Nottingham University Hospitals NHS Trust and Nottinghamshire Healthcare NHS Trust
Nottingham University Hospitals NHS Trust in collaboration with Nottinghamshire Healthcare NHS Trust, has developed a Medical and Mental Health Unit (MMHU) as a demonstration model of best practice to improve the care of older people in hospital with dementia or delirium.
Additional mental health trained staff have been recruited to the ward and an intensive staff education programme has been implemented. The ward environment has been adapted to meet the specific needs of the patients (signposting, orientation boards, de-cluttering and reducing noise levels).
We are proud of being able to help reduce a patient’s distress behaviour (eg agitation, pacing, exit-seeking, combativeness, withdrawal or repetitive vocalizations). This has been achieved by introducing a non-confrontational and ‘person-centred care’ approach, which focuses upon understanding the feelings and experiences of the person with dementia.
We have developed an ‘About me’ document which is completed by the patient’s carer at admission, and records the patient’s biography, likes, dislikes, interests and how they respond to stress and what helps them. These changes allow us to understand patients better and care for them in a patient-centred way.
We have developed new skills to care for patients with dementia and delirium and have formed an effective and mutually supportive multidisciplinary team that offers holistic care and comprehensive geriatric assessment. The team meets regularly to make decisions about patient care and has adopted a proactive approach to communicating with patient’s carers.
We aim to maintain patients’ independent functioning, autonomy and skills. Patients have an assessment at admission for the level of activity they can participate in. This activity is incorporated into routine nursing care or through the individualised planned activities such as games, painting and singing to decrease boredom, provide social interactions and maintain current levels of function.
Contact:Sarah Goldberg, B98, Division of Rehabilitation and Ageing on 0115 8230238 or sarah.goldberg@nottingham.ac.uk
