lifestyle changes associated with reduced risk. Need to consider nutrients that may be missing/reduced that have other important functions

21 Thank you for listening Admiral Nursing DIRECT: or direct@dementiauk.org 21

22 @nutri_dementia #nutridignityindementia 22

23 Nutrition and Delivering Dignity in Dementia Care No standardised interventions to maintain adequate nutrition Lack of nutrition training, skills, empowerment and leadership to embed values and behaviours in care Poor recognition of the meal experience to deliver personcentred care 23

24 Challenging

25 Complex. 25

26 Aims 1. To identify and understand best practice and delivering excellence in nutrition and dignity in dementia care to provide quality improvement in food and nutrition for people living with dementia. 2. To establish high quality nutrition education and learning. 26

27 Identify best practice Qualitative and Quantitative Research Methods Measures of nutritional status: food & fluid intake intake, energy expenditure/physical activity & sleep patterns (accelerometry) Focus groups/interviews: all those responsible for food, nutrition and delivery of care in care homes. 27

28 Quantitative research Take homes Variable physical activity and sleep patterns contribute to low intakes in some residents Majority of residents were not meeting recommendations for hydration Real time monitoring using wearable technology can support better food and nutrition for person-centred care in people living with dementia 28

29 Qualitative research Nurse managers of care homes Key care staff Family carers Chefs and kitchen staff Dietitians Speech and language therapists 29

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32 What do these aromas mean to you? 32

33 Establish high quality education Delivered and evaluated face to face training and education Assessed impact of learning follow up 33

34 Comments from attendees I would recommend this learning to all within the care-sector no matter what their role. Everyone would benefit ultimately Activities Coordinator Lots of valuable research-how to deliver, ways to deliver and a good combination of data and references to real life practice Care Home Manager Absolutely fantastic! So Inspiring! Really varied materialengaging-really thought provoking-so many new ideas and perspectives. So much to take away. Thank you so much Care Assistant 34

35 @nutri_dementia #nutridignityindementia 35

36 Discussion panel Dr Michele Board RGN DPSN, Senior Lecturer, Bournemouth University Dr Janet Scammell RN, DNSci, Associate Professor, Bournemouth University Professor Keith Brown, Director of National Centre for Post Qualifying Social Work, Bournemouth University Rebecca Robson RMN, Registered Manager, Waypoints Care Home, Verwood 36

37 @nutri_dementia #nutridignityindementia 37

38 #nutridignityindementia 38

39 Training tools 39

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41 Elaine Atkinson OBE Closing Comments 41

42 Thank you for listening! Register your interest for a copy of the training material before Further information #nutridignityindementia you leave 42