“By owning it and giving it a name ‘Aged Care Syndrome’ someone has to take responsibility for not changing since 1997”
So what is ‘Aged Care Syndrome?’
It all began upon the review of one man’s case where he had cognitive impairment, but no diagnosis of dementia.
Despite that, he exhibited a lot of behaviours and psychological symptoms of dementia – he would physically and verbally abuse people.
Colin McDonnell, the Dementia Excellence Practice Leader from Scalabrini village, wondered why this man had to communicate in such a way.
Upon further analysis, Colin saw that it was a lack of communication, in conjunction with people not listening to him, that was causing the man to act the way he was.
“I realised that since 1997, when Kitwood was talking about malignant social psychology, and we talk about the medical model, that it was time that we actually owned up and acknowledged that we are the people responsible for this sort of care.”
Professor Tom Kitwood was a pioneer in dementia research. According to Kitwood personhood is “a standing or status that is bestowed upon one human being, by others, in the context of relationship and social being….implying recognition, respect and trust”.
He essentially predicted the importance of person-centered care years before it facilities acknowledged the need to transform the model of care.
‘Aged Care Syndrome’, as Colin explains is an umbrella term he uses “the same way dementia is used as an umbrella term”, where in Aged Care Syndrome there are human needs that are unmet in aged care.”
He further elaborate that it ranges from unmet identity, unmet comfort, unmet care, stress and loneliness.
Loneliness is particularly dangerous, according to Colin “loneliness is 70 per cent times worse than obesity and smoking for mortality”.
If you haven’t got choice or autonomy, if it isn’t given by the aged care facility, then the person will continue to have stress.
Stress, though often thought of as a “mental” impairment, it can actually have some severe physical repercussions.
Too much stress can lead to a drop in the immune system, drop in memory, people can lose their ability to cope – and as Colin explains “as the care providers we are doing that by taking their choice and decision making”.
“Sundowning can be attributed to these unmet needs – and I say that because there is no control. You can imagine the stress you’re in when you’re in that position 24 hours a day”.
Change begins with the aged care staff, “with empathy and showing them what it’s like, as well as giving them the tools to feel”
This can be done with aids, such as wearables like goggles or even role playing tasks, that give staff some sense and idea of what it is like to live with dementia – essentially walking in their shoes.
Practice and repetition is key in developing new positive behaviours, which is what some staff wear small reminders on a card around their neck. Simple instructions, reminding them to smile and say hello, and knock before entering people’s rooms.
“These simple things are so important to people, to treat people like a person.”
“It’s really important that we acknowledge what we do and the environments we create for our people to live in.”
“It’s not working harder, it’s working smarter and thinking about how can you give choice and decision making in every little thing you do each day.”
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