Top tips for carers

When your loved one is being cared for in hospital

There are many things you can do to check your loved one is receiving good care in hospital. Working with the care home is the best place to start.

We have put together our ten top tips for carers whose loved one are now being cared for in a care home/hospital:

Let staff know that the person you care for has dementia.

Ask for the name of the main nurse who will be in charge of the person's care.

Ask that you be included in all decisions.

Give staff information about a person's individual preferences, likes and dislikes. Ask for these to be recorded. We have produced a leaflet 'This is me' to give to staff when a person with dementia goes into hospital.

If the hospital has a dementia specialist nurse, ask them to work with staff directly caring for the person with dementia about good care.

If the person has trouble eating and drinking ask that they have someone to help them at mealtime or ask if you can help out (if you are able to)If appropriate, tell the staff what the person says or the signs they make when they want to go to the toilet, and ask that they be taken straightaway.

If a person is prone to becoming restless or wandering let staff know and work together to identify ways of helping the person in their best interests.

Ask staff to discuss with you what will happen when it is time for the person with dementia to leave hospital so that you are prepared and know what support is available.

Consult Alzheimer's Society's factsheet on hospital care for more information.

SOURCE: Alzheimers Society
The Alzheimers Society should always be your first port of call for quality information and up to date strategies for caring for loved ones with Alzheimers.

50% of people said they didn't feel confident having a conversation with someone if they were concerned about their memory. What should people do if they're worried?

One of the most common calls to our National Dementia Helpline is from people who are unsure of how to start a conversation telling a loved one they're concerned about their memory. It can be a difficult conversation to have, but is worth it. We've put together some top tips to help people approach the subject in a sensitive way.

Take steps to get help when you're worried about someone's memory:

Step 1: Plan a conversation in a familiar, non-threatening environment

Step 2: Explain why talking is important - you're worried because you care
Step 3: Use examples to make things clearer - It's important to be careful not to create a sense of 'blame'. For example, instead of telling someone they couldn't make a cup of tea you could suggest they seemed to find it difficult to make the tea
Step 4: Have an open conversation - be honest and direct. Ask how they're feeling about their memory?
Step 5: Make a positive plan of action together.

Top Tips

• Be positive - a diagnosis can give people access to the help and support they need, or the GP can help you rule out dementia and treat other symptoms. Raising concerns with your doctor can be a really positive step forward.
• Make notes of situations that have got you worried. Giving examples will help you to express yourself in a clear and real way.
• Don't be upset if the person refuses to accept what you're saying - put yourself in their shoes, they may be frightened or confused.
• Due to the stigma surrounding dementia it is important to use non-judgemental language and make them feel at ease. Reassure them it's not their fault.
• Make sure it's an open conversation and be a good listener. Allow the person to discuss their feelings and thoughts  
• Be ready to take action together. Once you've broached the subject, don't hesitate, book a doctor's appointment so you're working towards getting help
• Never make promises about what can be done or what the future looks like - you can only offer support

Here are some leading questions that you can ask to start the conversation and explore how a person if feeling about their memory:

• You seem worried, I'd like to talk about it with you? 
• You don't seem yourself, how do you feel?
• I'd like to help you, what are you finding difficult at the moment?
• If you would like to talk I am here for you. I would really like to hear how you're feeling?
• Can we talk about how things are for you at the moment?
• Are you ok? You seem to be concerned about something?

Some carers of people with dementia have shared some of the reactions they got when broaching the subject with a loved one. Here are some of their experiences:

• Some people were in denial and refused to discuss the subject - they were overwhelmed by the use of the word Alzheimer's disease or dementia
• Many were pleased that someone else had noticed they were having problems with their memory and that they wanted to help
• Some were pleased that a family member/friend had talked to them about their worries, involving them in what plan to make rather than talking about the fact they're worried about their memory behind their back.

SOURCE: The Alzheimers Society

Replica bus stop donated to Lincoln care home to help dementia patients

Bus operator Stagecoach has donated a replica bus stop for inclusion in a Lincoln care home’s reminiscence garden.

The 30 bedroom Bernadette House Care Home, situated in an acre of gardens in the south of Lincoln, provides care and activities for people, many of whom suffer from dementia.

Many of the patients, would regularly use to use their local bus service, continued to walk around the home looking for a bus stop.

After being contacted by the care home, Stagecoach East Midlands donated a bus stop and timetable for patients at the care home for their comfort.

The donation will help with dementia patients’ reminiscence therapy, which encourages discussion of past events and memories that help people reconnect with their former lives and improve the quality of care they receive further.

The bus stop has been placed in the corner of the garden with a bench for those to sit and relax.

