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P19. Long-term care

Detailed Programme, abstracts and presentations

P19. Long-term care (Saturday, 6 October, 10.30-12.00, Europa 1)

P19.1. An Evaluation of the Dementia Quality Mark for Residential Care in the South West of England

Helen McFarlane, Ian Sherriff, George Giarchi

The Dementia Quality Mark (DQM) accreditation criteria for care homes are being introduced and processed in residential care in the South West of England. This innovative practice has primarily been informed by the government policy documents Living Well with Dementia Strategy (2009); and Dementia UK report (2007) and Tom Kitwood’s (1997) original ‘person to person’ dementia care model. In addition, the prevalence of dementia cases, accounting for between 50 and 60% of beds in South West care homes, has also triggered demands for additional staff training and specialist guidance. In response to these precipitating factors, the Department of Health South West (2010) produced a DQM assurance person centred toolkit designed around national Care Quality Commission (CQC) standards. This DQM toolkit was trialled by six South West government councils (BANES, Bristol, Dorset, Plymouth, Gloucester and Wiltshire). The ongoing process within each council requires accreditation and Plymouth University was commissioned to provide an evaluation of the implementation of the accreditation process and recommendations for its future use. Findings suggest that while progress is being made during this phase there are particular barriers faced by the participating councils in assessing care homes and awarding the DQM certificate. Issues ranged from staff training to both human and financial resources available to oversee this process. Overall conclusions are that further work needs to be completed around the outcomes of the process to fully appreciate the extent to which the DQM will improve the quality of care received by people with dementia living in care homes.

P19.2. Dementia as a priority problem of long-term care

Iva Holmerová, Michaela Baumanová, Dana Hradcová, Martina Jedlinská,  Pavla Lerchová, Lucie Sedláčková, Monika Válková, Hana Vaňková, Petr Veleta, Radka Vepřková, Petr Wija, Michala Tučková

Health and social care systems of CEE countries have substantially changed in the last two decades. The situation in some disciplines especially in acute medical care is now comparable to other  european countries. However in some fields (including long-term care and nursing home care) there is much less development and less communication  with professionals of other countries which results in a certain isolation, caused by different culture, lagugage barriers etc. Therefore the participation  in intenational projects, research, communication etc. is much lower . Despite this fact we are convinced that there are many efforts and many good practice examples and models that should be discussed and shared with others. There are also many enthousiastic professionals  who are interested in good quality care development and provision.

From these reasons we invited some experts interested in long-term care to participate in the first expert meeting in September 2011 which aimed at finding common questions and fields for collaboration and exchange of experiences which included also experts from CEE countries (Austria, Czech Republic,Germany, Hungary, Lithuania, Norway, Poland, Slovakia, Slovenia, United Kingdom, United States) participants from international organisations among them Alzheimer Europe, EUGMS, AMDA, Dignity for Frail Old Network etc. 

Based on above mentioned discussions we decided that continuing Exchange of Experience in this field would be useful and should focus mainly on interprofessional collaboration and communication in long-term care and as the first to address syndrome in long-term care we have selected dementia.

Based on these conclusions we organised the second meeting in Prague in the end of March 2012  to address these issues. The second ELTECA meeting with leading experts in the field including INTERDEM members and more than 80 participants from above mentioned and other countries including Bulgaria, Latvia, Romania, Russia etc. It was decided to continue in the international exchange of experience.  Consensus on best practices in long-term care should be also developed and should reflect both crosscultural and specific needs of patients. In the symposium we will present conclusions of this second ELTECA meeting.

Supported by the grant NT11325 of the Ministry of Health of the Czech Republic.

P19.3. Pain: important problem in long-term care of persons with dementia

Hana Vaňková, Iva Holmerová, Dana Hradcová

Pain is frequently underdetected in people with dementia, as has been observed in series of studies. Situation in LTC institutions in the Czech Republic will be discussed, regarding also communication about pain in interprofessional team and first experiences with deployment of pain assessment in these institutions.

The grant NT11325 of the Ministry of Health of the Czech Republic: "Long-term care for seniors: quality of care in institutions, organisation´s culture and support of frail older persons" is focused on indicators of quality of care. Pain may be considered  one of the most important indicators.

Preliminary results of this project concerning pain correspond with the international experience described above. In the analysis of two Czech Long Term Care institutions specialized for older adults with dementia (N=82), observed prevalence of pain in residents  was more than 70%.

Qualitative research methods help us understand these data in a complex way.

Case studies of mistreated pain are observed.

Especially in advanced stages of dementia  with communication deficits,  challenging behaviour can be the most noticeable sign of pain. It is vital that professional carers are able to understand this possible interrelation between BPSD and pain/dyscomfort. 

First experiences with deployment of pain assessment in five institutions specialized for older adults with dementia will be discussed.

Supported by the grant NT11325 of the Ministry of Health of the Czech Republic.

P19.4. Dining in long-term care for persons with dementia

Dana Hradcová, Iva Holmerová, Hana Vaňková

Dining is one of the most significant, understandable and meaningful activity of our life. It can bring back pleasant memories, offer sensory and social stimulation and cause pleasure.

Consultancy experience, observation of dining in care homes and sharing meals with staff and residents of these facilities suggest that the potential of dining is not being fully used and dining is turned into routine procedure, lacking joy, sense of belonging and sharing, as well as other aspects of quality of life. Residents of care homes have been through major loses; they will spend the rest of their life in long term care facility, where they have the right to maintain their individual tastes, habits and traditions, to participate in the preparation of meals, to enjoy the consumption and to build and maintain relationships during mealtimes. It is the task of care takers to give special considerations to organising dining for persons with dementia, so they could feel safe and comfortable. It is the task of managers to set up and to maintain systems allowing residents and their families, as well as the staff to eat with dignity, mutual respect and pleasure.

The purpose of the study is modest - to collect perceptions and narratives of “simple” everyday life situations such as dining. Is there anything special about personal contacts care home personnel have with the residents when dining? What are the messages persons with dementia are getting through the quality, appearance, smell and taste of food? What are the feelings and impressions of both residents and staff borne out by communication during preparation, eating and finishing the meals? What does the care home environment and procedures tell to residents? These and many other questions appeared and were partly answered during implementation of Jitka Zgola’s and Gilbert Bordillon’s Bon Appetit programme in the South Moravian Region of the Czech Republic.



Last Updated: Thursday 15 November 2012