Evidence and Practice

Clinical

Fast-track training of temporary healthcare support workers to supplement hospital staff during the COVID-19 pandemic

Fast-track training of temporary healthcare support workers to supplement hospital...

Why you should read this article: • To learn how a hospital in Scotland supplemented its support workforce during the COVID-19 pandemic • To understand how staff from non-clinical backgrounds can be rapidly trained to care for older people in hospital • To acknowledge what can be achieved when appealing to local resources in a crisis In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic, which generated concerns that the NHS could be overwhelmed. The predicted increase in the number of patients requiring hospitalisation prompted the need to increase the number of clinical staff working on hospital wards, particularly healthcare support workers (HCSWs), who play a crucial role in addressing the care needs of older people. This article describes how one health board in Scotland trained and redeployed volunteers among its staff to work as temporary HCSWs in its main hospital during the pandemic. A fast-track, one-day training course was delivered in March and April 2020 to 104 staff from various backgrounds – some non-clinical – by a team of volunteer trainers. Staffing during an emergency, such as the COVID-19 pandemic, presents significant challenges, but the experience at NHS Borders shows that it is possible to develop a training course rapidly and provide additional band 2 staff to supplement the support workforce in a time of crisis.

Palliative and end of life care for people with advanced dementia

Palliative and end of life care for people with advanced dementia

Why you should read this article: • To recognise that people living with advanced dementia should be offered early palliative and end of life care that aligns with best practice • To acknowledge the importance of early conversations with the person and family during diagnosis, and as dementia progresses, to support understanding and action planning for the advanced condition and end of life • To identify the need for accurate assessment of and response to pain in palliative and end of life care for people with dementia Despite growing understanding in recent years of the biological, psychological, social, environmental and spiritual aspects of dementia, people with advanced dementia continue to experience inequalities in accessing healthcare capable of improving their lives. The complexities of advanced dementia challenge professional competence and demand the highest level of skilled, compassionate care. This article, the last in a series on living with advanced dementia, considers the status and direction of palliative care as it applies to people with dementia and explores contemporary issues regarding advanced dementia and end of life, with a focus on guidance for practitioners and support for best practice. It identifies that open communication, clear information and a person-centred approach adopted as early as possible in the syndrome can make this period less distressing. Crucially, people at the end of life should be offered care in line with best practice in palliative and end of life approaches.

Using virtual care interventions to provide person-centred care to hospitalised older people with dementia

Using virtual care interventions for hospitalised older people with dementia

Using iPads can help patients connect with family and take part in person-centred activities

How nurses can support the inclusion in research of older people who lack capacity to consent

How to support the inclusion in research of older people who lack capacity to consent

Support for nurses to ensure that older people who lack capacity can participate in research

COVID-19: the experiences of a frailty specialist community rapid response team

COVID-19: the experiences of a frailty specialist community rapid response team

Changes made to service delivery by a team caring for older people living with frailty

Learning and leadership in advanced dementia care

Learning and leadership in advanced dementia care

Evidence about leadership skills and competencies needed in advanced dementia care is scant

CPD articles

Holistic pain assessment in older people and older people living with dementia

Holistic pain assessment in older people and older people living with dementia

Nurses have a crucial role in pain assessment for older people and those living with dementia

Sexually speaking: person-centred conversations with people living with a dementia

Sexually speaking: person-centred conversations with people living with a dementia

Why you should read this article: • To understand the importance of supporting the sexuality and sexual expression of people living with a dementia • To enhance your awareness of a new person-centred paradigm that can be used when undertaking conversations about sexuality and sexual issues • To recognise the issues related to sexual rights and consent that may arise in the care of people living with a dementia While sexuality is integral to being human and supporting sexual expression is fundamental to delivering person-centred care, many nurses find this area challenging. This is particularly true when working with people living with a dementia, irrespective of their age. However, it can be especially challenging in older adults. This article aims to support nurses in their work with individuals and couples living with a dementia. After briefly defining the term ‘sexuality’ and acknowledging the effects of the most common types of dementia, the article discusses the importance of person-centred conversations. It details a new person-centred paradigm that can assist nurses to learn about people’s sexuality and sexual wishes. Through enhanced understanding and increased objectivity, nurses can be better equipped to support people to continue living fulfilled sexual lives according to their choices and priorities. The article concludes by summarising the legal and professional context and nursing responsibilities involved in addressing sexuality with people living with a dementia, specifically when mental capacity becomes an issue.

Type 2 diabetes in older people: pathophysiology, identification and management

Type 2 diabetes in older people: pathophysiology, identification and management

Exploring the implications of increased longevity and how this is linked to type 2 diabetes

Sexual health and well-being in later life

Sexual health and well-being in later life

This article defines sexual health and explores the changes people experience in later life

Extending the Newcastle Model: how therapeutic communication can reduce distress in people with dementia

How therapeutic communication can reduce distress in people with dementia

Newcastle Model’s biopsychosocial framework is revisited to understand the caregiving context

Osteoporosis and fragility fractures: risk assessment, management and prevention

Osteoporosis and fragility fractures: risk assessment, management and prevention

Nurses need to be aware of the risk factors and identify at-risk patients

How to

Hearing loss

How to address the communication needs of older patients with hearing loss

Hearing loss is a common problem in older people and may have a negative effect on their care while in hospital, as well as resulting in significant cost to the NHS. This article outlines the findings of a two-year project in an NHS trust to improve the care of older people with hearing loss. An important outcome of the project was the development of a hearing loss toolkit containing good practice recommendations and tools to help staff in all NHS trusts, and other care settings, implement practical and cost-effective improvements.

Planning

How to use advance care planning in a care home

Admission to a care home is a major event for many individuals and, for some, a time when they may lose their independence. It is at this juncture that they should be given the opportunity to participate in planning their future care. An advance care plan (ACP) is a means for people with capacity to document their preferences for their care and to enable providers to advocate on their behalf. Some people will have lost mental capacity before admission to a care facility, so it is essential for staff to be familiar with the complexities of the Mental Capacity Act 2005 to support residents approaching the end of life. This article outlines the processes of ACP and identifies resources available to support the introduction of ACP into care homes.

Practice question

How do I manage delirium in older people with COVID-19?

Delirium is a common coronavirus symptom, and people in long-term care facilities are at risk

My research study improves patient care – how can I share it?

Tips and rules for successfully sharing your research at a conference or professional meeting

Picture shows a group of older people hiking in the countryside

How do I encourage older people to become physically active?

Types of physical activity that can benefit older adults and some suggested resources

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How can I ensure dementia care is based on the best available evidence?

Critically appraised topic (CAT) process helps ensure clinical practice is evidence-based

Nurse attending to an older patient who is experiencing and needs hydration

How do I manage the care of an older person with delirium?

Guidelines recommend prompt detection by screening older people on admission to hospital

Many older people use multiple medicines, medicines optimisation helps to ensure safe and appropriate polypharmacy

Why is medicines optimisation important for older people living with frailty?

Medicines optimisation can help ensure appropriate polypharmacy

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