Dementia BBC TV & Radio

This evening on TV BBC Two 2100 hours UT:

Can Gerry Robinson Fix Dementia Care Homes?

Businessman Sir Gerry Robinson returns in a new series in which he tries to turn around three struggling care homes.

In the next twenty years over a million Britons will have dementia, and sufferers are likely to end up in one of the country's privately run care homes. It's a huge business worth six billion pounds, largely paid for by taxation, yet a great deal of the care is woefully inadequate. Can Gerry, whose father had the disease when he died, change a culture of stagnant lounges, a lack of specialist training among staff, and a focus on keeping people alive rather than helping them to live a happy life?

It is very difficult to keep up with the various 'World Days' there are so many. The BBC's Archers has also dealt with dementia through the character Jack Woolley and the impact of the illness not just on the fictional families concerned, but the small fictional village community. The writers have done an admirable job in raising awareness about dementia.

Now over three years later, the past week has brought us to Peggy's final realisation of the extent of Jack's care needs with his arrival at a care home.

This care transition has provided an opportunity for wider debate and discussion:

Additional links:

Active Minds

memo FROM: Classroom health TO: Global health - PSHE education and model standards

Health care and educational professionals learn and adopt the key tools of the trade whilst training. Although for several decades experiential learning has also gained recognition and weight, it is the learning of theory and relation to practice in basic training that shapes the future career. We can describe this as formative professional education. We then trust that this learning and the tools in use are updated according to research, evidence and best practice. There is much navel gazing at present as to how to measure, nurture, instill and strengthen the character trait of compassion. This applies not only to children, but within nursing.

This issue highlights of course what students bring with them to the lecture theatre, clinical arena and what they take from there to carry them through their professional career. My ideal would be that students have already learned and used Hodges' model as 14-16 year old's, as they negotiate their personal, social, health and economic (PSHE) education.

While Hodges' model is a world away from a de jure standard
- that is, defined and enforced by the ISO -
it might just :) become a de facto standard,
because of its widespread adoption in and beyond the classroom.

There is a great opportunity here for Hodges' model in the UK as PSHE education becomes compulsory in 2011. Perhaps you can help in or beyond the UK?

Reference:
Mooney, H. (2009). Can you measure compassion?, Nursing Times, 21 April 2009.

Blog post inspired by adamatronics groups.drupal.org Drupal in Education: Joint effort on a D6 SCORM API

tags: 'preventive medicine' + 'preventive medical sociology'?

KT-EQUAL workshop: Who is the (research) User?

Dear Colleagues

Just a reminder that the next KT-EQUAL workshop will be on the subject of "Who is the User"

This will be held on 26th January at Loughborough University. As with all KT-EQUAL events there is no charge for attendance.

The workshop will be of interest to a wide range of professionals and policy makers, health and social care practitioners, employers, charitable and government bodies concerned with the needs of older and disabled people, all those involved in the provision of services and, of course, researchers and academics from engineering, biological, social science, medical and health care disciplines. Older people, who have the biggest stake in ageing research, are especially welcome.

To register please go to ... and follow the links.

Specific enquiries should be made to:

Heather Williams
Project Officer (KT-EQUAL)
School for Health, University of Bath

Kind regards
Peter Lansley

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Professor Peter Lansley, BSc, MSc, PhD, MCIOB, FCOT
Director, KT-EQUAL – Knowledge Transfer for Extending Quality Life
School of Construction Management and Engineering, URS Building,
University of Reading, Whiteknights, PO Box 219, Reading, RG6 6AW, UK

NIGH message for GANM network - We Need Your Help with the UN General Assembly

Please assist if you can....

Dear GANM Colleagues,

The Nightingale Initiative for Global Health (NIGH) (www.nightingaledeclaration.net) team invites you to join with us to ask the 2009 UN General Assembly to consider the UN Resolution proposal (see below) as they will be voting until the end of December 2009.
Currently the NIGH team is working in and around the United Nations in New York City — to propose a UN Resolution (below) recognizing the work of global nursing.

Please write to your country's UN Ambassador in New York City.

To find your country's UN Ambassador:

1.) ...

