Dementia training

I saw this on the BBC this morning. Many of the examples they listed were nothing to do with dementia care. Rather they were to do with basic care of any person. People do not need their teeth brushed, hygiene needs met, socialisation, regular medication reviews etc because they are suffering from dementia. They need these things because they are people.

All staff working in care home should (must?) be working towards some kind of NVQ/SVQ certification. Which if I recall correctly does not specifically include knowledge of dementia. The people assessing these courses (often from outside the care home) should ensure that things are relevant to the work place. So if people are working with those suffering from dementia they should make this part of the learning objectives.

I worked in a care home with an external NVQ assessor. She was really good on general basic care type things. Coming from a general nursing background (though she no longer actually practiced spending all her time assessing others). She was weak on anything that was less easily measured, use of non verbal skills, spending time talking to people etc.

Systems are in place to allow dementia care and knowledge to be improved they are just not being used adequately.

They make a good point about young staff being asked to deal with, what can be, a difficult client group without support and training.

Saddening, though not really surprising, that it actually has to be stated that people need training in order to work with people with dementia.

Unfortunately this will probably continue as long as dementia care continues to be seen as unglamourous, unrewarding and fit only for untrained, low-paid 17-year-olds to do, rather than what it *actually* is, which that it’s one of the most complex and challenging forms of nursing out there.

We wrote to every care home in our district, offering free training to improve standards.

In the last few years a couple local homes have been closed down and several have been investigated by CSCI.

Those found to be failing and investigated who worked with us and had training turned around in 6 weeks to be good care homes. Those who ignored our letters and declined training are the ones that have concerns about their care or have been closed down.

The crunch of the matter is that decent care homes are receptive to training and become good care homes. Poor care homes aren’t receptive to training and devolve in to bad care homes. Mandatory training, whilst having economic consequences, could improve patient care since training clearly improves standards.

I had difficulty working in elderly care. It used to make me pretty angry. Even as a Team Leader for a unit of 11 I was devastated by the sheer lack of personal attention. Even worse was trying to make changes and seeing the residents suffer as a result.
I would like to see a few ‘carers’ (not family carers - the other ones) who fall significantly short of the grade to spend a day or two as a resident.
I much admired the Post-Basic Nurse Educator whose Incontinence Training course required the participants to wear a nappy all day with only one toilet break. Everyone knew about it but they still went - mostly to see the Educator who seldom forgot to ‘toilet’ herself before the course but frequently shit her nappy anyhow (yes, she wore one too).

Just to expand on a point Mr Ian did not make:

“I had difficulty working in elderly care. “

(aside Monday at 2030 on BBC Panorama, there seems to be an undercover report on care homes)

There are some things it is forbidden for nurses to say. In my neck of the the woods if you say something like:

“I don’t want to work in over 65 nursing …”

You get treated as if you have actually said

“I hate old people. Over 65 nursing is not proper nursing. I am a rubbish nurse”

It leads to much ranting that elderly mental health care is just as important as adult mental health nursing, despite not being as sexy etc etc.

Whereas if you assess your personal skills, stengths and career goals and decide for example you are probably not well suited for IPCU or Addiction Services nobody bats an eyelid.

Just an observation I have made and explained badly

You explained it fine. And made my point that I omitted.

I’m not anti-old people. I loved the idea of it and enjoyed the work I did there.

Hated the poor standards.

My unanswered questions from elderly care were:
Why did we wake, wash and dress all 21 patients from 05:30am so they were all (except old Flo who got left in bed all day) ready for the day staff who sat them in a chair til breakfast - toilet - tea - lunch - toilet - tea - dinner - bed by 6pm? Do places still work this way?
Why did the staff always take their 45 minute tea break away from the residents?
Why did qualified nurses spend so much of there highly paid trained skilled time - making beds, hanging clothes and doing so much non-contact work?
Why did nurses bag out on other nurses who wanted to actually spend time with the residents doing those “extra special” activities like - talking to the resident, going thru photo albums, playing music and singing along, sitting with relatives to hear the old stories?
Why did we give out large doses of polypharmacy to then wonder why we had to give them enemas every other day?

I remember the ‘bath queue’ ARRRGGHHH…. wheelchairs lined up outside the bathroom with residents in them ready stripped except for a towel or robe waiting for their bath like a ^&%$$% production line.

I’m going now.

Yes almost all these things are still done. More so in hospitals than in community facilities in my experience. Not seen a bath queue for many years though thankfully.

Why did qualified nurses spend so much of there highly paid trained skilled time - making beds, hanging clothes and doing so much non-contact work?
Why did nurses bag out on other nurses who wanted to actually spend time with the residents doing those “extra special” activities like - talking to the resident, going thru photo albums, playing music and singing along, sitting with relatives to hear the old stories?

Because like it or lump it the culture in many over 65 wards does not see this as proper work. Often the wards are run at minimal staffing levels (with sickness absence etc) there is always basic work needing done, always, so if a nurse (or HCA) is doing something else (ie chatting with clients) they will be attacked by other staff for not doing whatever they are doing.