industry & reform
Michelle Harris-Allsop.
Photo: Supplied
Walking the talk
The time is now for person-centred dementia care.
By Michelle Harris-Allsop
M
uch has been said about person-centred care for people
with dementia, but it’s time for change to make sure the
good intentions of person-centred care don’t get lost in
busy day-to-day routines.
The crucial component needed to make this approach successful
is ensuring sufficient high quality and dedicated dementia care
specialists out on the floor ‘walking the talk’ and backing up the
rhetoric that exists around person-centred care for people with
dementia in community and residential care.
To develop more high quality and dedicated dementia care
specialists delivering person-centred care, there are a number of
critical factors needed:
1. Better support for carers in practice and effective
communication skills.
2. Continuous building of capability through formal
training programs.
3. More dedicated mentorship programs.
Braemar Presbyterian Care is a good example of proactivity across
these three factors. Wayne Belcher, chief executive of Braemar,
invited me in my capacity as Care Partnerships Australia co-director
to meet his leadership team, and explore opportunities to build
person-centred care and expand the learning about dementia and
the lived experience for people who have a diagnosis of dementia.
Person-centred care is a way of thinking and doing things where
the person living with dementia is always seen as an individual first
who lives with a disability.
The move away from an ‘assessed needs’ model towards a
‘perceived needs’ model will be advantageous for any aged care
provider going forward, and is in line with evolving aged care
industry compliance and funding requirements.
Based on all available research and information, a person-
centred approach to dementia care leads to improved outcomes
for customers, improved job satisfaction and performance for staff
and improved financial outcomes for providers. The delivery of
person-centred care in a dementia service requires:
• A commitment from all stakeholders to undergo the culture
change required to implement a person-centred approach to
dementia services.
• A clear vision of best practice, person-centred dementia care and
how that looks on the floor.
• A high degree of specialist skill in the domains included in its
organisational approach.
• Close monitoring and reinforcing of the culture as reflected in every
decision made and every interaction with customers.
16 agedcareinsite.com.au
• Regular evaluation of the services and their progress and
accountability for the results.
• A volunteer companionship buddy program to reduce loneliness
and isolation for the person living with dementia.
Mentorship embedded within care teams helps to bridge the gap
between formal training and day-to-day practice, so I introduced
the Care Partnerships Australia Mentoring Program to Braemar.
An important piece of the mentorship program in moving
toward a person-centred approach is the building of strong care
partnerships with families. Families need to be closely involved in
care planning and delivery via a case conferencing approach and
given education to enable effective communication with their
loved one.
While many staff do try their best to liaise with families, they are
often overwhelmed with their day-to-day work and have limited
capacity to really give families the time and support they require,
often leading to unsatisfactory experiences for families.
PART ONE OF THE PROGRAM
Braemar Presbyterian Care is offering free public workshops
on dementia training for its staff and volunteers, which it is also
opening up to family members and the wider community.
The first workshops took place in February, March, April and
June, with more on 27 August, 29 October and 26 November. The
workshops, all of which will take place at Willagee Community
Centre, will cover all aspects of good dementia care, including care
planning, communication and how to respond to clients who have
distress in their mood or in a change in behaviours. Resources from
Dementia Training Australia are given to participants.
PART TWO OF THE PROGRAM
Braemar staff work with me two days a month across all shifts
in the home with the clients and families, practising effective
communication using the principles of validation, reminiscence
or reality orientation. They will be supported to learn how to de-
escalate distress – for example when a person is anxious, frightened
or angry. Having effective communication with a person impacts
their wellness and quality of life. It enables the carers to support the
person to maintain their dignity, including fulfilment and a good
quality of life.
Staff in the majority are unaware of a resident’s background
beyond work and family. Braemar is looking at a communication
profile as being the guide for person-centred care.
There is little opportunity for meaningful or purposeful daily life
in residential aged care. There is an ‘entertainment and distraction’
approach which has been proven to have a disabling effect on
people with dementia. This mentorship program is leading a change
of direction for staff and families to understand the person living
with dementia and not focusing on the disability.
CONCLUSION
The time for change is now. The royal commission is in progress,
and I hope more mentorship programs can be funded in Australia.
It is essential to support person-centred choice for consumers, and
aged care providers will have to comply with this in their admission
process and care planning.
Knowing how to communicate with a person living with
dementia will be the most effective way to start these changes.
Michelle Harris-Allsop is a dementia consultant at Care
Partnerships Australia in Western Australia. ■