Clear Webinar Series: Person Centered Approach & Recreation Therapy. May 24, 2018

Transcription

1 Clear Webinar Series: Person Centered Approach & Recreation Therapy May 24, 2018

2 Please note: This webinar is being recorded Personal information in this initiative is collected under s.26(c) and 26(d)(ii) of the Freedom of Information and Protection of Privacy Act. The information is being collected in order to facilitate training and education as part of Clear. This webinar is being recorded and will be shared with program participants. We ask that you refrain from identifying patients, specific team members or offering any other personal information. If you have further questions, please contact the BCPSQC at or

3 Your Clear team Kate Harris, Improvement Advisor Sabrina Khan, Project Coordinator Geoff Schierbeck, Improvement Advisor Eric Young, Health Data Analyst Dr. Chris Rauscher, Clinical Lead Kevin Smith, Director of Communications Dr. Ian Bekker, Clinical Lead Leanne Couves, Interim Clear Director

4 Today s Tools: 1. Pointer 2. Raise Hand 3. Yes / No or 4. Chat Interacting in WebEx

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6 What Do We Want to Achieve? The provincial average for potentially inappropriate use of antipsychotics is 25.9%, which is above the national average of 21.8%. AIM: To reduce the rate of antipsychotic use in residents without a diagnosis of psychosis in participating care homes across the province from baseline to the national average (21.8%) by the end of the Clear initiative. *The percent figures are reported from CIHI for Q4 (adjusted rate).

7 Quick Reminder Monthly Reports & Data Due

8 Driver Diagram

9 Learning Objectives 1. Explain the importance in recognizing the benefits of a personalized approach to care 2. Outline additional dementia resources available to care givers 3. Demonstrate an effective use of the Dementia Observation System (DOS)

10 Jan Robson Alzheimer Society of BC

11 Working with People with Dementia May 24,

12 Agenda Communication Behaviour as communication A person-centred approach Alzheimer Society of B.C. resources 12 12

13 I don t think that Alzheimer s will ever take away someone s dignity; but we do. - Joanne Koenig Coste, Author of Learning to Speak Alzheimer s 13

14 Causes of Dementia Progressive, degenerative diseases Alzheimer s disease Vascular dementia Mixed dementia Lewy body dementia Frontotemporal dementia Others cause damage to brain cells and neural-pathways resulting in symptoms of dementia. Memory loss Confusion & disorientation Impaired judgement Communication problems Behaviour changes Others 14

15 Guiding Principle Every person, regardless of their losses, has a core of self that can be reached

16 Communication of Feelings & Attitudes Words 7% Body Language 55% Tone and Pitch of Voice 38% 16 16

17 Focus on Feelings I ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel. - Maya Angelou 17 17

18 Set the Stage Can they hear you? Reduce distractions Can they see you? Glasses Well lighted room

19 Get the Person s Attention Approach the person slowly from the front Do not talk from another room Call the person by name Make eye contact Speak one-on-one Touch arm or hand to get their attention

20 Verbal Communication Keep It Short & Simple

21 Speak Slowly and Clearly Use simple words Speak to the person as an adult Lower the pitch of your voice Use short sentences

22 Pause One Message at a Time Allow time for a response Put most important information at the end One thought = One sentence

23 Demonstrate Show as you talk Cues are very helpful Express feelings with your body Warm tone of voice

24 Pay Attention Avoid open-ended questions. Listen closely with your ears and eyes. What are their words saying? What is their body language saying? Facial expressions? What is their pitch and tone saying? 24

25 Be Patient Avoid arguing Take your time Ask them if they would like your help Repeat as needed

26 Respond to Feelings Respond to underlying feelings, not stories. Provide a positive distraction if they are upset. Use humour when appropriate. Is the person with dementia open to this? Will they feel like you are laughing at them or with them? Try not to take things personally. 26

27 When You Cannot Understand Acknowledge what is happening Reassure and suggest doing something else

28 Basic Facts about Behaviour There is a reason, cause, and meaning for every behaviour. Behaviour is an attempt to communicate. Some behaviours are a result of the disease. Behaviour is very individual. Behaviour can be influenced (we must adapt and problem solve)

29 If Behaviour Changes Suddenly Check various possible areas of concern: Depression Discomfort/pain Too much stimulation/clutter Are we expecting too much? Are we not communicating effectively? 29 29

30 Strategies for Responding Try to determine the immediate cause Don t apply logic and reasoning Focus on feelings, not facts Try not to get angry or upset If you don t insist, they won t resist

