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TX: 23.09.09 - Dementia Champions

PRESENTER: JULIAN WORRICKER
Downloaded from www.bbc.co.uk/radio4
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WORRICKER
Well now here's a striking statistic for you…two thirds of people living in care homes have dementia, but all too often those employed to look after them don't have a detailed understanding of their needs. Getting to know their history, their personality and their likes and dislikes can stop difficult or aggressive behaviour and improve the quality of their lives. When the government published its 'national dementia strategy' earlier this year, it said senior staff members should be identified to improve the quality of care at each home… so the Alzheimer's Society has been training staff to become so-called 'dementia champions'. The role is all about identifying the needs of individuals, like the ones dementia champion Kath Turpin looks after at the Copper Hill care home in Leeds.

TURPIN
This is a fixture of all sports that on today.

BIRD
So we've got world athletics at six on channel two; channel one final score, Match of the Day 11.00 p.m. and so on. And it's all written out on a piece of A4 paper. What's it doing here?

TURPIN
Well this is basically to remind staff that the gentleman that does like sport doesn't always know what time it's on and this gentleman does socially isolate himself. So we always say to him so and so on at this time, do you want to watch it and he will, he'll always come and watch it. He'll say have a cigarette, have his pint of beer and watch the sport, that were a big part of his life.

This is our garden and in the corner we have quite a large area which is our chicken run.

BIRD
And we've got two chickens.

TURPIN
We have got four.

BIRD
Oh right, we've got two on show anyway.

TURPIN
Yeah so maybe two - two are still inside.

BIRD
Two are a bit shy.

TURPIN
Yeah.

BIRD
So we're in the chicken run - how on earth do chickens fit into your role as a dementia champion?

TURPIN
Well I found out now that a lot of our residents did look after hens when they were at home and when they were children so I decided then to try it ourselves. We've got a lady who only by pure accident talked to the daughter and we found out that she had chickens. So this lady also comes out. I mean the daughters laughed that the mum had chickens on the table when they were kiddies and that's only by forming a relationship with relatives that we're finding out more about people. We're trying to give the people what they had before, their life doesn't stop because they're moving to these homes.

BIRD
How does that benefit them?

TURPIN
Well I think it stimulates them socially and they're not just inside four walls all day, they can still come out and it's part of their life.

BIRD
Well we're going down a corridor with rooms on either side, you're going to tell me about another fella who is a resident here, who - you found out he was a traveller, how did that come about?

TURPIN
On his admission you get to know all the background, so he lived in Romany caravan with a group of family and friends. He moved into Merry House and because of his history what he does now is understood by everybody on this unit. He does tend to wear more than one layer of clothing. We were told that they lived in a camp with all these caravans and they all slept in their clothes because if the police came in the middle of the night to move them on if they were in nightclothes they won't have a chance to get away quickly. And this gentleman still to this day will put two and three layers on but that's acceptable because that is that man's life, nobody tries to change it. He never gets inside the bedding, probably put one sheet over him. A quick getaway.

BIRD
The question I've got really is dealing with people on an individual level, on an individual basis, and getting to know them and their needs and their histories I'm not quite sure why it takes the training and the new position of a dementia champion to have staff realise how important that is.

TURPIN
Well I learnt in a big way. When I first came to this job I knew nothing about dementia. But now it has given me more insight. Because of the type of training that we've done - all the case studies, all the group therapy - it does make you think of people - how they feel. So that has made me more aware of other people's feelings and other people's needs. Take time - listen to them, talk to them, they're people.

WORRICKER
Junior sister, Kath Turpin, talking to Geoff Bird.

Well BUPA is introducing dementia champions, trained by the Alzheimer's Society, at 130 of its 300 care homes and Dr Graham Stokes is BUPA's head of mental health.

Graham, good afternoon.

STOKES
Good afternoon Julian.

WORRICKER
Does the appointment of dementia champions to some extent imply that the care of those with dementia thus far hasn't been good enough?

STOKES
No I wouldn't say hasn't been good enough but it is about driving forward standards and doing better than ever before.

WORRICKER
So what extra training are people receiving here?

STOKES
The dementia champions go through a six day training programme provided by the Alzheimer's Society and what we're really doing is building on the charisma and leadership skills that are lying latent within these workers. And so they receive training in skills, knowledge but also how to mentor, coach, inspire by example.

WORRICKER
And how can knowing a little bit more about an individual's background stop them from becoming distressed or violent has clearly has happened on occasions in the past?

STOKES
I think what's important that you work with the person not against the person. You need to see in many ways dementia as being a barrier - you get behind the barrier and work with that individual, learn who they are, what they want, what they don't want. And working with people who are living with dementia is I think the most challenging task there is because that person is in many ways concealed by the disease - they can't tell us about themselves, they can't tell us about what they're thinking and tragically they have no insight into their condition at all. So they don't even know they're dementing so it logically follows they don't even know they're in a care home. So the world is a very mysterious place to be living in and you need staff to get behind that dementia and really start looking at the world of a person living with dementia through their eyes.

WORRICKER
It takes time to develop that relationship clearly, are there the resources in sufficient amounts, are there the staff in sufficient numbers to actually do that and will you need to appoint more realistically?

STOKES
No, I think you have to accept this is the real world, there is no additional funding coming in from the state, 70% of BUPA's care home residents are funded by the state. It's often doing things differently by looking at things differently. We can often think we know how to do something but in fact we maybe able to do it quite differently. For example, it's often said by staff who are caring for a highly dependent group of people, who do have profound personal care needs as well as healthcare needs that they haven't, for example, got time to do activities - they can't put on one side an hour for example. But if you get into the mindset of a person who's living with dementia they may only remember for 30 or 60 seconds, so in essence what you could say is why not give them 30 or 60 seconds of intense wonderful closeness, what we call brief encounters, and then they will get the benefit of activity. You haven't got to devote one hour to activity, you can give them a quick burst and then move on to the next person and then you uplift the whole atmosphere of a lounge because the person has basically flitted from one resident to another resident.

WORRICKER
And just a brief word on the figures - 130 of your 300 care homes are going to have these people, why not all 300?

STOKES
Not all 300 care homes have people living with dementia, BUPA cares for a variety of need, including physical frailty and physical illness. So we have out of approximately 20,000 residents about 7,000 are living in dementia care units or dementia care homes and it's those homes that we're targeting.

WORRICKER
Thank you very much Dr Graham Stokes, BUPA's head of mental health.

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