28 Steps Towards a more “Dementia Friendly” Medicine for the OLDER PERSON Acute Admission Ward

• Published in: Age and ageing Vol. 48; no. Supplement_3; pp. iii17 - iii65
• Main Authors: Lavery, Paula, Smith, Finola, Peel, Michelle
• Format: Journal Article
• Language: English
• Published: Oxford Oxford Publishing Limited (England) 16.09.2019
• Subjects: Audits; Censuses; Cognitive ability; Cognitive impairment; Delirium; Dementia; Dementia disorders; Environmental requirements; Healing; Hospitals; Hygiene; Kings; Medical diagnosis; Mobility; Nursing; Occupational therapists; Occupations; Older people; Personal hygiene; Social interaction; Teams
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afz103.18

Abstract Background A “Dementia Friendly” ward is an environment that has been designed and adapted to take into account the care needs and environmental requirements of dementia patients (Dementia Action Alliance, 2013). Hospitals should be dementia friendly from admission to discharge (National Dementia Strategy 2014). Occupational Therapists (OT) have unique skills in assessing the environment and understand the influence these have on a person’s engagement in valued occupations. A one-day patient census on a Medicine for the Older Person Acute admission ward indicated that 60% of patients had an acute delirium. Fifty percent of patients had a documented diagnosis of dementia or mild cognitive impairment. In light of this, the OT team completed an audit to assess how “Dementia Friendly” the ward is. Methods The “Is your ward Dementia Friendly” Enhanced Healing Environment Assessment Tool, developed by the Kings Fund (2014) was utilised for the audit. The assessment tool contains seven sections which include “Orientation, Meaningful Interaction and Safe Mobility”. Following the audit, results were calculated in percentile format and long/short term goals for improvement were developed incorporating dementia friendly design principles. Results Meaningful Interaction: 35% Well-being: 37% Eating & Drnking: 37% Mobility: 34% Continence and Personal Hygiene: 40% Orientation: 44% Calm, Safety & Security: 53% The overall, average ward score achieved was 40% “Dementia Friendly” environment. Conclusion Following audit, the OT provided feedback to the ward manager and a ward committee was established with a wide variety of stakeholders, including, catering, nursing, allied health, and dementia services director. This committee meets on a regular basis with a joint vision to enhance the “dementia friendly” ward environment. Currently, actions are underway to target improvements in orientation and way-finding and social interaction. A re-audit will be completed in May 2019.