Elizabeth Stephens, Owner of Bernadette House Care Home, said: “We’re absolutely delighted Stagecoach were kind enough to provide us with a bus stop for our reminiscence garden. It’s a fabulous addition to the home and has triggered many fond memories of past bus journeys with friends and family for our residents.”

Michelle Hargreaves, Managing Director of Stagecoach East Midlands, added: “When Bernadette House Care Home approached us with the idea of providing a replica bus stop for the residents, we were more than happy to assist. We hope that the bus stop will provide residents with some familiarity and will help them during their Reminiscence Therapy.”

Source: The Lincolnite, Andrew Quann

What a great idea, helping residents feel more at home with familiar sights.

The cost of living in a care home is likely to swallow up half the value of a family house, say researchers.

They found the bills for a typical stay in a home were likely to be between £50,000 and £93,000 – and that the total would mean a loss of between a fifth and a half of the value of an average house.

The estimates, for an insurance firm, measure a family’s loss from the inheritance they would otherwise have expected when an elderly relative needs to go into a care home.

+3

The cost of living in a care home is likely to range between £50,000 and £93,000 - up to half the value of an average home. Around 160,000 pensioners have to pay their own bills (file photo)

Around 160,000 people living in care homes have to pay their own bills, and in many cases their property is sold or pledged to meet the costs.

The sacrifice of a house is demanded of care residents who have assets or savings above £23,250 – a threshold that means all homeowners must pay their own care home bills.

The analysis for Royal London showed, on average, someone who goes into a care home lives there for two-and-a-half years, paying bills that vary from £554 a week in the North East to more than £700 in the South East.

In the North East, care home bills can cost as much as 56 per cent of the price of a home. But in London, where the average house price is almost £500,000, bills are only 17.9 per cent of a house

The price of that stay in an average home in the North East would take up 56 per cent of the value of a typical house. In the South East the price would be just under a third of the value of an average house.

Researchers said that in some cases residents live in care homes for longer periods, and one in ten stay for six-and-a-half years. Long-term residents are in many cases likely to spend the entire value of their house and more.

The estimates have been drawn up at a time when Theresa May’s government is struggling with the growing difficulty of paying for social care for rising numbers of older people.

Royal London’s Debbie Kennedy said: ‘These figures are a shocking reminder of the huge costs which growing numbers of us will face if we need residential care later in life … The whole system is a lottery and we need to find better ways of supporting people to cope with these large and unpredictable bills.’

Steve Webb, a former Liberal Democrat pensions minister, who now works for the insurance firm, said: ‘Successive governments have failed to grasp the nettle when it comes to care costs … The Government’s plans for yet another discussion document on social care later this year are far too slow.’

SOURCE: Steve Doughty, Daily Mail

Clearing the fog of dementia with song

Music’s ability to trigger our deepest memories and emotions could help improve quality of life for people with dementia

Anyone who’s known a loved one with dementia can testify to its cruelty – the frustration, anger and sadness that comes from watching someone you love slip away.

Dementia, the umbrella term for conditions with a severe decline in mental function, can be an incredibly painful experience, marked by confusion, distress and a profound sense of loss. It’s also increasingly common. Dementia is now the second leading cause of death in Australia.

There is no cure, but researchers, including Professor Felicity Baker, co-director of the University of Melbourne’s National Music Therapy Research Unit, are looking for new ways to help people cope.

Professor Baker studies how music, especially singing and songwriting, can be used to treat people with a range of conditions – from young people with traumatic brain injuries to adults with substance abuse issues. She says music therapy can be a way for people living with dementia  and their carers – to deal with its symptoms.

 “We know that managing dementia with medication actually can make people more confused,” she says. “We need to be creative in finding ways that people with dementia can manage the challenges they face, and to address distressing symptoms such as agitation and depression.”

Professor Baker recently developed a songwriting program for people living with dementia and their carers at Caladenia, a care centre based in Melbourne’s eastern suburbs. Participants worked together in small groups to write and compose songs with a music therapist.

In one 10-week session, participants wrote seven songs. They sang about family, cruise ship holidays and staying out until the sun comes up. They thought about, talked about and even argued about songs they created, from the lyrics to the musical direction.

Even participants who normally struggle with conversation and interaction were able to work together on a music project.

“With music, they’re really engaged in a way that they’re not in other activities,” says Professor Baker. “They’re offering their ideas and perspectives. They’re happy to argue with each other about what they think the lyrics should be and whether the lyric fits the melody.”

But what really struck Professor Baker was that participants remembered the music they created.

