A Care Home Voice
As their illness progresses, not everyone with dementia will be able to remain in their own home. Some will have no close family able to support them, and would be unable to live alone safely. Our hope is that as our communities become more dementia friendly, and as support services for carers become more available, there will be less need for people to leave those familiar surroundings which can be so important in helping them feel and stay safe and retain the sense of who they are. In the meantime, and particularly in the latter stages of the illness, the responsibility for looking after people with dementia will often be handed over to the staff of residential care homes.
If you’ve been caring for someone with dementia at home, you won’t suddenly stop being a carer just because the person you care for has had to move into residential care. In many cases carers find that being free from the stress of providing round the clock physical care makes them more able to provide the emotional support and friendship their loved ones need most of all. (See Alzheimer Scotland: A Positive Choice, and Letting go Without Giving Up).
It’s estimated that some 40% of people with dementia are currently living in care homes. In any care home for older people, well over half of the residents are likely to be living with dementia. (Alzheimer Scotland figures). How well they are living was the subject of a 2009 report from the Mental Welfare Commission and the Care Commission. The concerns highlighted included inappropriate use of anti-psychotic drugs, lack of dementia awareness amongst staff, poor documentation of personal histories and limited access to outdoor activities.
It’s probably fair to say that there have been some signs of improvement in the standard of residential dementia care in recent years:
- Pioneering work at the Dementia Services Development Centre in Stirling has increased awareness of the importance of a carefully planned physical environment to dementia care;
- the need for safe and interesting outdoor spaces is also more widely accepted;
- these considerations can help inform the design of new purpose-built facilities, though they are often difficult to introduce in existing buildings;
- Dementia care training has also become more widely available to staff in care homes;
- and most homes now make some attempt to provide a variety of meaningful activities;
- Lastly, the use of tranquilisers as a substitute for individual care is now probably less common in the wake of research findings and negative publicity.
Despite these welcome signs, the overall picture is that progress is slow and patchy – there is an enormous difference between best and worst practice, and we need to work hard together to keep things moving in the right direction.
In A Care Home Voice we want to share some of the latest innovations:
- how care homes for people with dementia are being designed and run;
- how staff go about sustaining the health and happiness of the people who live in them;
- examples of good (and bad!) ideas in residential dementia care wherever we hear about them – check out Ann’s visit to Sneha Mendir, a care home in India; and
- any good ideas you come across yourselves and want to share with us.
Between us let’s work together to make our care homes here in the Highlands good places for residents, visiting families and the workers …
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