Post on 20-Jul-2020
Birmingham Dementia Services Scrutiny Inquiry
23rd July 2014
Angela Bradford
Shirley Hall
Michael Spellman
The Enriched Opportunities Programme®
The Enriched Opportunities Programme® (EOP) was developed
by The ExtraCare Charitable Trust to support residents experiencing dementia to live independent, healthy, and active lifestyles.
The service began as a research project with the University of Bradford which involved:
• A 2 year cluster randomised controlled trial of a new approach to living with dementia and other mental health issues in ExtraCare
• Development of a specialist staff role the “Locksmith” who unpicks impairments and unlocks a persons potential.
+ =
EOP Research Outcomes
Residents supported by a Locksmith were…
• 50% less likely to move out of ExtraCare into a care home
• Spending less time in hospital as an in-patient
• More likely to have their mental health condition diagnosed
• Had improved access to Health services
Residents also…
• Rated their quality of life more positively
• Experienced decreased symptoms of depression
• Experienced greater feelings of social support and inclusion
(As detailed in the 2009 Bradford dementia group report, available on the ExtraCare website)
The Enriched Model of Dementia Care
The programme is based on Tom Kitwood’s Enriched Model of Dementia Care. Developed from person centred psychotherapy it is a caring and effective way to establish a person’s unique experience of their condition.
D = NI + H + B + P + SP• Neurological impairment
• Health
• Biography
• Personality
• Social Psychology
Helps to understand and ‘connect the dots’ in a maze of misunderstanding.
Its holistic, and reduces the ‘failure to listen’ which can lead to a person being labelled as ‘challenging’.
EOP in practice
It’s the difference between seeing
A Person with Dementiaor
APerson with Dementia
‘The Uncle’
‘The Sports
Person’
‘The
Gardener’
‘The Baker’
‘The
Brother’
‘The
Student’
‘The Film
Lover’
EOP in practice
The EOP achieves this through five major elements working together:
Specialist Expertise• The right Locksmith – found through unique recruitment
• A senior role, influencing and teaching everyone to think ‘person centred’
• Skilled empathic communicators that create therapeutic relationships
Individual Assessment and case work• One to one ‘quality time’ with residents, understanding their individual
experience of dementia or other mental health condition
• Development of an ‘Enriched Profile’ & ‘Resident Story’
• Use knowledge to improve the way we care and support
EOP in practice
Activity and Occupation• Understanding a person leads to activity that is meaningful
• Create opportunities to learn new skills and retain abilities
Staff Training• Specific Locksmith Training through the University of Worcester
• Locksmith CPD – creating a Locksmith Curriculum
• All staff training – mental health awareness and understanding of the EOP
Management and Leadership• Requires Scheme / Village Managers full participation
• Organisational support, EOP Services Coordinator
• Requires an enabling Policy, with commitment to quality and improvement
The Enriched Opportunities Programme® today…
• Over 900 residents in ExtraCare live with a mental health
condition
• Over 390 experience dementia
• 66% have been supported by their Locksmith to receive a
dementia diagnosis.
• The average hospital stay for a resident receiving Locksmith
support is 11 days
The Enriched Opportunities Programme® is a big part of achieving our vision to create
Birmingham
Birmingham
The EOP currently supports 157 residents in
Birmingham
• 29% have a diagnosis of dementia
• 42% have a diagnosis of depression
• 29% receive Locksmith support for other EOP
needs e.g. Risk of social isolation or other
mental health condition.
Birmingham – next steps
• Dementia friendly communities
• Intergenerational work - schools
• Memory assessment clinic – Pannel Croft
• Working with other organisations
• Prevention (well-being), early identification – the
EOP model
• Helping to keep residents at home
• Partnership working
Outweigh the challenge
The Dementia
Challenge:• 800,000 people with
dementia in the UK
• £23 billion cost per year
to the NHS
• Many people feel they
are not living well with
dementia
• Many people feel a loss
of choice and control
Alzheimer's Society
Dementia 2012 Report
Hopeful and
Positive:
• Better care &
approaches
• Better lives
• Supporting
health services
More!
Contributing factors to the ‘experience of dementia’
Dementia
Drugs &
AlcoholDepression
Learning
disabilities
Physical
Health
Other MH
conditions
Each of these can
affect the
experience of
dementia
Unpicking issues and Unlocking potential
“Why?” is normally the
starting point…
The role of the Locksmith
is to use their knowledge
to unpick the mystery, and
provide an answer.
Understand a person’s
weaknesses but focus on
their strengths to achieve
living well with dementia
Living well with dementia for longer
Development of
Dementia
End of life
EOP and external
service intervention
Higher independence
Reduced reliance on care
Good quality of life
Risks to independence
Increased care needs
Risks to quality of life