Admiral Nurse who plotted a course for dementia care in her local trust

After a 37-year nursing career, with 15 years spent as an Admiral Nurse, Helen Springthorpe retired this year. She explains the approach of the team she established in Worcestershire to support those living with dementia

After a 37-year nursing career, with 15 years spent as an Admiral Nurse, Helen Springthorpe retired this year. She explains the approach of the team she established in Worcestershire to support those living with dementia 

Admiral Nurse Helen Springthorpe

Helen Springthorpe became the first Admiral Nurse in Worcestershire 15 years ago and established a strong and successful team that has helped thousands of families.

Admiral Nurses like Ms Springthorpe, who are supported by the charity Dementia UK, provide specialist dementia support across the UK, offering one-to-one advice in the community, care homes, hospitals and hospices.

Mental health training

‘When I qualified in the mid-1980s, older people’s nursing was seen as the least attractive option in nursing,’ says Ms Springthorpe. 

‘I worked in a general hospital initially, then trained as a mental health nurse shortly afterwards.

‘Training as a general nurse gave me an understanding of a range of conditions and introduced me to people presenting with dementia who tended to be older. I wanted to be able to help and training in mental health helped me understand people more holistically.’

Person-centred care

When Ms Springthorpe qualified in mental health 30 years ago she was offered a post as a staff nurse on a long-stay ward for people with dementia.

‘When I was training as a general nurse I tended to get upset about how older people were simply seen as disease entities and you didn’t get to know the person,' she says. 

'But as I progressed in my career research started moving towards developing a more person-centred approach to care and viewing a person as a whole being, understanding their life experiences and seeing the person behind the illness or the disability.’

Ms Springthorpe moved on to become a manager working on an acute older people’s ward with patients who had dementia and functional mental health problems. She also took a diploma in counselling course and used her days off to work for a local dementia charity counselling carers and families. 

Standards of practice

‘To be an Admiral Nurse you need to have a background of working with people who have dementia,' says Ms Springthorpe. 

'We offer support at important times to families living with dementia, from time of diagnosis to end-of-life care and bereavement support.’

The team is employed by Worcestershire Health and Care NHS Trust, and Dementia UK provides practice development and clinical supervision. 

‘We are required to have group clinical supervision on a monthly basis to maintain high standards of practice. A clinical supervisor from Dementia UK will come to see us and it could be with other Admiral Nurses from surrounding areas so we can also learn from each other and share best practice,' says Ms Springthorpe.

‘We generally have clinical supervision in the morning and practice development in the afternoon. There are many elements to practice development and, before the session, nurses may, for example, be expected to read a journal or research article and appraise it so they can share it with the group.’

Patients and carers

Ms Springthorpe says patients are referred to the team in a number of ways, including self-referral by calling the team directly, through GPs, other health professionals or social services and via charities.

‘We may see people in a variety of settings, but we always try to start with a phone conversation with the carer to get a sense of any presenting issues of the person with dementia and for themselves and the family,' she says.

Sometimes carers come into the clinic because they want to see the team on a confidential basis for advice, she adds. 

‘It could be about equipping a carer with the necessary skills to support the person with dementia,' she says. 

'Carers may also need to address their own needs as they may be contending with issues such as anxiety, depression or other health conditions.' 

The team's visiting times vary, depending on the needs of the case. 

'We may visit every week or fortnight, it could be a one-off visit or it might be a series of clinic visits,' says Ms Springthorpe, adding that 'all interventions are tailored accordingly'.

‘We take a family-centred approach so if we do a home visit and the person with dementia is there, they may be able and want to discuss planning their future care. As the condition progresses we may then become role models for the carer in terms of watching how we communicate with the person who has dementia.'

Supporting choices

She describes one of her most moving memories of working as an Admiral Nurse, involving a man with dementia whose wife was caring for him.

‘They were in their eighties,' says Ms Springthorpe. 'She was struggling to cope because of her own health needs. The two of them went to hospital with health problems, then the wife moved into a care home because of her ill health.

‘The couple wanted to be together and we facilitated moving them into the same room in the care home by working in a multi-professional way with various health professionals and agencies.’

She explains that after a period of time the couple wanted to return home as the wife had mental capacity to make the decision. The Admiral Nurses again helped so the couple were able to return home with a full care package.

‘The couple were childless and didn’t have any family around them but they had lived in the area for a long time and had the support of friends and neighbours who we also worked with.'

Even after the wife died her husband was able to stay at home with a professional carer looking after him for quite a long time. 

'To be able to support people to live in a way of their choosing is exceptionally rewarding,’ says Ms Springthorpe.

Fulfilling career

Ms Springthorpe wants to carry on raising awareness about the effect of dementia. 

‘I know that, as I retire, there will still be a national shortage of nurses, particularly those who are highly skilled older people’s nurses,' she says.

‘It is not a situation that will be quickly resolved, but it is one that must be addressed.'

However, she looks back with pride on her own contribution. 

‘It has been wonderful to be part of a culture shift in older people’s nursing,' she says. 'I hope that newly qualified nurses starting out will continue to look at it as a worthwhile specialism because I could not have asked for a more fulfilling career.’

The GEANS programme

During 2016 and 2017 Dementia UK’s research and evaluation team worked with seven newly established Admiral Nurse services to evaluate their work as part of the Getting Evidence into Admiral Nurse Services (GEANS) programme.

Dementia UK says there is still little published evidence of the effectiveness of Admiral Nurses and the added value of their specialist role. They maintain that commissioners and service providers require data to prove the Admiral Nurse service met their expected outcomes to continue the service.

The charity’s research and evaluation team has used data collection tools as part of the programme, which was developed with five senior Admiral Nurses, to collect evidence about the service.

All the data are being collated in an evaluation report that will be aimed at management and commissioners to prove the effectiveness of the Admiral Nurse service and recommend how it can be developed. 

The GEANS model has been adapted from Generating Evidence in Multiple Sclerosis Services, an evaluation and service improvement project developed by the MS Trust for multiple sclerosis specialist nurses.

Source: Dementia UK


Petra Kendall-Raynor is a freelance journalist

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