Sharing best practice for delivering excellence in ... · Sharing best practice for delivering...

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www.bournemouth.ac.uk 1

Sharing best practice for

delivering excellence in nutrition

and dignity in dementia care

Partnership project

Started January 2014

Council

Dorset LEP

Care homes

Service users/ carers

Overview of afternoon

Welcome by Jane Murphy

Dame Christine Beasley, Burdett Trust for Nursing

Hilda Hayo, Chief Admiral Nurse, Dementia UK

Overview of the key research findings

Panel discussion

Networking

Training film viewing

Next steps

Social Media

@nutri_dementia

#nutridignityindementia

Dame Christine Beasley

@nutri_dementia

Hilda Hayo

Working with People Living with

Dementia

Hilda Hayo

Chief Admiral Nurse/CEO

What are the issues?

Growing numbers of people with dementia

Majority live in their own homes

Growing number of family members

providing care estimated to save the nation

£17.4 billion

Patchy services and postcode lottery

High multiple health and social care needs

Multi morbidity

A ‘potted history’ of Admiral

Nursing

Family experience

Specialist dementia nurses

Family focus

Tier 3

Admiral Nurses

Tier 2

Dementia Skilled

Tier 1

Dementia Awareness

3 Tier Dementia Pathway

Dementia Pathway

Pre diagnosis

Diagnosis Living with dementia

End of life

Grief and bereavement

Supporting families affected by dementia through

the trajectory of dementia

What does an Admiral Nurse do?

Family & relationship centred approach

Work in partnership

Specialist assessment & intervention

Promote and implement best practice

Provide supportive education

Provide bio psychosocial support for the family

Liaison with other professionals and organisations

Work in consultancy and supervisory role

Some nutritional issues

encountered

Under nutrition

Reluctance to eat

Obsessions

Overeating

Dental and oral issues

Swallowing issues

Recommendations from

Nutrition and Dementia Review

(ADI, 2014)

More research into: supplementation;

MIND diet; Vitamin E; fortification

Clear, consistent and independent advice

Nutritional standards of care for dementia

Nutritional standards of care

for dementia Weight and nutritional status assessed

Dietary advice from a dietician to all families

affected by dementia.

Under nutrition: dietician and OT assessment.

Natural food fortification to be tried first but

then oral nutritional supplementation.

Staff training in hospitals and care homes re:

nutrition

Diet and Brain Health

Fish oils: heart disease, arthritis, cancer,

cognitive function

Vitamins – especially B vits and antioxidants

Flavonoids: antioxidant properties, protect

against cell damage

No one food / nutrient likely to reduce risk of

developing AD/ Dementia – need a mixture

The MIND Diet

Developed to help Improve brain function and reduce risk of Dementia

Combination of the Mediterranean diet and diet to reduce blood pressure (DASH diet)

Which key foods most important?

American study, 960 older people, spanned 9 years (2004-2013)

52% reduction in Dementia, slower mental decline

MIND Diet

“brain healthy” foods

Green leafy & colourful veg

Nuts & berries - blueberries,

strawberries etc

Beans, lentils, soya

Wholegrains

Poultry

Olive oil

5 “unhealthy” foods

Red meats

Butter and margarines

Cheese

Pastries and sweets

Fried and “fast foods”

Should you follow the MIND Diet? Maybe hard to follow it rigidly

Even those who followed it partly obtained some benefit

Making your diet more MIND like – easier to follow long term

Diet important, but only one aspect of lifestyle changes associated with reduced risk.

Need to consider nutrients that may be missing/reduced that have other important functions

Thank you for listening

Hilda.hayo@dementiauk.org

Admiral Nursing DIRECT: 0800 888 6678 or

Email : direct@dementiauk.org

@nutri_dementia

Nutrition and Delivering

Dignity in Dementia Care

• No standardised interventions

to maintain adequate nutrition

• Lack of nutrition training, skills,

empowerment and leadership

to embed values and

behaviours in care

• Poor recognition of the ‘meal

experience’ to deliver person-

centred care

Challenging…...

Complex….

1. To identify and understand best practice and

delivering excellence in nutrition and dignity in

dementia care to provide quality improvement in

food and nutrition for people living with

dementia.

2. To establish high quality nutrition education

and learning.

Identify best practice

Qualitative and Quantitative

Research Methods

• Measures of nutritional status:

food & fluid intake intake,

energy expenditure/physical

activity & sleep patterns

(accelerometry)

• Focus groups/interviews: all

those responsible for food,

nutrition and delivery of care in

care homes.

Quantitative research –

Take homes…

• Variable physical activity and sleep patterns contribute

to low intakes in some residents

• Majority of residents were not meeting

recommendations for hydration

• Real time monitoring using wearable technology can

support better food and nutrition for person-centred

care in people living with dementia

Qualitative research

• Nurse managers of care homes

• Key care staff

• Family carers

• Chefs and kitchen staff

• Dietitians

• Speech and language therapists

What do these aromas

mean to you?

Establish high quality

education

• Delivered and evaluated ‘face to face’ training and

education

• Assessed impact of learning – follow up

Comments from attendees

I would recommend this learning to all within the care-sector

no matter what their role. Everyone would benefit ultimately”

Activities Coordinator

“Lots of valuable research-how to deliver, ways to deliver and

a good combination of data and references to real life

practice”

Care Home Manager

“Absolutely fantastic! So Inspiring! Really varied material-

engaging-really thought provoking-so many new ideas and

perspectives. So much to take away. Thank you so much”

Care Assistant

@nutri_dementia

Discussion panel

Dr Michele Board RGN DPSN, Senior Lecturer,

Bournemouth University

Dr Janet Scammell RN, DNSci, Associate

Professor, Bournemouth University

Professor Keith Brown, Director of National

Centre for Post Qualifying Social Work,

Bournemouth University

Rebecca Robson RMN, Registered Manager,

Waypoints Care Home, Verwood

@nutri_dementia

Training tools

Elaine Atkinson OBE

Closing Comments

Thank you for listening!

Further information

http://www.bournemouth.ac.uk/nutrition-dementia

@nutri_dementia

Register your interest for a copy

of the training material before

you leave

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