31 Strategies for Responding Agree with the person Accept blame Talk positively about the future Shift the focus to a familiar activity; e.g. going for a walk, looking at a photo album 31 31

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34 Personhood When the emphasis is on the person, behaviour is not seen as a problem to be managed, but rather actions and expressions that need to be understood. - Tom Kitwood (Bradford Dementia Group) 34 34

35 PC P.E.A.R.L.S. The Alzheimer Society of Canada has identified 7 key elements of personcentred care: 1. Person and Family Engagement - Families and friends are involved, supported and engaged in the life of the person with dementia

36 PC P.E.A.R.L.S. 2. Care - Effective care planning focuses on each resident s abilities, experimenting with various options to avoid inappropriate use of restraints. It includes routine pain assessment and management to help the person enjoy an improved quality of life

37 3. Processes - PC P.E.A.R.L.S. Person-centred care principles are embedded into the strategic plan and operational processes to begin and sustain culture change

38 4. Environment - PC P.E.A.R.L.S. Working within current regulations and legislation, a physical and social environment is promoted to support the resident s abilities, strengths and personal interests and enhance the daily life of people with dementia

39 PC P.E.A.R.L.S. 5. Activity and Recreation - Each resident is engaged in stimulating and meaningful activities, with recreational plans tailored to the person s interests, preferences and abilities. Continuous assessment, review and revision of these plans is done as the person s abilities and interests change

40 6. Leadership - PC P.E.A.R.L.S. Person-centred care can only happen with strong leaders who are champions of personcentred care, ingrain it in their organizational philosophy and values, and model the actions expected of staff in their own interactions with residents, families and staff

41 7. Staffing - PC P.E.A.R.L.S. Staff training and support, continuity of care, and the fostering of intimate and trusting relationships between families, residents and staff are key factors in optimizing personcentred care and the well-being of residents

42 PC P.E.A.R.L.S. For more information go to:

43 Alzheimer Society of B.C. Vision and Mission Our ultimate vision is to create a world without Alzheimer's disease and other dementias. The Alzheimer Society of B.C. exists to alleviate the personal and social consequences of Alzheimer's disease and other dementias, to promote public awareness and to search for the causes and the cures. 43

44 Alzheimer Society of B.C. Programs and Services Alzheimer Resource Centres for information, education, support and referrals. First Link Dementia Helpline (Lower Mainland) Minds in Motion Weekly exercise and social program for people with early symptoms of dementia and a care partner. Support groups For people with early symptoms For care partners Education Getting to Know Dementia Shaping the Journey : living with dementia Family Caregiver Series Transition to Residential Care Dementia Dialogues Tele-workshops Information bulletins First Link Bulletin Connections Insight for people with dementia Website 44

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46 Dementia Helpline

47 Information 47 47

48 Newsletter & Bulletins Connections A quarterly publication featuring submissions by and resources for caregivers, as well as news, updates and ways to get involved with the Society. Insight Educational bulletin for and by people with dementia To subscribe, visit: Events/Newsletters.aspx Or call or (toll free) 48

49 Dementia Education For people with early symptoms For care partners For health care providers Throughout the progression of the disease Different modes of delivery 49

50 Dementia Education Series: a clear progression that matches families needs Shaping the Journey: living with dementia Family Caregiver Series 50 50

51 Dementia Education Workshops along the journey with dementia: Brain health Advocacy Accessing services Transition to, and life in, residential care Grief and loss Intimacy and Sexuality Wandering 51 51

52 Tele-Workshops 2018 June 7, 2 or 7 p.m. Understanding Dementia July 12, 2 or 7 p.m. Understanding Communication August 8, 2 or 7 p.m. Understanding Behaviour September 13, 2 p.m. only Research Update 52

53 Support Groups For people with early symptoms of dementia For care partners Model Information & Mutual Aid 53

54 Online Resources 54

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56 Dementia Observation System (DOS) Erin Buskermolen Simon Fraser Lodge Prince George

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59 Sample Form #1

60 Sample Form #2

61 Key Messages Completed monthly reports are needed for your IA to provide you any necessary coaching for your improvement Utilize a person centered approach to care Recreation therapy is everyone s responsibility Utilize a DOS to capture times where residents may need extra support

62 What is one thing you heard today that you may start to use by next Tuesday?

63 Upcoming Webinars June 14 Exploring Foundations of Strong Teamwork and Communication June 28 Engaging in Effective Communication July 12 - Fostering Trust and Leadership August 2 Navigating Conflict Successfully

64 Thank You Participating Teams Faculty Support Team 64

65 Evaluation! Please complete the evaluation of the webinar after you close the webex.