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Holistic approach enhances dementia services in care homes

More collaboration between professionals, residents and relatives brings benefits.
Care planning

Care home residents with dementia, who were at the end of life, received effective holistic care after an innovative approach was introduced, research has found.


The new model improves advance care planning for care home residents.
Picture: iStock

The compassion intervention model, which was tested in two London care homes, encouraged staff to adopt a person-centred approach, with an increased focus on shared decision-making with residents and relatives.

It improved pain management and advance planning for those in the later stage of dementia, the feasibility study found.

Collaboration

The model uses an integrated approach to improve working between all health and social care professionals involved in the care of the person with dementia. 

An interdisciplinary care leader acts as a linchpin for health and social care professionals, care home staff and family or informal carers involved in the resident’s care.

The leader enhances education, training and support for formal and informal carers to improve understanding of care planning and reduce unnecessary admissions to hospital.

The model was designed by the Marie Curie palliative care research department at University College London to help nursing home staff improve the management of residents’ complex needs while avoiding the occurrence of unnecessary and costly hospital admissions.

Prevalence of dementia

Eight out of 10 people in UK nursing homes are living with dementia or another form of cognitive impairment, and more than half of the people with dementia in the UK will die in a long-term care institution.

Research suggests that, for people with dementia, essential components of good end of life care may often be neglected and referral to palliative care services is rare.

The researchers have published a manual on the compassion intervention model for care homes to follow.

Lack of coordination

Lead author of the research Kirsten Moore said: ‘Even where nursing homes are well supported by local services, there still appears to be a widespread lack of coordination between professionals.

‘This model offers a way for all healthcare teams to work together in the nursing home setting as they would in a hospital setting.’

Process driven

Sarah Davis, research nurse at the Marie Curie palliative care research department said she hoped other care homes would use the model to improve care for the growing number of people with dementia.

A lot of care was very process driven, such as staff doing pain assessments, but then not acting on the results.

‘There was quite a lot of poor knowledge about dementia in care homes and a need for more training,’ she says.

‘There was a lack of understanding of the patients needs, attributing all their problems to dementia and feeling there was nothing they could do about it. If, when moving a patient, the patient yelped, they didn’t necessarily think it may be pain, but driven by the dementia.’


Further information

  •  Read the study here

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