Design For Dementia

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Design For Dementia Powered By Docstoc

Jason Burton
Alzheimer’s Australia WA
Research and Consultancy Department
Relationship Based Care
      “Changing Worlds”
Where Have We Come From?
The Medical Model – A Double
       Edged Sword
              Institutional Care
What makes an institution?

• Physical

• Social

Reference: Wolfensburger
    Moving to a Relationship Based
            Model of Care
• Culture change
• Organisational change
• Acceptance of risk
• Supportive Environment
• Leadership
          Understanding the Risks

•   Emotional
•   Organisational
•   Liability
•   Professional
       Challenging the Paradigms

“We have always done it this way”………..
Paradigm1 Focus
Doing v’s Being
Gladys Wilson and Naomi Feil
   (available on YouTube)
Paradigm2 Outcome
Task v Experience
      Paradigm3 Behaviour
BPSD v Communication of Unmet Need
    Paradigm4 Activity
Entertainment v Meaning and
“There’s only so much ‘roll out the barrel’ you can take! ....”
Paradigm5 Companionship
   Role v Relationship
          Models to take us forward
•   All share key concepts and beliefs
•   Growing evidence base for their effectiveness
•   Challenge the social and physical environments
•   Focus on culture change
 Wellbeing, illbeing and Personhood
• Still misunderstood and misinterpreted
• Do we see it?
• Do we create our environments to grow and nurture or
  wither and degenerate?
Mildred’s Move Into A Greenhouse
            Person Centred Care

Developed by Tom Kitwood 1980’s
• Uniqueness of individuals
• Dementia as a social experience
• Importance of personhood
• Rejects “stage” theories of dementia
• Challenges “Behaviour” as a consequence of brain
  damage only
                        Eden Alternative
Developed by Dr Bill Thomas early 1990’s
• Focuses on loneliness, helplessness and boredom
• Culture change model
• Promotes the creation of human habitats in care
• Promotes wise leadership and shifting of decision
• Challenges the medical model
                            Spark of Life

Developed by Jayne Verity
• Focuses on re engagement
• Provides a framework change
• Brings fun back into people’s lives
• Challenges medical model thinking
                 Best Friends Approach

Developed by Virginia Bell& David Troxel
• Breaks down the role of professional v sick person
• Focuses on friendship and understanding
• Requires understanding of the individual and life story
• Matches staff/volunteers/families and elders based on
  commonality or connection
• Relationship based care is paramount in our work with
  people with dementia
• Requires culture change and challenging of existing
  care paradigms
• Needs to be “whole of environment”
• Number of models that can be used to start the journey

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