“There’s this assumption that people with dementia can’t learn, that they’re just losing memories,” says Professor Baker. “But what we found is that they were actually remembering lyrics from week to week.”

Professor Baker’s findings will be used to inform her next project, a large-scale study funded by a grant from the National Health and Medical Research Council. She hopes to find out more about how collaborative music therapy, such as group music therapy or choir groups, might affect the cognitive function, depression, neurological symptoms and quality of life of people with the condition.

The project will include a major randomised control trial, comparing standard dementia care practices with three music-based interventions – group music therapy, larger choir groups and a combination of both.

There’s no doubt that music is a huge part of our lives. The simple act of listening to a song can evoke memories and emotions of heartbreak, love affairs, places or people in our past. And scientists, too, have long known that music has a powerful effect on brain function.

Unlike other stimulants, Professor Baker says, music engages all parts of our brain.

“When we engage in some activities, specific neural networks are activated. But when we listen to music, we actually engage quite a distributed network of neuronal activity.”

Studies have also shown that the act of creating music – songwriting, singing or playing an instrument – is more effective in stimulating our brain than just listening to music. In other words, it’s more stimulating to write and sing a song than listen to your favourite album.

“When we sing, we’re stimulating our auditory system, we’re stimulating our physical system,” she says. “When we use language in song, it’s tapping into our emotions and it’s tapping into physiological processes like our heart rate and our breathing.”

Since music is an emotional and physical stimulant, Professor Baker wants to see how much it can trigger memory function for people living with dementia.

“The theory is that pairing music and lyrics with an emotional experience can reach the threshold for memory,” she says. “It connects people and helps them to remember.”

A 2009 study by the University of California, Davis, for example, found that the area of the brain that holds our memories and links music to emotions is also the last part of the brain to atrophy during Alzheimer’s disease, the most common form of dementia.

Professor Baker’s research project is the Australian arm of a much larger study into the effects of music therapy on people living with dementia. Work in Australia will involve 500 participants, but academic colleagues in Norway are leading similar and even larger initiatives.

“It’s going to be the biggest music therapy study in dementia care ever and it’s certainly a game-changer for the dementia field,” she says.

Previous literary reviews about the effects of music therapy have been promising but inconclusive, citing the need for larger studies and more evidence.

“Worldwide, we have amassed a lot of small scale studies that show it’s effective but nothing big that will help us be taken more seriously when healthcare policies are being made.”

The NHMRC grant used to fund Professor Baker’s research is part of the Boosting Dementia Research Initiative, which gives $200 million to dementia research projects, including several other studies based at the University of Melbourne. Nearly 1 million Australians are expected to have dementia by 2050, and health policymakers are wondering how the system will deal with it.

“Dementia is going to be a challenge for this country,” says Professor Baker. “And they want to invest extra funding into projects that will help us with this massive problem that’s ahead of us.”

SOURCE: Kate Stanton, University of Melbourne

With studies and research already proving the benefits of such initiatives, how great would it be if this was properly funded? Considering we know that dementia is going to be an increasing challenge for all in the future isnt it time these projects were given greater importance?

Charity finds 'stark variation' in quality of care homes in England

Older people are victims of a postcode lottery when it comes to the quality of their care homes, with the North West being the worst performing region and London being the best performing, according to a new report.

The analysis, based on CQC inspections of care homes, by Independent Age, the older people’s charity, revealed that the North West contains seven of the eight worst performing English local authorities on care home quality, with one in three care homes across the region performing poorly.
In the North West, 33.6 per cent of care homes perform poorly, in Yorkshire and The Humber, it is 32.2 per cent and in the South East, it is 28.2 per cent.
The best performing regions are London with 20.3 per cent of care homes being rated highly by the CQC, the East of England with 20.8 per cent and the South West with 21.1 per cent.
Simon Bottery, director of policy at Independent Age, said: “No one should be forced to live in an unsatisfactory care home but our analysis shows this is the grim reality in some parts of the country.

“The market is simply not providing a decent choice for older people and their families but there is little indication that local authorities or the Government are giving the problem the attention it deserves.”
He believes the reasons for the poor quality homes are a lack of funding as well as low pay and difficulty in recruiting staff and the lack of a good support mechanism for improving care homes that are struggling.
“The Government has an opportunity to address this in its upcoming Green Paper on social care but, in the meantime, councils must demonstrate that they understand the reasons for care home failures and are working to resolve them,” he added.
The difference between various regions can be huge
Stockport, Salford, Tameside, Manchester and Kensington and Chelsea have over more than half of their care homes rated as Inadequate or Requires Improvement.
While in the Isles of Scilly, Islington, Rutland, Richmond upon Thames and Thurrock, less than five per cent of their homes are rated Inadequate or Requires Improvement.
In response to the report, Martin Green, chief executive of Care England, said it "clearly shows that in areas dominated by local authority funded care, the level of funding is having a significant impact on quality".

