UK must rethink dementia care approach, warns care professional

A leading care home professional has said that the nation needs to completely rethink the way it looks at people living with dementia in care homes, shifting the focus beyond just prolonging life and towards the quality and enrichment of life.

That’s the view of Hannah Miller, head of dementia at Orchard Care Homes, who spoke at the Care Managers Show at the NEC recently.

Orchard Care Homes runs 23 care homes across the North of England and the Midlands.

The group’s ‘Reconnect Communities’ are centred on people rather than dementia and the focus is on bringing pleasure to the people who live there, through meaningful engagement, inclusion and having a sense of purpose and contributing to their home if they choose.

Nexus Media Group’s Care Managers Show brought together the country’s care home professionals and leaders, with two days of detailed content, CPD training and networking as well as more than 150 exhibitors.

“We need to support people to live fulfilled and happy lives – not merely focus on being alive”

Miller, who has worked in the care sector for 13 years and is a specialist in dementia care provision.

She spoke about perceptions of people with dementia, saying: “We need to support people to live fulfilled and happy lives – not merely focus on being alive.”

Miller said that common practices by care professionals for people living with dementia were focusing too much on the condition and not on the person, using common, outdated labels and stigmatising language, offering limited opportunities for the individual to be mentally and physically busy, restricting activities that are perceived ‘a risk’ and are therefore unstimulating, providing only basic physical needs, and offering merely a ‘care home life’ – not a normal life.

She said this leads to inequality in care, with many providers assuming that a person’s behaviour is caused by their dementia, failing to consider what may be causing their distress, and using medication to control behaviour.

Miller added that commonly used language around people who live with dementia must change if society is to reframe how it sees and cares for people with the condition.

Archers Court Dementia Care Home in Farringdon
Archers Court Dementia Care Home in Farringdon, Sunderland

Outdated terms such as ‘challenging behaviour’, ‘resistive’, ‘aggressive’, ‘non-compliant’, ‘can’t communicate’, ‘wanderer’ and ‘EMI unit’, she said, already set up a negative image before a carer or care home has even met the person.

Miller said care homes and professionals had the chance to evolve their approach by providing opportunities for people to be meaningfully occupied, offering facilities people can relate to, providing activities that give a sense of purpose and achievement, enabling access to items which people can access independently, and involving people in the running of their home.

She said: “For decades, expression of distress has been labelled as caused solely by dementia. This is not the case – people are responding to their needs and feelings. We need to recognise behaviour is a form of communication.

“Frequently benzodiazepines or antipsychotics are used to reduce behaviours. These mask true causes of distress and are harmful over long periods.”

“The event was a huge success and both sessions went really well”

Miller talked about what Orchard Care Homes is doing to tackle the issues identified. In building skilled and knowledgeable teams, colleagues undertake a comprehensive, evidence-based training programme, delivered by the in-house specialist dementia team.

This focuses on people and what they can do rather than what they can’t, developing a better understanding that behaviour is communication, enabling truly meaningful occupation, understanding causes of distress, enabling positive risk and reducing the use of psychotropic medication and anticholinergics.

Hannah concluded: “The event was a huge success and both sessions went really well. There was plenty of interest and many people came to me after to say how they had found it useful and enjoyable.”

For more information on Orchard Care Homes please call 01423 859859. Last year Orchard Care Homes was named winner of the LaingBuisson Award for Excellence in Large Residential Care. It has also achieved a five-star food rating at every home across its portfolio.

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