Life in Residential Aged Care (RAC) is often associated with living in an institution, and for those with dementia it is even more restricted. While Person Centred Care (PCC) has tried to address some of the issues, residents are still expected to work around our task based routines, from morning showers, to set meal times, activities and bed time to name a few. Yet, we as individuals all shower at different times, eat when we want, and go to bed when we choose! Thus, how can a model of care deliver individualised choice, dignity and wellbeing in a dementia setting?
While the physical environment within a dementia setting is typically designed to ensure resident security, creating a neighbourhood setting can provide a familiar environment. Minimal clutter and noise are encouraged as are large, open, yet secure areas to allow resident movement.
For the model of care, residents should be allowed to rise, shower, eat and sleep when they choose to. Specific staff assigned to certain neighbourhoods to create familiarity further supports the physical and social environment. Meanwhile, engaging and meaningful activities should be established that suit the individual versus traditional activities.
Guidelines for staff and shifting culture works best as an inter-disciplinary team and staff slowing down to the residents’ pace. Staff should be engaged in particular during sundowning, and allowing residents to go to bed when they want.
Designing and conducting specialised training for staff needs to move from a task based system of “to-do” lists, to a greater focus on service and residents’ involvement in decision making. There should be an inter-disciplinary focus from catering, to allied health professionals, nursing, laundry, and cleaners.
To support more Person Centred Care, residents’ days shouldn’t revolve around tasks and to-do lists. Instead, various Allied Health activities such as Physio, Occupational Therapy and leisure therapies should be individualised and offered at a range of times throughout the 24 hour day. To enable this, care staff should be trained and empowered to engage with residents in meaningful activities after-hours.
Achieving good dementia care will ultimately ensure improved quality of life provided such residents are not institutionalised. It relies on a shift in thinking, staff education, a neighbourhood model and a cohesive inter-disciplinary team.
Criterion’s series of Aged Care conferences cover topics including Choice & Control, Dementia, Retirement Living, Residential Aged Care and more. View upcoming events here.