Dementia falls presentation Abby Whiting Dementia Falls Nurse for - PowerPoint PPT Presentation

Dementia falls presentation Abby Whiting Dementia Falls Nurse for Suffolk Suffolk Mental Health Partnership NHS Trust

Training outcomes • Introductions • Overview of dementia and falls • Case study of Alice • FAIL & GAIN • Questions and feed back • Tool kit Suffolk Mental Health Partnership NHS Trust

What is Dementia? Suffolk Mental Health Partnership NHS Trust

The term 'dementia' is used to describe the symptoms that occur when the brain is affected by specific diseases and conditions. Symptoms of dementia include loss of memory, confusion and problems with speech and understanding. (Alzheimer's Society 2011)

‘ Dementia a national priority ’ Launched in 2009, the National Dementia Strategy set out a vision for transforming dementia services with the aim of achieving better awareness of dementia, early diagnosis and high quality treatment at what ever stage of the illness in what ever setting. (DH Dementia strategy 2009) 2038 YEAR 2008 PEOPLE LIVING WITH 700,000 1.4 MILLION DEMENTIA IN THE UK ESTIMATED 17 MILLION OVER 50 BILLION COST Suffolk Mental Health Partnership NHS Trust

Alzheimer’s Vascular dementia Lewy Frontal- bodies temporal

Global symptoms • Forgetfulness • Communication difficulties • Personality changes • Mobility difficulties • Decreased judgement • Disorientation • Difficulties in performing familiar tasks • Depression/anxiety • Mood swings • Sleep disturbances Suffolk Mental Health Partnership NHS Trust

REASONING MOVEMENT PLANNING ORIENTATION SPEECH PERCEPTION OF MOVEMENT STIMULI RECOGNITION EMOTIONS VISUAL PROCESSING PERCEPTION MEMORY SPEECH Suffolk Mental Health Partnership NHS Trust

What is a fall? Suffolk Mental Health Partnership NHS Trust

A fall is an event that results in the person, or a body part of the person, coming to rest inadvertently on the ground or surface lower than the person, whether or not an injury is sustained. (NHS slips, trips and falls policy 2009) Suffolk Mental Health Partnership NHS Trust

Someone with Alzheimer's is three times (3x) more likely to fall WHY Suffolk Mental Health Partnership NHS Trust

The three key stages Suffolk Mental Health Partnership NHS Trust

1. Early stage Dementia patients have similar risk for falls as elders residing in the community, patients may develop psychiatric complications such as depression, or complications that may cause orthostatic hypertension. Suffolk Mental Health Partnership NHS Trust

2. Mid-stage Dementia patients may fall for a variety of reasons. Patients begin to lose fine motor coordination and forget how to perform basic functions of daily living. Patients misinterpret their environment and fail to recognize unsafe situations such as loose rugs, loose floor boards, etc. Suffolk Mental Health Partnership NHS Trust

3. Late stage Dementia patients are particularly prone to falls. Patients forget how to walk (gait apraxia) and seem uncoordinated with the placement of their feet. Patients can no longer follow verbal direction and communication barriers complicate intervention. Suffolk Mental Health Partnership NHS Trust

Falls for the individual Suffolk Mental Health Partnership NHS Trust

Related issues • Injury/pain • Hospitalisation • Isolation • Fear of falling again • Changes in medication • Immobility • Death Suffolk Mental Health Partnership NHS Trust

Common causes of delirium • P Pain • IN Infection (urine/chest infections, wounds) • C Constipation and poor nutrition • H Hydration • M Medication • E Environmental changes Suffolk Mental Health Partnership NHS Trust

Case study Suffolk Mental Health Partnership NHS Trust

FAIL • F flawed environment • A altered perceptions • I inappropriate medication use • L lack of resources and training Suffolk Mental Health Partnership NHS Trust

Environment People with Alzheimer’ s Disease or probable Alzheimer ’ s Disease have a poor awareness of danger. (Starkestein et al 2004) Suffolk Mental Health Partnership NHS Trust

Sundowning The term "sundowning" refers to a state of confusion at the end of the day and into the night. Sundowning isn't a disease, but a symptom that often occurs in people with dementia. Sundowning Mayo clinic 2011 Glenn Smith, Ph.D. Suffolk Mental Health Partnership NHS Trust

Think……! LIGHTING FLOORING HEATING FOOTWEAR & CLOTHING INACCESSIBLE ITEMS MIRRORS NOISE CLUTTER Suffolk Mental Health Partnership NHS Trust

Perception Suffolk Mental Health Partnership NHS Trust

People with dementia very often seem to see more than we do, to see through things, round things, past things. Their senses appear at times to be differently deployed so that they hear smells, see voices, taste pictures. Karen Hayes from The Landscape of Dementia (unpublished) Suffolk Mental Health Partnership NHS Trust

Test your senses Suffolk Mental Health Partnership NHS Trust

Agnoisa Dementia affects the brain‘s ability to understand and recognize visual input (what is seen). A loss of ability to recognize objects, people, sounds, shapes or smells. Suffolk Mental Health Partnership NHS Trust

Dementia can cause someone to mistake a glare, a dark shadow or a reflection of themselves in a mirror for an imposter, a patterned carpet for insects and vermin. They may try and manoeuvre around rugs and carpets thinking they are holes in the ground. Suffolk Mental Health Partnership NHS Trust

Medication management Antipsychotics are drugs designed to treat conditions such as schizophrenia, however they are often inappropriately prescribed as a first response to behavioural and Psychological Symptoms of Dementia. Suffolk Mental Health Partnership NHS Trust

Antipsychotic medication Side-effects can include excessive sedation, dizziness, unsteadiness, and symptoms that resemble those of Parkinson's disease (shakiness, slowness and stiffness of the limbs), chest infections, ankle swelling and falls. Ballard and Howard 2006 . Suffolk Mental Health Partnership NHS Trust

All people with dementia who are receiving antipsychotic drugs should receive a clinical review from their doctor to ensure that their care is compliant with the current best practice guidelines and the alternatives to medication have been considered by the 31 March 2012. Suffolk Mental Health Partnership NHS Trust

Medication risks in the elderly Polypharmacy with dementia Polypharmacy means ‘many drugs’ and refers to problems that can occur when a patient is taking more medications than are actually needed. Suffolk Mental Health Partnership NHS Trust

GAIN • G getting to grips with the environment • A awareness of altered perception • I improved medication management • N necessary equipment and training

Toolkit Suffolk Mental Health Partnership NHS Trust

Questions and feedback Suffolk Mental Health Partnership NHS Trust

Dementia falls presentation For more information contact: Abby Whiting Dementia Falls Nurse for Suffolk abby.whiting@smhp.nhs.uk

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