Victoria Jacques - Villa Maria - Transitional Care: An Emotional Journey from Home to Care
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Transcript of Victoria Jacques - Villa Maria - Transitional Care: An Emotional Journey from Home to Care
Moving into aged care- not a cause for celebration?
Victoria Jacques General Manager Residential Services
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Decision has been made
• No happy campers • Visit to the site • Measure up the room • Does the furniture fit? • The reality • I am old!
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Admission
• Warn families that it can take up to 2-3 hrs for admission • Guilt is heightened during admission- reality sinks in • Resident fuels the situation • Blames the child if they have forgotton something • Not unusual to see mocking of the child
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Transition Experience
• First 6 weeks normally traumatizing for new residents and families
• Guilt, Grief, loss • Packing up memories • Deciding what to keep and what to take • Financial considerations- sell the home • Bond or daily accommodation fees- New fee structure in
July 2014 • Taking my mother away from her own home ‘and her cats’
was the most trauma7c and saddest event I have ever had to cope with in my en7re life (adult child)
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Having Friendship is important
Villa Maria/Swinburne Program
• New facility in Wantirna admitted over 220 residents in a period of 12 months
• Experience of staff – feedback that they felt overwhelmed by the emotional needs of residents and families
• Centre Manager developed family groups where debriefing took place –sharing of guilt and grief
• Individual counselling for residents specifically referred for depression and complex needs
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Villa Maria/Swinburne Program
• Swinburne/Villa Maria program • Identify Residents with depression and dementia • Encouraged staff to look at complex residents and family
issues • Offer One on one counselling • Quality of life indicators measured • Cornell scale for depression • Nursing staff referred to the social worker and then screened
for suitability to the program
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Villa Maria/Swinburne Program
• Residents did not oJen miss their appointments • A chance to talk to someone for an hour • Gave staff an alternaOve to drugs/lifestyle DATA Number of counselling appointments made= 64 Number of counselling appointment kept=61 Number of counselling appointments per resident (on average)=8.7 1 Amount of counselling Ome provided (in total)=3660 Amount of counselling Ome provided per appointment= 60 mins
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Villa Maria/Swinburne Program
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Resident Baseline Post-treatment
VM 3 2 MM 16 9 RC 18 8 Average 12.33 6.3
Preliminary evaluation of benefits to clients, as perceived by staff and by the client
Cornell scale for depression
Alexopoulos, G. S., Abrams, R. C., Young, R. C., & Shamoian, C. A. (1988). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23(3), 271-284. doi: 10.1016/0006-3223(88)90038-8
These results show that depression severity reduced by half by the end of counselling, compared to the start.
Counselling Feedback
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Enabled me to accept my situaOon to be able to talk through my situaOon I’m in” “To have a conversaOon with an independent person knowing it was confidenOal”
•The Quality of Life Scale – Alzheimer’s Disease (QOL-‐AD) Logsdon, R. G., Gibbons, L. E., McCurry, S. M., & Teri, L. (2002). Assessing Quality of Life in Older Adults With CogniOve Impairment. PsychosomaOc Medicine, 64(3), 510-‐519. • 66% of residents had an improvement in quality of life indicators
Dementia and Carers -what helps?
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Acknowledge the emotional impact of the transition into Aged Care on the carer and the person with dementia by using a person-centred approach to care.
• Provide education about dementia to carers of residents with dementia as well as all staff working in the facility.
• Instigate consumer groups within each facility to hear the voice of the carers and/or support carers to join dementia carer support groups in the community.
•
I don’t think it could have been improved; the social worker made my job very easy and the staff in the home also helped make the move less stressful (carer)
Villa Maria Interventions to reduce hospital admissions and minimize risks
• Provide nursing and medical expertise in the home- • All staff trained in dementia specific skills and clear dementia
strategy • Difficult discussions made • Futile interventions are avoided • All residents are encouraged to have an End of Life
discussion
Villa Maria rate – 60% of all residents have an ACP across four facilities. This is unusual across aged care.
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