Eileen’s Answers

Below are a selection of Eileen's Answers, from 2007 - 2013. Eileen's Answers are a series of blog posts containing useful links and information on a range of dementia-related topics.

Bibs, aprons, clothing protectors

Question:
At mealtime in the ward we use disposable aprons for patients and we would always ask patients’ permission to use them.

We have recently received criticism for using them but all the research I can find supports their use for patient dignity reasons and I was wondering if you had ever heard of any articles on the subject.

Answer:
This question has cropped up before when we had some sample clothing protectors here. This sparked a debate about dignity and we concluded that if possible, normal napkins should be used. I’ve been looking online and found a couple of suppliers of extra large linen and paper napkins each measuring 48cm

http://www.wcsupplies.co.uk/Luxury_White_Napkins_48cm_Square_4ply_p/322.htm

http://www.qualitynapkins.co.uk/napkins/duni-luxury-napkins-unicolour/

This article may be of interest although it doesn’t mention protective clothing:

Twigg, Julia (2007) Clothing, age and the body: a critical review. Ageing and Society 27(2) pp 285 305

 

Cookers

Question:
I work with a number of clients who still live in their own home and have dementia. With regard to kitchen safety, are you aware of any devices which will automatically shut off a cooker if it has been left unattended for a specified amount of time. I have done some research and found a few products but all of these were aimed at the USA market. I was wondering if you have come across a similar product in the UK?

Answer:
You can find out about safety aids on these really good websites -

Also visit the Virtual Care Home and click the kitchen view for design tips for a dementia-friendly kitchen

There is also a new product called Hob Angel which has its own website http://www.jordan-shaw.co.uk/hob_angel.php

 

Life story

Question:
My father has recently been diagnosed with dementia and I want to record as much as I can about his life while he still has recall and is still living at home. Can you suggest anything?

Answer:
A life story book can be useful in so many ways:

  • happy reminiscing as you sort through photographs
  • bringing generations of the family together on a project
  • making an album to return to again and again for pleasure and nostalgia
  • if the person with dementia moves on to a care home, the life story book can tell the staff a lot about their life and often give insight to behaviours. It can also be a point of social contact

The Life Story Network is hosting an online conference later this month http://www.lifestorynetwork.org.uk/event

Here is a short film about life story work:

Switching on a light: an introduction to life story work

 

Driving and dementia

Question:

What are the psychological effects on a person with dementia of giving up their driving licence?:

Answer:

There is an account by James McKillop of his experience of giving up driving in our free download Dementia Now

Here is a link to a search in our catalogue on Driving

This article is from the US National Center for Senior Transportation but useful for comparison

 

Tearing clothes

Question:
We have a resident in our care home who continually rips her clothes. Can you tell me if there is a supplier of unrippable clothing that you know of?

Answer:
I did a search for unrippable clothing and found very little apart from fashion items. So the short answer is no, but have you considered that you might be approaching this from the wrong direction? The clothes ripping may just be an outward manifestation of a deeper problem, and providing unrippable clothes might just serve to frustrate the individual and divert the behaviour into some other equally destructive channel.

Obviously I don’t know the whole story, but perhaps if you looked for reasons related to the particular clothes (relatives might offer suggestions); perhaps some discomfort in the clothes themselves causing irritation; is the temperature comfortable?; can they be given something else to rip – like paper or bubble wrap or fabric oddments; does the individual’s life story offer any clues?

 

Person-centred care

Question:
Our service is developing care plans for our clients. Are there any examples of person-centred care planning?

Answer:
Tom Kitwood identified 5 key elements to providing person-centred care, which are outlined in his book Dementia reconsidered: the person comes first

They are:

• Biography – life story, significant events
• Identity – what makes them the person they are now
• Autonomy and agency – personal independence
• Communication and interaction – sociability, ways of understanding and being understood
• Comfort and attachment – a sense of belonging, sources of comfort

We have some items in the Dementia library on care planning – here is a link to the catalogue to see what we have
http://shelcat.org/F/?func=find-b&request=care+plan*&find_code=WTI&adjacent=Y&local_base=PDEM

Some have sample care plans, for example Building on strengths by the Alzheimer’s Society and Dementia Care Matters has master copies of forms for photocopying.

 

Fabrics, floors and patterns

Question:
I am refurbishing a care home where some of the residents have dementia. Are there any studies on what patterns should be used or avoided?

