071An Innovation to Delivering Person-centred Dementia Care in the Acute Hospital Setting: Dementia Companion Role

Abstract

Background: Demographic changes have contributed to increasing numbers of patients living with dementia admitted to acute hospitals, which have no infrastructures to meet their specific care needs. This leads to greater risk of patient falls and deterioration in functional/cognitive capacity. The patient/family experience can be frightening and stressful. Methods: Two Dementia Companions were appointed to care of the older peoples' wards. Following refinement, a further test spread of four Dementia Companions across five acute medical wards and the Emergency Department were introduced. A bespoke training programme was developed for the companions in line with tiers 1-2 of The Dementia Learning and Development Framework (Public Health Agency PHA 2016). Regular reflective learning sessions were held, facilitating peer support and an opportunity to inform practice. Quantitative measurements analysed were; falls rates and episodes of distressing/challenging behaviour. Qualitative data on patient/carer feedback, staff experiences and Dementia Companion reflections was collected in the form of semi-structured interviews, focus groups and the recording of personal journals. Results: Falls activity indicates a decrease of 71 falls (approximately 7% reduction in the total number for one year). A reduction of 40-90% episodes of distressing/challenging behaviour was observed. Themes emerging from qualitative data from patients, carers and staff were reassurance on patient safety, promoting adequate nutrition and hydration, a calm environment and releasing professionals' time to deliver effective acute clinical care. Significant information from the companions' reflective journals suggests that the companion role promotes and facilitates "personhood", fundamental to person-centred dementia care (Kitwood 1997). Conclusions: This innovation demonstrates improved outcomes for patients. Cost benefits to healthcare include: reduced patient falls and episodes of distressing/challenging behaviours. The evaluation validates this as a service delivery model which encompasses addressing the clinical need whilst contemporaneously preserving the identity and dignity of the patient and improving their acute care experience.