Debra Carberry, nurse specialist for older people at Warrington and Halton NHS Foundation Trust, has seen how imaginative changes in the hospital environment have helped improved dementia care by cheering, calming and consoling patients with dementia.
Here she describes how a ward at Warrington Hospital has been refurbished following a successful bid from the King's Fund...
"Here at Warrington and Halton hospitals NHS foundation trust, a traditional acute medical ward was refurbished with dementia at the forefront of the design. This was made possible by a successful bid from the King’s Fund and the ward re-opened in May 2014.
The Forget Me Not ward is now fully established as our specialist dementia ward for acutely ill patients and it is useful for us to look back to our original aims and aspirations for the ward and reflect on the benefits to patients their families and the care staff.
We are proud to have achieved a care setting that, whilst still delivering the care expected of an acute hospital ward, provides a less clinical, more homely, more welcoming, altogether warmer environment. It is clutter-free, bright, calming and relaxing and promotes social interaction, independence and mobility for our patients.
Improved dementia-friendly environment
The lighting is controlled to mimic daylight hours, and this assists in bedtime and morning orientation. We have also introduced colour-changing lights in the single bed rooms and quiet room, which makes the environment feel tranquil. The bays and bedrooms are now painted in different colours and this helps patients find their way back to their beds from the lounge, dining area or garden.
We have also enlarged our signage, using black text and images on a white background to suit the partially sighted. Signs can a subtle hint to patients who may have forgotten the reason why they have got out of bed or left their room and this promotes independence and reduces distress. The non-slip, wood-effect vinyl flooring gives a matte finish to diminish the perception of wet floors, and lowers the risk of slips and falls. It also creates a more homely environment.
Homely atmosphere promotes social interaction
We have introduced a lounge/dining and social area separate from the bed area to encourage social interaction. The activities coordinator has proved very successful in promoting enjoyable recreation, making sure they take patients’ previous interests into account. Family members are actively encouraged to take part. This social area feels like a domestic space, a home within the hospital, and it has clearly helped to improve eating patterns and social behaviours.
Research carried out since the Forget Me Not ward opened shows that the environment and clinical care approach has significantly reduced distress and agitation for acutely ill patients and subsequently for family members.
But our work to improve dementia care has not just stopped at our dedicated ward: we have introduced a number of trust-wide initiatives to improve the experience of those with memory problems and their families and reduce the distress associated with admission to hospital. One initiative is the Carers’ Card used throughout the hospital to facilitate flexible visiting for family members and carers. This complements the “This is me” document used for all people with dementia admitted to the hospital and attending our pre operation assessment clinics. Dementia specific care plans have also been developed to facilitate “reasonable adjustments” to the care approach.
Improved dementia outcomes
The feedback from carer-organisations as well as patients and their families has been excellent, with comments from families such as: “The staff on this unit are brilliant and treat every patient in their care with the respect and dignity that they deserve.” “The ward is very good; they are getting to know my mum’s little ways. I think she will get what she needs on the FMN ward.”