COVID-19: supporting people with dementia during the pandemic
How an Admiral nurse has adapted her role to help families cope during the crisis
Norfolk’s first Admiral nurse has returned to the front line to help people with dementia and their families cope with the impact of COVID-19.
'I’m really glad to be able to support them,’ says Zena Aldridge, an Admiral nurse research fellow at charity Dementia UK.
Families have had their support systems ripped away overnight
‘Demand is increasing and the concerns of families are accelerating. A lot of their coping strategies have been ripped away overnight, and those who may have got respite from peer support, day care or other family members being able to spend time with the person, no longer have it.’
Ms Aldridge is currently spending two days a week signposting carers to the right services, and providing emotional support and practical guidance to those who are struggling. ‘Initially, people were resilient,’ she says. ‘But the longer time goes on and there’s no light at the end of the tunnel, it’s incredibly difficult when you’re caring for someone 24 hours a day, seven days a week.
‘Stress levels are going up, alongside anxiety about what the future might hold,’ she adds.
Explaining the pandemic to people with dementia can be difficult
Explaining the effects of the pandemic, such as why they can no longer visit friends, to someone with a severely impaired short-term memory is extremely problematic. ‘You can tell someone a hundred times, but they’re not going to retain that information,’ says Ms Aldridge, who qualified as a mental health nurse in 2003.
‘It’s about using distraction techniques and different ways of managing anxiety. Coping is difficult for families at any time, but when you’re not able to rationalise and make sense of a situation it becomes even harder,’ she says.
Other concerns centre on carers’ anxieties about what happens if they contract COVID-19 themselves and become ill, or even die. ‘We’re doing lots of care planning,’ says Ms Aldridge. ‘People with dementia often have other conditions and are frail and vulnerable.
‘Everything is heightened because of the restrictions,' she adds. 'There’s also a feeling that they shouldn’t be accessing primary healthcare, so we’re reassuring them that it’s okay to engage with services if they need to.’
A return to providing direct support for families
After working in various mental health posts, including as an out-of-hours dementia worker, Ms Aldridge became Norfolk’s first Admiral nurse in 2014.
‘My heart was always drawn to people with dementia,’ she says. ‘I find it fascinating. Even with patients who have advanced dementia, I get a real thrill from those moments when you see that person come to life and you can share that with their families.’
‘People are very isolated, so just having someone at the end of a phone line who they can talk to about how difficult it is, and have that validated, is incredibly important’
Zena Aldridge, Admiral nurse research fellow, Dementia UK
About four years ago, she joined Dementia UK as a service evaluator, looking at the difference Admiral nurses make to families, how they promote best practice in dementia care, and gathering feedback on families' experiences of using the service.
After becoming a senior consultant Admiral nurse, she began a PhD three years ago at De Montfort University in Leicester, looking at care in nursing homes for people with advanced dementia. She combines three days research with another day working for Dementia UK's research and publications department, and a further day working as a dementia consultant with the local clinical commissioning group.
When COVID-19 made it impossible to carry out some of her work – which involved hospital and nursing home visits – she suggested she return to providing direct support for families and colleagues for two days each week.
‘Some of it is crisis intervention, including for those who have been coping well up to this point,’ says Ms Aldridge. ‘People are very isolated, so just having someone at the end of a line who they can talk to about how difficult it is, and have that validated, is incredibly important.’
Visiting restrictions can make communication challenging
Those whose family members are in care homes face particular challenges. ‘While many of us know that those in care homes are the most vulnerable, there is a heightened awareness now,’ says Ms Aldridge. ‘Families can’t even go in and check on their loved ones.’
Although being online has helped some stay in touch, for others it can be too confusing. ‘If you put a tablet in front of them, with a family member who is trying to communicate, it just won’t resonate,’ she says. ‘We’ve had instances where the person has been wandering around the home trying to find them.
‘We’re assessing what the person’s level of understanding is and then trying to find a strategy that’s the best fit for them. But sometimes we don’t have the answers.’
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Giving advice over the phone also has its limitations. ‘I’m quite a tactile person and value being with people,’ says Ms Aldridge. ‘It’s hard because when people are distressed, I want to be there for them, to support them physically and not just be a voice at the end of the line.
‘You feel you can’t give them what you usually can. But I’m glad to be able to help the families and my colleagues, so they are not feeling over-burdened either. It feels like the right thing to do.’
Lynne Pearce is a health journalist