2.) to find the mailing address and a link to your country's web page (where you can find their email address) for your country's representative - go to:
https://www.un.org/en/sections/resources-different-audiences/delegates/

Address the following message to your UN Ambassador. Finding the email address may take a little more effort, but it is quicker. We hope you will take the extra effort to let your representative know how important this issue is.

If you want to add a personal note to this example message please feel free:

≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈
re: Resolution to Acknowledge Campaign for 2010 to Support UN MDGs

(Enter the name of your UN Ambassador and country)

Permanent Mission to the United Nations

EXCELLENCY,

We ask you please to consider, now, initiating or supporting a Resolution for this 2009 General Assembly:

1/. The General Assembly, in recognition of the devotion and dedication of the world’s nurses and midwives and their care and concern for the health and well-being of the “peoples of the United Nations,” hereby acknowledges, with gratitude, their celebration of the “2010 International Year of the Nurse,” the Centennial of Florence Nightingale, through their campaign to raise global public awareness and support for the eight Millennium Development Goals (MDGs).

2/. The Assembly recognizes, in particular, their vital contribution to reducing child mortality and improving maternal health — as specified in MDGs 4 and 5 — and expresses appreciation for their overall commitment to the achievement of these United Nations’ objectives.

Sincerely yours,

Phalakshi Manjrekar, MScN, RN, India
Barbara Dossey, PhD, RN, AHN-BC, FAAN, USA
Dionne Sinclair, MSN, RN, Jamaica
Cynda H. Rushton, PhD, RN, FAAN, USA
Deva-Marie Beck, PhD, RN, Canada

Co-Directors, Nightingale Initiative for Global Health (NIGH) on behalf of 20,000 nurses from 110 nations who have signed the ”Nightingale Declaration for a Healthy World.” See: http://www.NightingaleDeclaration.net

≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈≈ end of message~~~~~~~~~

”Global Public Health“ has been a key focus of the United Nations, until December 31, 2009, and then the UN focus moves to “Gender Equality” for 2010. We believe that it is, therefore, urgent that we get this Resolution into the UN General Assembly agenda for adoption before the end of 2009.

We have contacted Ambassadors from all 192 Member States, asking them to support this proposal. As well, we have sent them the attached press release, which we will also be forwarding on to all 200+ media representatives and media agencies accredited at the UN.

The NIGH team thank you for your consideration of our request. Please circulate this request to other colleagues.

Additional links: 2010 International Year of the Nurse (IYNurse)

GANM (Global Alliance for Nursing and Midwifery)
 

Sheltered housing, care domains, ADLs, telecare and wardens

Shelter is a basic human need, one rendered acute when people are forced to flee their homeland. On a rather different level in the UK there is currently quite a debate about sheltered housing and the withdrawal of live-in wardens. This 'debate' has even progressed to judicial review.

I've visited many clients when the warden has appeared at the window or door to check that things are aok? Such has been the time keeping and client's faith in their clock that on occasion it could have been Kant walking by. It is often helpful to invest some time and get to know the warden, too see what they know not just about 'care of older adults', but about their residents many of whom become friends. We need to remember what a difference an individual can make in these situations. The clue is in the title 'sheltered housing' which in Hodges' model spans the interpersonal and sociology care domains. I've illustrated this below:

Suddenly, the advent of telecare, video and mobile comms and resulting benefits raise the possibility of service 'duplication' at a time when cost savings are sought in social care. Alternately, we might ask if some overlaps in service provision are good insurance? For the people in sheltered housing and their relatives what did sheltered mean to them when they first viewed the facility, what does it mean now? As is the case with day care centre managers, the more dynamic wardens really do make a difference to these communities of individuals. As Peter Sellers showed us sometimes for a gardener - or a warden - just Being There is reassurance enough.

Hodges' model can be used as a reflective device for this real-world bricks and mortar example of a clash between the humanistic and mechanistic care domains.

Additional link: International Human Rights Day 2009

Original dwelling image from: http://www.cherokeemedicineman.com/dwelling.html

Film image source IMDb

comment: Activities of Daily Living ADLs and Hodges' model [1]

Guy Dewsbury got in touch through LinkedIn in response to the ADL post [1]:

On 12/01/09 6:49 AM, Guy Dewsbury wrote:
--------------------
Hi Peter
Really like your post on ADLs, but it seems that ADLs whenever they are used omit the need of the person in preference to the risk associated with them. I am sure you would agree, that is why I tend to pay a passing nod to ADLs but instead concentrate on what the person actually wants and aspires to and see how this can be achieved.