However, Caroline Abrahams, charity director at Age UK said that lack of funding cannot be used to excuse poor quality care and added: “It is horrible to think that in some areas the choices are so limited.
“This is a frightening situation for older people and their families who above all want their loved one to be somewhere caring and safe – and this really shouldn’t be too much to ask in an advanced economy in the twenty first century.
“In the worst affected areas the social care infrastructure is now so threadbare that there's a real risk of vulnerable older people and their desperate relatives waiting endlessly for a good and affordable local care home place that no longer exists.”
Independent Age wants the Government to tackle variation in care home quality in its forthcoming Green Paper on social care.

In addition, it wants local authorities to look at the drivers for variation in the different areas.
Independent Age offers a free advice guide, ‘How to find the right care home’. The guide looks at what to consider and essential questions like location and cost, what you want from a home and whether a care home is actually the best option.

SOURCE: carehome.co.uk, Sue Learner

Therapy dog assists home care clients in Meriden

MERIDEN — A small plastic bag filled with dog treats was on Aurore Lagace’s kitchen table Tuesday morning and right below the table sat Sonny, a very patient 4-year-old Golden Retriever with his eyes locked on the snacks.

Very gently, Lagace pulled two small treats from the bag to present to Sonny, but before she could even pull them completely from the bag Sonny had already snagged both the treats from Lagace’s hand and ate them.

“Oh my, you got both of them,” said Lagace laughing as she stroked Sonny’s head. “Oh dear, now one more.”

Lagace reached into the bag once again and gave Sonny another treat. This time he waited for Lagace to feed him the snack.

“That’s it, that’s it. Oh my goodness,” she said, still laughing and rubbing Sonny. “Oh, that’s it. No more, no more.”

Sonny is a certified therapy dog registered with Pet Partners Therapy and works alongside his owner, Sharon D’Aquila, the president of Assisted Living Services on Broad Street in Meriden.

Assisted Living Services provides home care to thousands of seniors and those with disabilities throughout the state with personal care assistants, live-in aides, and homemakers.

They were visiting with Lagace, who is one of D’Aquila’s clients. Lagace has been seeing Sonny since he was a puppy nearly four years ago. Lagace looks forward to the visits and said that she “loves Sonny” and he brings her good company.

Sonny started training in a puppy class, then took an obedience class before finally going through therapy training for eight weeks. He is evaluated every two years, D’Aquila said.

Clients of D’Aquila’s can request Sonny to come to their visits. She typically sees about six clients a month with Sonny, not including the people who greet and pet him at the nursing homes D’Aquila goes to.

There are many health benefits with animal therapy, explained D’Aquila. Many clients take walks with Sonny and having him around helps decrease their anxiety depression, or feeling of loneliness. 

The positivity of Sonny’s presence rubs off on her clients, she said.

“It’s a bonus to bring him out with a client,” said D’Aquila. “It lowers their blood pressure.”

Sonny sees patients with dementia, who have suffered a stroke, and others with disabilities.

D’Aquila said one of her clients who had a stroke visits with Sonny and when they are together D’Aquila said “her face lights up” and she starts walking faster to see him. Another client sings to him.

Every time D’Aquila sees a client with Sonny, she leaves a card with a picture of Sonny with them. The card is from Sonny and says “thank you for having me visit today. Looking forward to another soon.”

For Lagace, those cards make her happy and she said she keeps them every time Sonny visits with her.

Tuesday afternoon Lagace was all smiles with D’Aquila as they sat around her kitchen table and enjoyed the dog.

“Come on, honey. Over here,” said Lagace as she called for Sonny who scooted up next to her chair. “OK, lovey. Aw, you’re a good boy.”

SOURCE: Farrah Duffany for Record-Journal

'Helping new care home managers establish themselves in their role'

The care home sector has for some time suffered with a poor image despite the excellence that exists within in it. Like any industry, service or public sector there is good and bad everywhere.

Being a care home manager is not for the faint hearted and the transition from a public sector role to working in the independent sector takes more than a leap of faith.

How can we help people to make that transition?

Problems can arise from these roles being isolated and at times it can be “tough at the top”. Buddy schemes for new managers and an induction programme that creates a network of support from peers is crucial to help new managers find their feet.

In larger organisations, home managers have a chance to meet with area and regional managers and peers, but within in our communities many managers sit alone in small or single providers. For them in particular the network is crucial, not only to offer support in times of “crisis” but also to share the good work we do.

