02 September, 2021
An increasing number of patients are coming to us with illnesses other than cancer - dementia being particularly prevalent. With this set to have a significant impact on palliative care in the future, two of our Inpatient Unit nurses went to the Dementia Care New Zealand conference to learn more about what this means for our community.
The number of New Zealanders living with dementia is projected to increase from 70,000 to 170,000 by 2050. We’re living longer and, by default, becoming more at risk of developing illnesses.
Thanks to the Merv and Crocker Fund Scholarship, Harbour Hospice nurses Jan Buchan and Ruth Reidy were able to attend the conference to learn about the impact of this growth, and what can be done to provide more intuitive care for dementia patients.
Getting comfortable with the word ‘dementia’
One area that needs marked improvement in New Zealand is that of diagnosis, the conference highlighted. “Some doctors seem reluctant to diagnose dementia,” Ruth explains. “There seems to be a lack of confidence in using the term, they’re more comfortable with ‘cognitive decline’.
But it’s much easier for families, in terms of having support services made available to them, if the term ‘dementia’ is used.”
Ruth understands this first-hand after nursing her late mother-in-law, who had dementia. “Elizabeth used to say, ‘I can’t put my finger on it, Ruth, but I just don’t feel myself.’”
The family had noticed symptoms, too, such as memory loss. “But it wasn’t until Elizabeth was under hospice care that the term ‘dementia’ was used comfortably, and just having that definite diagnosis brought such relief,” she says.
It’s now known that cognitive stimulation therapy is hugely beneficial for newly diagnosed dementia patients, Jan adds. “At the moment it is offered 18 months after diagnosis, but it’s better to receive it within the first 12 months.
Patients have claimed they’ve noticed a difference in their cognitive ability within the first two weeks.”
Looking back on Elizabeth’s decline, Ruth says, “Through it all she never lost her ability to laugh or enjoy the company of others. ‘I am still me’ is what was reinforced to us at the conference, and this was our experience with Elizabeth, too. That’s what needs to remain the focus for anyone caring for a patient with dementia.”
How we’re meeting the needs of a growing number of dementia patients
Over the past year we cared for 10 more patients with dementia than the previous year.
Meanwhile, our Palliative Outcomes Initiative (Poi) team, who works with general practice teams and aged-care facilities to help staff identify patients in the last 6-12 months of life and develop strategies to improve their quality of life, has found that in almost half of the cases it advises on, dementia and/or frailty is identified as the primary illness.
We’re addressing the shift in need by investing in staff education and making our patient rooms and spaces dementia-friendly.
We’ve introduced contrasts in décor and furniture colours in our Inpatient Units, as well as clear signage (words accompanied by pictures).
We’ve added dementia clocks, which not only tell the time, but also what day it is, the date and if it’s morning or afternoon.
In planning the building layout for our North Shore redevelopment, creating dementia friendly spaces has been incorporated, and we’re working hard to be formally recognised as a dementia-friendly organisation.
