Care and Support

Day care for people with dementia: comparing experiences from Norway and Scotland

Louise McCabe

This paper presents findings from two research studies that engaged with people with dementia who attend specialist dementia day centres and their carers living across Scotland and Norway.  Day care is a central part of dementia policy in Norway and the provision of day care is specifically promoted within their national dementia plan.  In Scotland day care has not received the same attention within recent dementia policy.

The research study in each country involved interviews with people with dementia currently attending day care and their family carers.  In Scotland, 19 people with dementia and 15 family carers attending six day care centres in both rural and urban areas of Scotland were interviewed.  In Norway, 17 people with dementia and 17 family carers were interviewed.  The data from the semi-structured interviews were coded thematically to draw out the benefits of day care attendance for both people with dementia and their family carers as well as identifying areas for potential development and improvement.

The findings from the research suggest many positive outcomes experienced by people with dementia attending day care, especially in small rural communities, as well as identifying benefits for family carers.  Similarities in experience and outcomes were noted between Scotland and Norway.  In both countries it was recognised that there are potential improvements to the current day care model and the paper concludes by presenting what works well and what could be improved within dementia day care in Scotland and Norway to innovate this important avenue of support for those affected by dementia.

How do people with dementia make assistive technology work for them? Innovation, personalisation and bricolage
Grant Gibson

In the United Kingdom Assistive technologies (AT) are being ‘mainstreamed’ within dementia care services. However, little is known about how people with dementia use either these technologies, or the services that provide them in practice. Reporting the results of part of an NIHR study exploring provision of services to people with dementia in primary care, in this seminar Grant Gibson explores issues around the use of assistive technologies within dementia care.  In the bulk of the seminar Grant reports on a project examining the everyday use of AT among people with dementia and their carers.

Qualitative, in-depth semi-structured interviews with 29 people with dementia and carers explored their experiences of using AT within their everyday lives and facilitators and barriers to their use.  From using sticky notes as signs or re-purposing of everyday or even novelty devices, to networking smartphones and tablets within bespoke telecare systems, AT were used in combination with everyday devices to provide care in often individual, personalised and novel ways.

In practice this use can be characterised by ‘bricolage’; the non-conventional combination of devices in diverse ways often differing from their original design. Factors influencing the bricolage based use of technology in dementia care included the ability and willingness of informal carers to act as bricoleurs, a lack of awareness of AT products or how to access AT through formal services among people with dementia, carers and GP’s and a lack of flexibility in AT systems.

While everyday use of AT among people with dementia can be characterised by bricolage, current design and delivery of products, alongside the organisation of technology services for dementia, limits the use of AT in person centred ways.  How people with dementia and carers engage in bricolage when using AT, and how services can mobilise these experiences in order to provide truly person centred technology enabled care services in dementia, therefore requires greater attention.

Personalised physical activity for people with dementia living in care homes
Alison Bowes

The project is funded by the Healthcare Management Trust and aims to develop recommendations on how to increase physical activity in care homes, where residents tend to be sedentary. The first phase of the project involved a literature review and fieldwork in five care homes to ascertain current scientific background and the current situation for care homes, including the barriers and facilitators of physical activity. We used these findings to inform the development of workshops for care home staff at which we supported them to review current practice and to start developing a movement strategy for use in their care homes. We are currently working with care homes to finalise these action plans, and will shortly be observing their implementation and the impact of the plans for residents and staff. The talk will briefly review the findings of the work to date.

Best practice in dementia care: research into practice
Shirley Law

The Best Practice in Dementia Care Learning Programme is a six part self-study programme which requires participants, supported by a facilitator, to work through a set of six booklets. The booklets include exercises and questions which link to aspects of the participant’s role in Acute Hospital Care, Emergency/Critical Care, Care Home, Domiciliary Care or Housing Support. Each booklet is designed to help participants think about how they should respond to a person with dementia. Underpinning the programme is a person centred approach to care which focuses on the needs of the individual.

During the programme participants receive the support of a group facilitator who will arrange regular group meetings to discuss the topics covered in the booklets. Between the meetings participants are asked to think about answers to exercises which are designed to relate to their practice.

The role of the facilitator is to assist participants in making sense of what they read as well as helping them to meet their personal learning objectives. This involves encouraging them to reflect on their previous experiences and practices and, thereby, helping them to link new knowledge to real world experience. Knowledge of the participants work environments, past and present, will enable facilitators to link the course work into these personal experiences and actions. Where participants do not have direct practice examples to draw from facilitators are required to support them to reflect on their learning and utilise it to complete the exercises. Facilitators are asked to remember that individual learners may have deeply held views on the way they practice and that, consequently, changing their perceptions of situations will involve helping them to see things from a different perspective. The workbooks will begin this process and provide a basis on which to build change.

The role of volunteers in dementia care
Vikki McCall

This project is exploring the role(s) of volunteers in supporting those facing dementia within different housing settings. It does so within the context of the reshaping of health and social care across the UK, which is increasingly shifting the locus of care from ‘institutional’ settings to within the space of the home. Our project will provide new knowledge and understanding of the role played by volunteers in the lives of people with dementia and produce practical guidelines and advice that will help people living with dementia, those who volunteer with people living with dementia and the housing services and care organisations that support them.

We have conducted an exploratory study using a mixed methods approach, including an extensive literature review, secondary analysis, organisational survey and qualitative interviews with volunteers, family carers and people living with dementia. Despite these pertinent issues however, there is surprisingly little known about the role(s) of volunteers in dementia care. This cross-disciplinary research builds on prior work by the Dementia Services Development Centre (DSDC) which sought to ascertain the needs of volunteers around supporting people with dementia.

The project explores what the perceived impact of volunteering in dementia care settings might be; who the volunteers are in dementia care settings and they engage in. Therefore this project will shed light on the nature and extent of volunteer involvement in the provision of support for those facing dementia, identifying key themes and research gaps. It will also identify the opportunities and challenges of doing so for both individuals and volunteer involving organisations. Finally, it will seek to identify implications with regard to volunteering within different housing settings more widely, and within the broader context of public service reform in Scotland and England.what the activities are that they engage in. Therefore this project will shed light on the nature and extent of volunteer involvement in the provision of support for those facing dementia, identifying key themes and research gaps. It will also identify the opportunities and challenges of doing so for both individuals and volunteer involving organisations. Finally, it will seek to identify implications with regard to volunteering within different housing settings more widely, and within the broader context of public service reform in Scotland and England.