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The need to match high quality services in dementia with education and training

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You can of course be forgiven for thinking you live in a ‘parallel universe’ as the NHS and social care get put under the Brexit bus as ‘there’s no money left’ tomorrow in the annual Budget.

 

I’ve just published a free online guide for current practitioners and professionals to help them in their learning about dementia.

 

http://dementiasoc.org.uk/wp-content/uploads/2017/03/V2-Signposts-to-dementia-care-Shibley-Rahman.pdf

 

This is not intended to replace, or to compete with, other platforms of learning. It’s simply to provide a perspective on the current aspirations in education and training in dementia, which may not be immediately obvious to people trained outside of the field of dementia.

 

The guide points to what I think is important about the current literature, but is based on the ‘Dementia Core Skills and Learning Framework’ published last year.

 

http://www.skillsforhealth.org.uk/services/item/176-dementia-core-skills-education-and-training-framework

 

This was commissioned and funded by the Department of Health and developed in collaboration by Skills for Health and Health Education England (HEE) in partnership with Skills for Care. Development of the framework was guided by an Expert Group including a wide range of health and social care organisations, relevant Royal Colleges and education providers.

 

Putting together this guide made it immediately obvious to me that the needs of people with dementia in ‘dementia friendly health and social care settings’ are often not met by traditional professional training, but coincide almost exactly with reports of needs elsewhere.

 

The Alzheimer’s Society is about to launch their updated ‘I’ statements. The original National Dementia Declaration described seven outcomes that people living with dementia and their carers would like to see in their lives.

 

A list of them is provided at

 

http://www.dementiaaction.org.uk/nationaldementiadeclaration.

 

Two examples are “I have the knowledge and know-how to get what I need” and “I live in an enabling and supportive environment where I feel valued and understood.”

 

Reflected in my guide, I give an account of the type of information currently available to persons with dementia who come into contact with health and social care services, including research. I think it’s important for practitioners and professionals to know what is out there, in order to be able to signpost to these resources effectively.

 

And dementia friendly environments are not simply wards which have had a lick of paint. In my guide, I signpost to the substantial evidence to what makes an environment ‘dementia friendly’, which might include staff culture or other person-centred behaviours.

 

I’m also struck by how this converges with the findings from Healthwatch, in a report “What do people think of dementia services?” from 19 January 2017.

 

http://www.healthwatch.co.uk/news/what-do-people-think-dementia-services

 

Healthwatch found that the availability and type of information regarding services and support following diagnosis helps to set the tone for the experiences of those with dementia and their carers.

 

They also found that more work needs to be done to make public spaces dementia-friendly by improving elements such as lighting and signage.

 

These findings indeed come from a substantial sample. Since the beginning of 2015, more than 1,000 people across the country have spoken to local Healthwatch about their experiences of dementia care – from the help provided by GPs to the support offered through hospitals and social care.

 

The most troubling Healthwatch finding, I felt, was that more generally, many people felt that the quality of services themselves was inconsistent, sometimes within the same locality.

 

Indeed, it js a stated learning objective of the guide for professionals and practitioners to know how to signpost to high quality services, including hospices and clinical specialist nurses, locally, including an awareness of multi-agency collaboration.

 

It is for me very pleasing to see a rights-based consciousness begin to embed itself from persons living with dementia and care partners. The international work promoting the United Nationals Convention of Rights of People with Dementia has been a big part of this.

 

But it is important that we ensure equality and equity in service provision, and while human rights are universal and inalienable, ‘I statements’ can all too often be driven from the perspective of the consumer and market.

 

And, of course, the overriding objective of the daily work in health and social care sectors will be that professional values, behaviours and skills will to provide the best care and support possible for persons with dementia and care partners to live as effectively as possible. In a person-centred integrated care approach, persons should be both enabled and protected in the right way, in the right place, and at the right time.

 

 

@dr_shibley

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