Answer:
We have done some recent work on patterns for soft furnishings, and drew up some guidelines for our visitor handouts:

Fabrics & Patterns

  • Generally speaking, patterns are best avoided in interior decoration for people with dementia, as they can tend to confuse the eye. Some pattern may be desirable, just to add interest, although plain colour can be used to good effect.
  • As with many design features in a dementia-friendly environment, what is fine for one person may not be for another; individual needs and preferences must be considered. So instead of trying to identify what is right or wrong in a pattern, it may be more helpful to list features of design to keep in mind
  • Colour. Think of possible connotations such as political affiliation, football colours, superstition, water. There is quite a lot written on perception of colour and contrast by the ageing eye; this needs to be taken into consideration
  • Age/generation appropriateness. Retro patterns of the 50s and 60s may be familiar to 70 and 80 year olds
  • Movement. Swirling or sinuous patterns may cause some queasiness, especially if the person is taking antipsychotic medication
  • Small geometrics or flecks. These can look like something has been spilt and needs to be swept up or picked off
  • Flowers/leaves. Abstract designs generally work better, as realistic patterns can look too much like the real thing
  • Stripes. There may be a danger of these looking like bars

There are no hard and fast rules, as the experience of dementia will be different with each individual, so these are ideas to think about when choosing fabric patterns.

On floors, a pattern can have a noticeable effect on gait, and studies show that a plainer floorcovering can help with mobility by reducing hesitancy and allowing more confidence in where you place your feet.

Reference

Perritt, M.R., McCune, E. and McCune, S.L. ((2005) Research informs design: empirical findings suggest recommendations for carpet pattern and texture. Alzheimer’s Care Quarterly 6 (4) pp. 300-305

 

Post-operative delirium

Question:
My Mum, who was quite independent and reasonably fit, had a fall, injuring her hip, and needed surgery. She went from being self sufficient to requiring 24/7 care and is currently being assessed for a nursing home!!  We are told she id suffering from postoperative delirium and we are devastated by the effect this illness is having on our Mum and as we have never heard of this before, I was wondering if you could point me in the right direction to gain information on this, ie leaflets, questions we should be asking, things the family can be doing to help etc.

Answer:
If you follow this link it will show you what we have in the DSDC library on Postoperative Delirium
http://shelcat.org/F/?func=find-b&request=delirium+and+%28postoperative+or+surgery%29&find_code=WRD&local_base=PDEM

Here are some links to websites which help to cut through the vast amount of information:

The Mental Health Foundation http://www.mentalhealth.org.uk/help-information/mental-health-a-z/D/delirium/

Understanding NICE guidance – information for people who use NHS services
https://www.nice.org.uk/guidance/cg42

 

 

Books for public libraries

Question:
What books should our local library have in stock for people with dementia, their families and carers, living in the community?

Answer:
Our dementia library has a wide range of books for readers from different backgrounds, including the professional care workforce and personal, family carers. If you wanted to get some ideas for books to stock your libraries, our library catalogue is online at www.shelcat.org/pdem and you can narrow your search to just books, if you want to exclude journal articles. For example here is a search on Reminiscence:

http://shelcat.org/F/func=find-b&request=reminiscence&find_code=WTI&local_base=PDEM

The books linked below are available as free downloads, but we also have print and dvd formats which we can supply free on request. These are an excellent introduction to understanding and coping with a family member with dementia, for family carers, people with dementia, and younger readers, respectively:

http://www.healthscotland.com/uploads/documents/15770-CopingWithDementia2009.pdf

http://www.healthscotland.com/uploads/documents/9365-FacingDementia2008.pdf

http://www.healthscotland.com/uploads/documents/11414-UnderstandingDementia_3247.pdf

 In our online bookshop we have some titles which would be useful in public libraries, such as the 10 Helpful Hints series and the Skill Starters http://www.dementiashop.co.uk/category/profession/carers

 

Chairs

Question:
Is it advisible to have 3 different styles of chairs.My thought were that if all of them are the same it is very institutional.

Answer:
Different styles of chairs would be a good idea I think, not just to make the look less uniform, but also to allow for different arrangements, heights and levels of support to suit different needs.
We produced an issue of Dementia Now featuring seating, with an article written by Maria McManus, which has useful and practical ideas for seating http://dementia.stir.ac.uk/pdffolder/DementiaNow-Vol6-Part2-Feb09-Seating.pdf
 
Some furniture companies specialising in health and care facilities
Teal Furniture http://www.teal.co.uk/
Renray Healthcare http://www.renrayhealthcare.com/
YTM Furniture http://www.ytmfurniture.com/
Knightsbridge Furniturehttp://www.knightsbridge-furniture.co.uk/