I wonder what your take on this is. I would have thought that aspiration and need are critical in mental health as well, in fact I would posit that by concentrating on ADLs it is easier to omit looking beyond them to the real needs of the person.
Over to you..
Guy

On 12/01/09, Peter Jones wrote:
--------------------
Hi Guy
Thanks for your comments and feedback. I quite agree - in a way that's what the blog post is saying. If you look at the basic ADLs they are 'placed' or associated with the sciences - processes - physical tasks. That's why I highlighted some of the psychological aspects in the intra-interpersonal domain.

For example, in future posts I may add the way that there are a lot of people with quite chronic respiratory problems, but they carry on as their behaviour has modified such that they know they can no longer run for the bus. Although an assessment of respiration may reveal their (medical) problem their needs are elsewhere.

Perhaps - if you don't mind - I could post your reply and my note above on the blog as a follow-up - since the comments are disabled.

Cheers Guy appreciate your getting in touch.
Peter J.

--------------------
Guy Dewsbury has sent you a message.
Date: 12/02/2009
Hi Peter
Happy for you to post anything you want.
Great reply too
Guy

Image source: Running for the bus - Jess and James

h2cm - Being at the center of things [I]

The center of Hodges' model can represent many things:

an epistemological nexus for the transdisciplinary dependencies of our times
multidisciplinary coffee shop
self-care engagement stage
the chaos of all things
holistic harmony
integrated idyll*

More down to Earth and acknowledging this cruciform '+' structure as a mythic device, in addition to searching for the mysteries of the universe at the center we can also place the 'well' person there.

As the previous post on ADLs suggests the 'well' person can function on a basic level and has negotiated the four axes and the four and five fold knowledge domains. They can therefore be considered (sufficiently) wholly integrated. We are all travellers, constantly traversing these domains of experience consciously, unconsciously, expertly or with the awkwardness that denotes the novice.

Conversely and reflecting the model's utility: it is also possible to locate the unwell individual in the center too. In this instance the placement suggests impoverishment of experience, ongoing personal and social stasis and in the case of substance misuse the presence of specific disruptive focus and preoccupations. The person becomes lost to their potential, stuck in a 4:5-fold minima. They continue to travel chronologically, but the journey is spiral, self-iterative and diminishing by return.

However: what you can see you can change, or come to terms with.

*from Greek eidyllion, little picture (h2cm as a snapshot).

Original image source: http://www1.lsbu.ac.uk/water/protein2.html

Activities of Daily Living ADLs and Hodges' model [1]

The Hodges' model matrix below lists some basic Activities of Daily Living. The intention is to read the table as per the numbers. In 1. - the sciences domain - is a list of basic ADLs, this represents my classification of 'where' these ADLs live within Hodges' model. This is followed by a qualification in the intra-interpersonal domain 2.:

2. While basic ADLs are typically designated as 'functional', that is related to physical abilities they are of course also very dependent upon mental health status. Including: mood, motivation, memory, orientation, confusion. Many ADLs are closely associated with disease and illness, which affects people's independence.	1. personal hygiene dressing - undressing eating and drinking toilet: (urinary and faecal) elimination (often taken for granted) transfers: e.g. bed to chair and back degree of mobility (sitting - standing balance)
4. We can appreciate the impact of the carer's burden by arriving here finally. The sciences, interpersonal and political domains weigh heaviest here, as the carer assumes responsbility for the care of another, themselves and often other dependents.	3. Assessment of ADLs covers aspects of safety and risk to SELF, OTHERS and risk of SELF-NEGLECT. Increasingly, however the emphasis is on self-care, independent living and strengths in the above ADL skills.

In further blog posts I will present a similar treatment of other ADLs with references.

Link:
"Activities of Daily Living Evaluation." Encyclopedia of Nursing & Allied Health. Ed. Kristine Krapp. Gale Cengage, 2002. eNotes.com. 2006. 30 Nov, 2009 http://www.enotes.com/nursing-encyclopedia/activities-daily-living-evaluation