Meeting the Needs of Patients with Dementia

MEETING THE NEEDS OF PATIENTS WITH DEMENTIA St Peter’s Hospital is a specialised centre for the assessment, treatment and rehabilitation of individuals with a wide range of complex neurodegenerative and organic disorders, including dementia.

There are many different causes of dementia, the more commonly known being Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, and Frontotemporal Dementia.

Rarer forms include Creutzfeldt-Jakob’s Disease (CJD), alcohol related dementia, HIV/Aids and Parkinson’s dementia.

The clinical expertise of our multidisciplinary team (MDT) makes us ideally suited to deliver high quality, evidence based therapies to those living with all types of dementia — helping us to provide the best possible care with the aim of optimising our patients’ independence and quality of life.

St Peter’s Hospital is part of the established Ludlow Street Healthcare group

OUR CARE PATHWAYS Located on the outskirts of Newport, St Peter’s Hospital offers 33 beds split into single gender units and, since our launch in 2013, our safe and friendly environment has provided specialist support to dementia patients at every stage of their journey through our three clearly defined care pathways:

DEMENTIA

Recovery & Wellbeing Pathway

Assessment & Treatment Pathway (16 Weeks)

Patients with dementia will experience a progressive decline in mental ability and overall cognitive function, characterised by changes in memory, functional ability, general mental wellbeing, personality and behaviour.

Although many diagnosed with dementia will live meaningful lives at home, there are some for whom changes in their personality and behaviour — combined with co-morbid mental illness — means it is unsafe for them to receive care in the community. These individuals can present with risk of selfneglect, increased personal Specialist vulnerability, or pose a risk to Palliative others — requiring rapid access Care Pathway to specialist services.

At St Peter’s Hospital, we provide a safe environment where the functional ability of those with dementia can be maximised, offering access to a team who understands the challenges that the disease presents for both the patient and their family.

Community / Home Setting

OUR EXPERTISE IN CARING FOR THE UNIQUE NEEDS OF PATIENTS WITH DEMENTIA OUR ENVIRONMENT

NUTRITION

Our centre incorporates dementia friendly design features (as advised by the DSDC, Stirling University), including level flooring, appropriate lighting and a range of signs and communication boards to encourage orientation — and every patient’s room has a uniquely designed front door and memory box.

Our onsite speech and language therapist is available to respond to any changes in patients’ swallow reflex.

We plan to install the innovative Floor in Motion system — providing our patients with privacy and dignity, whilst maintaining their safety and independence.

Gender specific units afford dignity and reduce risk for patients with sexually inappropriate or disinhibited behaviour.

At St Peter’s Hospital, we are committed to reducing the use of the antipsychotic medication typically prescribed to manage the behavioural and psychological symptoms of dementia. Instead, we offer evidence based, non-pharmacological therapies designed to reduce agitation and promote overall mental and physical wellbeing.

OUR FACILITIES We have a dedicated therapy and activities wing offering reminiscence therapy, pet therapy, sensory therapies (TACPAC), music therapy (including Sing for the Brain), arts and craft groups, a nail bar, a hair salon, gentlemen’s and ladies’ groups, and more.

We have pioneered a therapy programme using the Nordic Relax Chair — combining music, tactile stimulation and a rocking motion to provide a calming multi-sensory experience.

Patients have access to level, landscaped gardens providing a variety of sensory experiences and opportunities to engage in gardening groups and outdoor activities e.g. exercise such as walking and pedal power.

Working in partnership with our commissioners, we aim for positive clinical outcomes and a progression in our patient’s care pathway towards less restriction and greater independence.

Our kitchen delivers nutritionally balanced, textured modified meals catering to patients at every stage of dementia.

Our dietician can prescribe specialist food supplements, make dietary modifications and meet the needs of those on PEG feeding.

OUR SPECIALISED MDT Our psychiatrists are skilled in assessing and treating psychiatric comorbidities that affect people with dementia.

Our psychologists work to reduce behaviours that challenge by formulating person centred care plans.

