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Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant [email protected] May 2007

Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant [email protected]

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Page 1: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Towards person-centred descriptions of dementia

for person-centred services

Geoff Jones

Dementia Consultant

[email protected]

May 2007

Page 2: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Contradiction

• Person-centred services:

D = NI + H + B + P + SP

• Descriptions:

D = NI

Page 3: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

1.1.1.1.

PCA is widely accepted as the service

delivery model of choice with people

living with dementia in Australia.

Page 4: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

2.2.2.2.

PCA is based on

the Kitwood enhanced model -

not the bio-medical model.

Page 5: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

KItwoodKItwoodKItwoodKItwood enriched modelenriched modelenriched modelenriched model

D = NI + H + B + P + SP

Health

Neurological

impairment

Biography

Personality

Social

psychology

Page 6: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

3.3.3.3.

Current descriptions of dementia are

based on the bio-medical model

• For people with dementia

• For family carers

Page 7: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

DementiaDementiaDementiaDementia

Changesin brain

Dementia= symptoms

CognitionMood

Behaviour

Group of illnesses

Page 8: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

3.3.3.3.

Current descriptions of dementia are

based on the bio-medical model

• For staff

Page 9: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

DementiaDementiaDementiaDementia

Changesin brain

Dementia= symptoms

CognitionMood

Behaviour

Group of illnesses

Page 10: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Changed behavioursChanged behavioursChanged behavioursChanged behaviours

Changesin brain

Environment

Health

Medication

Changed behaviours

Mood

Behaviour

Page 11: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

4.4.4.4.

PCA considers the bio-medical model as

a cause of poor dementia services

Page 12: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Knowledge:

• AD Pathology & clinical symptoms

• Health, biography, personality, &

social psychology

Page 13: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Elements of a person-centred description?

1. Loss of mental functioning

2. Experience of dementia

3. Bio-psychosocial for all changes

4. Positive personal attributes

5. Carers challenged – partnership best

6. Supports impact on quality of life

Page 14: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

A person-centred description would not suggest:

1. Solely brain based causation of symptoms

2. Global decline

3. Typical life expectancy

4. Solely negative future

5. Medical sub-types of dementias (in first paras)

Page 15: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Examples of text person-centred descriptions:

• NICE Guidelines UK 2006

• Silver Chain

Page 16: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Dementia Dementia Dementia Dementia –––– PCAPCAPCAPCA

Changes

in brain

Environment

Health

Medication

Personality

Biography

Relationships

Dementia = Symptoms

Cognition

Mood

Behaviour

Group of

illnesses

Page 17: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Person at the centre Person at the centre Person at the centre Person at the centre

Page 18: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Person at the centre Person at the centre Person at the centre Person at the centre

Strengths/resiliencePersonality

Health

Personal relationships

Life experience

Cognitive reserve

Faith

Satisfactions/Joys

Material resources

Social status

Wider social network

Page 19: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Person at the centre Person at the centre Person at the centre Person at the centre

Strengths/resiliencePersonality

Health

Personal relationships

Life experience

Cognitive reserve

Faith

Satisfactions/Joys

Material resources

Social status

Wider social network

Threats/lossesMemory/thinking

Future

Relationships

Emotions

Decision-making

Sexuality

Occupation

Living skills

Senses

Mobility/driving

Discrimination

Page 20: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Person at the centre Person at the centre Person at the centre Person at the centre

Strengths/resiliencePersonality

Health

Personal relationships

Life experience

Cognitive reserve

Faith

Satisfactions/Joys

Material resources

Social status

Wider social network

Supports and treatments: Information, advocacy, environmental mods,

transport, exercise, health care, social networks, counseling, ADLS

Threats/lossesMemory/thinking

Future

Relationships

Emotions

Decision-making

Sexuality

Occupation

Living skills

Senses

Mobility/driving

Discrimination

Enhance Neutralise

Page 21: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Next steps:

• Talk with colleagues and consumers

• Check the descriptions your agency uses & ask for review

• Check staff training - Cert III

• Give feedback to state & Commonwealth initiatives

Page 22: Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au

Towards person-centred descriptions of dementia

for person-centred services

Geoff Jones

Dementia Consultant

[email protected]

May 2007