I am a community general nurse for the last twenty years. I work as part of a primary care team. I am particularly interested in the challenges of providing appropriate services/care for clients with early dementia. I see this as the biggest challenge for the future especially with an aging population. It was this interest that led me to complete Dementia Champion course.
Supporting communication between dementia care services
What was the problem you were trying to address with our project?
I work as an acute nurse, part of a primary care team, we provide services for 91 clients who have a diagnosis of dementia and the issue I had identified was that services that are provided by two agencies, by the primary health care team and also by the Alzheimer Society of Ireland. The problem I identified was communication between both agencies, and I was hoping to improve the level of communication between the two agencies
What was your vision for how things should be?
My vision for how things should be was that, as nurses we would go and assess clients with dementia, that the services could be coordinated for that individual and in the ideal world we would be able to sit down and meet and discuss what services this client needed at this stage and what services each of the agencies could provide, were in a position to provide for the client.
What did you do?
So initially what I did was.. I wanted to ensure that I had identified a problem in the first place.. that it wasn’t something that I had identified from personal experience. So I did a questionnaire to 17 members of the multidisciplinary team asking them to identify the level of contact they had with the Alzheimer Society and who initiated that contact, whether it was the Alzheimer Society or themselves and also looking for any comments or suggestions in relation to communication with the Alzheimer Society and ourselves. So 17 members of the team replied and of the 17 members 53% had not been in contact, but also that meant that 47% had been, which was positive over the previous three months. And 16 of the 17 people felt that we could improve communications between ourselves and the Alzheimer Society and made comments that even a once off meeting where we would exchange information on the services we provided would be helpful but also some member said that it would be very helpful to get feedback when clients are receiving a service from the Alzheimer Society on how they’re managing that service.
What was the outcome?
The outcome was that at a primary care team meeting, I identified myself as being on the Dementia Champion course and have a specific interest in making a change plan and the team were very enthusiastic and were agreeable that we could ask the coordinator of the Alzheimer Society services within our area within our team meeting, to meet the team and so that we could exchange some information on the different services that were being provided and we could update each other. So I then arranged to meet the coordinator of the Alzheimer Society just to talk to her and see did she also agree that there were problems of communication between the two teams and she very clearly agreed that there was plenty of room for improvement in relation to communication. She cited difficultly in contacting people by phone and felt that maybe email may be a more appropriate way of making contact. She identified an issue that when a client is referred to them, if there is a crisis, who really is the case manager and who do they contact? When I spoke to her about the fact that some of the team members really like to get feedback in relation to how clients were managing or reports back attending day care or services she said that definitely we could on an individual basis always access that information but there wouldn’t be regular feedback because it just wasn’t feasible because of resources.
So it sounds like there is on- going development with the project.
Yes the coordinator is going to attend the next meeting and we also feel that as a primary care team that we have services that the Alzheimer Society are not aware of, as we now have a multi-disciplinary team, we have occupational therapists now interested in clients with dementia who are very proactive. We also have psychology services, social work and dietetic services. We now have a much broader service to offer the clients.