I am fortunate that my care home is part of the ’Teaching Care Home’ pilot programme. This has prompted me to think about learning in our home and how we can share this learning in our community and with others. Being a Teaching Care Home means we are striving to be a recognised beacon within our community and within Methodist Homes.

”We aim to be seen as a beacon of good support for newly appointed managers”

Our home is open to visitors from across the sector to share the changes we are striving to make and the culture of learning and continuous improvement we are developing. We aim to be seen as a beacon of good support for newly appointed managers to help them transition into the role, learn about systems, processes, team leadership and home culture and ultimately help them establish themselves in a new role in a very different and challenging environment.

This can be made more difficult by the complexity of the home manager role which is often poorly described or misunderstood.

It’s multi-faceted, complex and with a touch of the entrepreneurial about it. Learning about the process and interfaces from the care home perspective with regards to local authority departments, CQC, CCG and local health services is one thing. Internal compliance with new management, budget and governance procedures is another.

”Learning how to pace and plan is key”

The home manager role is often a combination of HR, finance, governance, catering, housekeeping, maintenance and PR, with external support in big organisations, but single providers may find they are also their own CEO. Therefore, learning how to pace and plan is key.

The pressures are often great and the clinical and commercial aspects of the role take enormous energy, determination, negotiation and sheer hard work to ensure an efficient safe and effective environment for residents and staff.

Having the ability to spend time with an established manager and gain insight into how a home functions could also be used as an opportunity for learning for potential future managers. At a time when we are struggling to recruit, “growing your own” has never been more needed and we could build capacity within our teaching care home to be a place of learning and a test bed for new career opportunities.

”We need to support each other and create networks”

Connecting across our communities is key in sharing the learning, developing skills, and building our future leaders.

We need to support each other and create networks to demonstrate how care home careers can be exciting interesting and changing. With a shrinking pool of talent we have to up our game and offer a new opportunity for the future.

Sustaining the momentum, spreading the word and describing both the challenges and many, many opportunities of working in a care home could help us remind people we are an important part of the health and social care system and a vital part of keeping it going.

SOURCE:Nursing Times,Siva Sivanandarajah 

Toddlers brighten up the lives of care home residents

In the sunlit front room of Hengrove Lodge residential care home, residents smile with delight as they see how many children are visiting today from the nearby Hengrove branch of Southern Links Children’s Center. 

Two-year-old Lexie-Jay makes a beeline for the home-made play-dough on the coffee table, and everyone becomes absorbed in every move the children make, many waiting in anticipation for a cuddle from their favourites.

Hannah Stopford is a community development worker at Bristol Aging Better, who are running this scheme in partnership with the children’s centre. “We wanted to do more integrational activities in the area,” she explains. “The main aim is to reduce social isolation but it’s also to set up projects that are going to last. We are working with the community to help them run these schemes and we’re also tapping into activities already going on within Bristol.

 “The visits to Hengrove Lodge run on a stay-and-play basis, so the parents bring the children along as they would in the children’s center, and we’ve set up the activities so the residents and children can enjoy them together.”

With many children’s toys brought along to the sessions, as well as art and craft activities, these stay-and-plays sessions last an hour and take place every other Wednesday.

 “Raising awareness of social isolation is key, but these visits are also having a big impact on the elderly who are suffering from dementia,” explains Lil Bowers, centre manager for Southern Links Children’s Centre. Around 850,000 people in the UK live with Alzheimer’s disease – the most common cause of dementia.

Lil says that, following a few visits, the children have started to mean a lot to the residents, who remember more and more about them each time and even ask for them by name. “It’s a real show of community spirit, and having these families visit Hengrove Lodge is vital to the work we do.”

Alex Evans carefully places her eight-month old son Charlie-Jay into the arms 95-year-old resident Dot Whittingham, who coos over him, a picture of happiness. “From the moment Dot’s cuddling Charlie-Jay, she alters,” comments Sue Hodge, deputy manager of Hengrove Lodge. “It’s an indescribable feeling watching one of our oldest residents light up with joy from cradling a child. She just loves to see him and for us that’s a wonderful thing to be a part of.”

As the session draws to a close, Josh Stanford helps his two-year-old son take off his brightly-coloured crocodile suit. “This kind of thing should definitely happen more often,” he says. “It’s a brilliant idea and it makes a lot of sense. I don’t see why this kind of amalgamation couldn’t be developed further across the city. All the residents love it and it’s good all round for everyone involved.”

SOURCE: Bristol247.com, Lily Newton Browne