In Shropshire last year the DAA carried out a survey of experiences of people living with dementia and their unpaid carers. The areas of greatest concern were experiences of care in general practice and in hospitals.
So Shropshire Telford and Wrekin Dementia Action Alliance is concentrating on GP practices this year to get them to become dementia friendly, or at least start.
Here are some dos and don’ts for practice staff. No doubt you can add more…
Don’t expect patients living with dementia to remember their appointment dates and times. Find ways of helping them.
Do use text reminders of appointments, but if you call us an hour before our appointment we are much more likely to arrive! A stitch in time…etc.
Don’t play music or radio in your waiting area. We need to concentrate on what we are about to say rather than be distracted by noise which is not loud enough to understand but too loud to ignore. Local radio is the worst.
Do use large, contrasty signage to help patients not be confused about where to go.
Do place name signs on doors, not walls, and at around 5 feet off the ground.
Don’t plaster your walls with posters and amateur artwork which will often confuse us.
Do provide information about local facilities, groups or services that we may like or need to use.
Don’t tell patient who is concerned about their memory or other functioning that since there is no cure there is no point in betting a dementia assessment.
Do use the Young Onset Dementia guidance to help you decide whether to refer a patient under 70 for assessment.
Don’t tell a patient that you keep losing your keys or forgetting names and it’s just a sign of ageing.
Do remember that the few drugs available to relieve symptoms often provide significant help, so it is important to get a diagnosis.
Don’t just get frustrated at the lack of support locally for us. Lobby your CCG to get action to improve this.
Do look and smile at us when you meet us and when you speak to us.
Don’t stare at your computer screen while talking or listening to us.
Do make your entrance and waiting areas bright and welcoming. Use pastel colours. Provide soft and firm seating at a variety of heights.
Don’t use dark or patterned floor coverings.
Don’t place a dark dirt catcher mat at the entrance.
Do make sure all staff are dementia friends.
Do require staff who regularly work with people living with dementia complete Level 2 training.
Do make sure every patient who is an unpaid carer is flagged on your system.
Do ask every time you meet a carer if they are ok, and be proactive about providing support.
Do put a contrasting colour seat on your patient toilet, and clear hot and cold signs on or above taps.
Do put an exit sign on the inside of the toilet door.
Do use pictogram signs for toilets and for nurse or doctor consultation rooms.
Do use colour or white to pick out doors that patients may use, but leave others the same colour as adjoining walls.
Do promote double sessions for people living with dementia so they have time to say what they need to say, and to reflect on discussions. So they don’t feel rushed.
Do tell your staff to smile at patients as they walk through waiting areas. Say good morning. Smile. Put people at their ease.
Don’t march through looking as if you have just sucked on a lemon.
Do develop a model for sharing care and living planning with your patients. Co-produce it. All professionals contribute. Patient includes what matters to them. Patient has read and write access and can share it as they choose.
Do identify and support a dementia champion on your staff. Make sure they have the passion and understanding and support to make things happen.
Do use the approaches set out in ISPACE (search on line for this guide for general practice).
Do help patients living with dementia to take their medications correctly. Work with local pharmacies to use appropriate dose boxes or pods.
Don’t expect us to remember to re-order prescriptions correctly. Find ways to help us, like automatic re-ordering.
Do work with pharmacies to get them to ring patients who have not collected medications when expected.
You cannot do all this at once, but if you don’t start you will never finish.
And, as Kipling might have said, the world will be yours, and everything in it, what’s more, young man, you’ll be a dementia friendly practice.