According to the Office for National Statistics, over 290,000 older people in the UK live in care homes – a number expected to rise as the number of over-65s continues to grow. Recent studies also show that the number of people living with dementia in the UK will increase from 800,000 to 1.7 million in the next 40 years.
As a result of this, it is becoming increasingly important for care providers across the country to adopt a culture of innovation that includes developing and trialling new approaches and techniques. It is also crucial to take an integrated approach, encompassing all aspects of wellbeing, including environmental, physical, social and psychological. This will mean that, when the number of those living in care homes and the number of those living with dementia rises, the industry is providing the highest quality, person-centred care possible.
As part of a Trust-wide initiative to improve care quality, increase research and innovation, and heighten the lived experience of care teams and residents, the Orders of St John Care Trust (OSJCT) has developed and implemented a number of initiatives over recent years to better support those working and living in its care homes. These have the potential to be adapted by other providers to ensure those receiving services have the best quality care and experience.
Cognitive Stimulation Therapy
One approach that has been used successfully is Cognitive Stimulation Therapy (CST), – a psycho-social treatment that uses a series of 14 structured group therapy sessions to provide peer support to people living with memory loss.
The use of CST has led to a number of positive effects on residents with dementia, including improved confidence levels and bonding amongst group members. Most participants not only identified improvements in their view of friendships, but some also felt their memory had improved as a result of the therapy.
Employing specialist dementia nurses
Employing specialist dementia nurses such as Admiral Nurses is another innovative way of improving the quality of dementia care delivered within a care environment.
These specialist dementia nurses are tasked with providing skilled assessments of dementia care practice, as well as offering practical advice and support to families and carers of those with the condition. There are approximately 100 Admiral Nurses currently working throughout the UK; however, the majority of them work in the NHS, with only a few working in the care sector today.
Following an in-depth look at the role specialist dementia nurses such as Admiral Nurses play, OSJCT found that they have a direct positive impact on the care provided to residents within its homes. This is by improving quality of life and helping to resolve specific issues. For example, Admiral Nurses assisted care teams to reduce residents’ pain, increase residents’ independence and meaningful engagement, and also generally improve upon the wellbeing and physical health of residents.
The study also found that Admiral Nurses have a positive impact on care home employees, by helping to expand their knowledge and skills, whilst also making them feel more supported and confident in doing their jobs.
Ground-breaking household designs
It is possible to aid those with dementia by refining the design and layout of care homes – although this is simplest when undertaking a new build. The quality of life for people with dementia is influenced significantly by the environment in which they live. Following months of research, OSJCT developed a layout for future specialist dementia care facilities, incorporating a number of features proven to suit those living with the condition.
For example, the new layout utilises a design resembling a small, home-like environment, instead of including features like long, double-loaded corridors and large multi-function rooms. Features like these were very common in facilities designed and built a decade ago as a way of catering to those who were physically, not cognitively, disabled. However, many people with dementia live in homes with these features today, despite them not being the most appropriate to meet residents’ needs.
People with dementia may also encounter difficulties retrieving a mental image of a place they cannot see, so another feature that has been used in designing a dementia-friendly facility is ‘total visual access’ – which allows residents to see all of the places relevant to them. For example, the dining room and lounge are designed with a combination of solid walls, half-height walls and timber-screening, providing maximum visual access into the rooms while ensuring both privacy and the mitigation of noise transfer.
The small-scale environment laid out in a dementia-specific care home design, combined with the inclusion of themed areas and variances in décor, not only encourages residents with limited mobility to walk and maintain independence, but also assists with way-finding and orientation.
Empowering residents through art and choice
Another way of implementing innovation into a care setting is through meaningful activities and projects that engage residents.
Thanks to funding from The Baring Foundation’s Late Style Programme, OSJCT has recently taken part in a project, designed and supported by New Brewery Arts. It involved the creation of a piece of artwork designed to explore ageing through art, with input provided from older people.
As part of the project, Robert Race, a 70-year old Wiltshire artist, was commissioned to create an automaton based on the theme of ageing, with an important part of the project being to engage with older people during its development. Another key criterion for developing the work of art was to ensure that the final result would be something that was highly-interactive and accessible to all ages, including those with varying levels of cognitive impairment.
Over six months, Robert inspired and assisted residents to print, cut, fold and craft their own small automata, making something new each week. He then used this experience, and his own thoughts on ageing, to shape and inspire his final work of art.
Now complete, the automaton, called Getting on, will go on tour to 16 OSJCT care homes across Gloucestershire, Wiltshire, Oxfordshire and Lincolnshire, providing access to a large number of residents – a group that have historically had limited access to high quality art exhibitions and displays. It will also be exhibited at Gloucester Cathedral, New Brewery Arts Centre in Cirencester and at the UK Dementia Congress.
There is no requirement for care providers to develop, trial and evaluate innovative approaches. However, any organisation that embraces a culture where innovation is encouraged and that strives to continually improve the lived experience of residents and staff will be in a prime position to meet the growing and changing needs and expectations of the workforce, residents and families.
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