Are you embarking on a similar initiative in your facility? Here are resources that CLeAR teams used and continue to use in their work. Feel free to customize them for your own use – but please acknowledge CLeAR as the source.
CLeAR Driver Diagram
This document provides suggested strategies and changes to reduce antipsychotic medications in residential care. Here’s a video that explains how driver diagrams are used in improvement work.
Culture Change Toolbox
Culture is the way we work together. Improving culture can be a concerted effort, or it can mean taking a different perspective on current change efforts. But the bottom line is that better culture means better outcomes for our residents and fewer adverse events.
Collectively changing how we work together usually involves a few steps: awareness and engagement, assessment of current culture, discussions about what changes can be made, and making small changes over time. This guide contains tools that can be used as the focal point for a shift in culture – and it is designed specifically for use in residential care facilities.
Additional Resources of Interest (Themed)
Improving Infrastructure in care homes
Swindon’s Great Western Hospital Gets Dementia Friendly Ward: Discreet adaptations, such as clocks that help patients distinguish between night and day and a matte finish floor to reduce falls, have been made. More Informational Here
Understanding Dementia and Managing Symptoms of Dementia
Maximizing Success when communicating with someone with Dementia: We communicate verbally, non-verbally and through written words. In order for communication to occur, the message that is transmitted must be interpreted and understood. Unfortunately, when an individual has been diagnosed with a type of dementia, the communication process is affected. This often leads to misunderstandings and frustration from both the individual with dementia and the caregiver. This webinar detailed some very important strategies to keep in mind in order to effectively communicate with an individual diagnosed with dementia.
Living with Dementia: This brutally honest film reminds us that although dementia causes the loss of some abilities, people’s feelings remain intact. Four people with dementia talk about their emotions: fear, guilt, embarrassment, isolation, powerlessness. The film also shows the difference a supportive, empathetic relationship can make.
Best Practice Guideline for Accommodating and Managing Behavioural and Psychological Symptoms of Dementia in Residential Care: This guideline was developed in response to “A Review of the use of Antipsychotic Drugs in British Columbia’s Residential Care Facilities” conducted by BC’s Ministry of Health in 2011.
World Alzheimer Reports: These annual reports examine global trends related to older people who need dementia care, including those with Alzheimer’s disease.
Shifting Focus- A Guide to Understanding Dementia Behaviour: This booklet is meant to help family members, friends and co-residents of those who live at home or in a long-term care home and are behaving in unpredictable ways that create unease or distress. It helps care partners and fellow residents to learn about the brain and how dementia affects it; recognize your family member’s actions and their meaning; offer ways to respond; and increase patience and acceptance for those living with a dementia.
Guidelines for the Recognition, Diagnosis and Management of Cognitive Impairment: This guideline provides recommendations for adults ≥ 19 years within the primary care setting. It focuses on Alzheimer’s disease, the most common form of dementia seen in primary care. The guideline encourages early recognition and assessment of dementia and supports the development of a care plan that includes the identification of community resources for patients and caregivers.
Putting the PIECES Together in the Health Care Maze: A story illustrating the benefits of the PIECES (Physical, Intellectual, Emotional, Capabilities, Environment, Social) framework, a tool created in Canada for those who work with older adults who have complex health issues.
All About Me: A Booklet About a Person Living with Alzheimer’s Disease or Other Dementia: All About Me is a resource for people with dementia to tell health care providers about themselves – their needs, likes, dislikes and interests – so that the providers can build relationships with them and support personalized care.
Free Online Course! Dementia – Understanding and Managing Challenging Behaviour: If you are someone looking after a family member with dementia in your own home or a professional working with people with dementia, this free online course will help you better understand the person and develop the skills needed to manage their challenging behaviour.
Medication Reconciliation and Reducing Antipsychotics
You Decide Sheet for Antipyschotics in Treatment of BPSD in Elderly: Shared Care’s Polypharmacy Risk Reduction Initiative created this evidence-based summary which has been reviewed by an expert clinical advisory group to inform medication reviews and decision making
Best Practices Guide for Safely Reducing Anti-Psychotic Drug Use in Residential Care: The BC Care Providers Association (BCCPA) has developed this Best Practices Guide to help long-term care providers reduce the use of anti-psychotic drugs in their residential care homes.
Reducing the Use of Antipsychotic Drugs: A guide (pdf) to the treatment and care of behavioural and psychological symptoms of dementia.
Appropriate Use of Antipsychotics Toolkit for Care Teams: The Alberta Guideline on the Appropriate Use of Antipsychotic Medications (2013) and accompanying resources provide health care professionals with direction regarding assessment and management of responsive behaviours associated with dementia.
“It’s Your Medicine, What Shall We Do With It?” The Health Foundation published a short video about a medication review project in the UK that “brings together care home residents, their families and health professionals to ensure residents are getting the right mix of medications.” Among the project’s achievements is reducing the amount of medicine prescribed to residents by 17%.
Improving Quality of Life of Residents
How the NHS has Addressed Dignity in Residential Care – Pecha Kucha-Style: On March 6, 2012, Helen Bevan, chief of service transformation at the NHS Institute for Innovation and Improvement, spoke at Health Talks. She used a Pecha Kucha presentation to describe how the National Health Service has addressed dignity in residential care. Watch it here.