Our mental health and general nurses are able to meet the psychiatric and physical health needs of people with dementia.

Patients have regular access to onsite GP clinics aimed at managing the physical health issues that often impact on behaviour.

MOBILITY AND FUNCTIONAL ABILITY Our physiotherapy and occupational therapy teams help maintain patients’ mobility (responding to the increased risk of falls typical with dementia) and provide tailored equipment that promotes independence e.g. specialist beds, chairs, walking aids and cutlery.

OUR LOCATION Our semi-rural location — and fleet of specialist adapted vehicles — allows patients to engage in a range of safe and risk assessed communitybased therapeutics and leisure activities.

LIVING WITH DEMENTIA MIKE’S* JOURNEY

JOHN’S* JOURNEY

Admitted to hospital presenting with increasing agitation and aggression, 53 year old Mike was diagnosed with Frontotemporal Dementia. The intensity and frequency of his behaviour that challenged led to his transfer to a psychiatric intensive care unit, where he was nursed on 2:1 levels of observation and required segregation due to the high risk of violence he posed towards other patients.

Diagnosed with Alzheimer’s disease and presenting with behaviours that challenge (including verbal and physical aggression and attempts to abscond from hospital), 81 year old John was admitted to St Peter’s Hospital after a breakdown of his nursing home placement.

HOW WE MET MIKE’S NEEDS Referred to St. Peter’s Hospital, Mike commenced our 16 week Assessment and Treatment Pathway.

We carried out a comprehensive assessment of his needs and found Mike presenting with significant behavioural disturbance, impaired impulse control, poor concentration and difficulties with speech.

Alongside starting treatment for depression, Mike — a former dog owner with a love of animals — was also successfully engaged using pet therapy.

THE OUTCOMES FOR MIKE AND HIS COMMISSIONERS Mike responded well to our neurobehavioral, person-centred model of care and the team reported: •

A reduction in incidents of aggression: 99 incidents in the first 4 weeks of admission > 4 incidents in the last 4 weeks of admission.

•

A reduction in levels of nursing observation: 2:1 > 1:1 support.

•

An improvement in communication — Mike was able to make choices about his diet and activity programme.

With the support of our team, Mike was ultimately discharged home with a care ultimate package provided by his Commissioners.

Dr. Kumi Pillay MBChB MRCPsych, Psychiatrist, St Peter’s Hospital

HOW WE MET JOHN’S NEEDS Embarking on our Recovery & Wellbeing Pathway, John was provided with a person centred care plan and activity schedule that included daily walks, alongside pet, reminiscence, and sensory therapies.

Using this approach, our team reduced John’s levels of restlessness and agitation, as well as the doses of psychotropic medication he required on admission.

THE OUTCOMES FOR JOHN AND HIS COMMISSIONERS Despite an overall improvement in his mental state and behaviour, John’s physical health deteriorated over time. Keen for him to remain in our care, John’s family supported the provision of our Specialist Palliative Care Pathway and he was nursed with input from staff of St. David’s Hospice.

In the terminal stages of his illness, John’s family were by his side daily and were with him when he passed away. His family expressed their gratitude for the care provided by our team by honouring John with a commemorative bench, which sits within the gardens of our facility.

I really can’t thank St Peter’s enough… the care, respect and dignity my dad received was outstanding. In his last few days, when we stayed with him 24/7, we were provided with food, drink and even a room for us to get our heads down.

This gave us the opportunity to spend valuable time together as a family. I believe if my dad hadn’t been here, we would have lost him two years ago. An outstanding hospital.

John’s daughter

*patients name changed to protect identity.

PROVIDING SPECIALIST CARE AND TREATMENT, OPTIMISING LIFE BEYOND ILLNESS

HOW TO REFER Please contact our Referral Co-ordinator on 029 2039 4410 or referrals@lshealthcare.co.uk St Peter’s Hospital, Chepstow Road, Langstone, Newport, NP18 2AA

www.lshealthcare.co.uk