By Debbie Jones, Manager of Hospice in your Care Home
Around 70 per cent of residents in care homes have some form of dementia.
Therefore, one of the key areas my team focuses on in our training, is how to support people who are at the end stages of life and who have dementia.
We are currently working with over 60 care settings across Wigan Borough by providing training, advice and education on all aspects of caring for people who are coming to the end of their lives.
Although a person with dementia may not be able to make some of the bigger complex decisions – such as around their personal finances – they may still have the capacity to tell us about their wishes for their future care or simple wants and needs. It is important that we do everything we can to involve the person with these types of conversations, and speak to the people important to them too.
Individual preferences
We have to recognise that, as much as possible, care at the end of life must be person centred, tailored to an individual’s preferences and wishes.
A few years ago, the ‘Rules of Thumb’ guidance was developed to assist in problem solving at the end of life for people with dementia, and is considered an effective tool to promote good practice around decision-making. It is a guide which can help the staff who are caring for the person. The Rules of Thumb guides care staff through different scenarios and helps them to work through an assessment of the person, taking their holistic needs into consideration.
For example, it helps staff to examine whether or not causes of deterioration can be reversed; how to assess pain if someone is unable to speak, and how to address eating and drinking difficulties.
Dignity
By using the Rules of Thumb guidance, comfort measures can be explored, and it can reduce unnecessary invasive traumatic procedures, ultimately promoting dignified end of life care.
We have always offered education in dementia care but were made aware of this guidance earlier this year so since then have embedded it into our training. We advocate that staff in care settings use this guidance as part of their everyday practice with patients/residents.
We offer training routinely on this guidance alongside our standard 12-week training programme. The next session on Introducing the Rules of Thumb will be on September 29th, 2021. A session on Dementia at End of Life is also available on September 30th, 2021. The training is open to any health and social care professionals working in Wigan Borough including GPs, district nurses and staff working in care. It is offered free of charge.
Please email: hiych@wlh.org.uk to enquire about accessing this training.