Interest in Older Adult Safewards adaption?

9 years 10 months ago #245 by SianTaliesin
We're getting more and more Early Onset Dementia clients coming in to our PICU - 3 this year so far. They come to us because of "challenging behaviours" and I'm really interested in any adaptations/innovations that might come under the Safewards banner that can help us manage these clients. The generic Safewards principles work obviously, but it would be interesting to hear if any other areas have ideas to share. We've added dementia (and Learning Disability) to our Patient Staff Conflict checklist, as they cause significant peaks in conflict behaviours, but we're keen to hear from other areas.


Sian Williams
Ward Manager
Taliesin PICU
Hergest Unit, Ysbyty Gwynedd
Betsi Cadwaladr University Health Board
The following user(s) said Thank You: GBrennan
9 years 10 months ago #246 by LynneR
It would be worth staff who are sending those and perhaps some of your staff attending a dementia care mapping course. This shows that there are no challenging behaviours but expressions of unmet need. I too, in the past referred people to PICU for the very same thing but one of my wards is trying to change things for themselves by training the staff up. The course is so enlightening and you reflect deeply in experiences with patients who have expressed behaviour which was aggressive etc and often passed off because 'they have a frontal lobe demetia'. This isn't the case but it does demonstrate how some of the things in safe wards such as the calm down box can be used with someone with dementia who is experiencing distress. To be able to offer them something which would comfort and reassure them. It may be something from the box or something very specific to the individual - this is where the Life Story work is invaluable too.

Happy to discuss more.
9 years 10 months ago #247 by LynneR
This can work but the patients physical health would also need to be considered as some (diabetic ) do have a de sensitivity to heat, so would also need to be monitored.
9 years 10 months ago #248 by GBrennan
Interesting. The issue with early onset dementia is that it is a catch all for a number of things - could be organic, could be the effects of alcohol etc. The main issue as I see it is the cognitive difficulties - particularly if frontal lobe damage.
But I think the main thing is to try and make sure they are included as much as possible – particularly in interventions like mutual help, positive words, know each other and the use of the chill box and talk down.
There will be a need to repeat information – reassurance may need to be repeated and also if we are reassuring other patients we might need to think a bit about how much and how we can tell them to explain behaviour – that memory and impulse control may well be damaged in the person. Most patients will see that there are particular difficulties for the EOD person
Kitwood, who wrote great stuff on dementia under the title Person Centred Care, would, I think, advise us to see these clients as needing adjustments, but who we should try to include and not see as beyond the help of any intervention. I have attached alink to an article on his approach.
And finally do tell us any lessons you learn. We don’t know the answers but we can struggle for the knowledge together.

Geoff Brennan
9 years 10 months ago #259 by HelenM
Hi, I'm part of a small team of nurses/OT/Psychology working on a trial implementation in Cardiff & Vale Mental Health Services for Older People, with a young onset dementia ward, two extended assessment dementia/behaviours that challenge wards, an acute assessment ward and a neuropsychiatry ward. We're at the early stages of identifying champions on each ward and having the discussions about adapting interventions for the populations we're working with. So we are also looking for any tips/thoughts on adaptations but hopefully we might be in a position to share some of our experiences in the not too distant future. Really encouraged to find this board and to see there are some other areas thinking about this too.
9 years 9 months ago #274 by salli
we are definitely going to implement on our OP functional ward and are thinking through for dementia services. the wards are going to run together (Adult and OP) with implementation leads.
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