Towards person-centred descriptions of dementia for person ... · Towards person-centred descriptions of dementia for person-centred services Geoff Jones Dementia Consultant gjones@silverchain.org.au
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Towards person-centred descriptions of dementia
for person-centred services
Geoff Jones
Dementia Consultant
gjones@silverchain.org.au
May 2007
Contradiction
• Person-centred services:
D = NI + H + B + P + SP
• Descriptions:
D = NI
1.1.1.1.
PCA is widely accepted as the service
delivery model of choice with people
living with dementia in Australia.
2.2.2.2.
PCA is based on
the Kitwood enhanced model -
not the bio-medical model.
KItwoodKItwoodKItwoodKItwood enriched modelenriched modelenriched modelenriched model
D = NI + H + B + P + SP
Health
Neurological
impairment
Biography
Personality
Social
psychology
3.3.3.3.
Current descriptions of dementia are
based on the bio-medical model
• For people with dementia
• For family carers
DementiaDementiaDementiaDementia
Changesin brain
Dementia= symptoms
CognitionMood
Behaviour
Group of illnesses
3.3.3.3.
Current descriptions of dementia are
based on the bio-medical model
• For staff
DementiaDementiaDementiaDementia
Changesin brain
Dementia= symptoms
CognitionMood
Behaviour
Group of illnesses
Changed behavioursChanged behavioursChanged behavioursChanged behaviours
Changesin brain
Environment
Health
Medication
Changed behaviours
Mood
Behaviour
4.4.4.4.
PCA considers the bio-medical model as
a cause of poor dementia services
Knowledge:
• AD Pathology & clinical symptoms
• Health, biography, personality, &
social psychology
Elements of a person-centred description?
1. Loss of mental functioning
2. Experience of dementia
3. Bio-psychosocial for all changes
4. Positive personal attributes
5. Carers challenged – partnership best
6. Supports impact on quality of life
A person-centred description would not suggest:
1. Solely brain based causation of symptoms
2. Global decline
3. Typical life expectancy
4. Solely negative future
5. Medical sub-types of dementias (in first paras)
Examples of text person-centred descriptions:
• NICE Guidelines UK 2006
• Silver Chain
Dementia Dementia Dementia Dementia –––– PCAPCAPCAPCA
Changes
in brain
Environment
Health
Medication
Personality
Biography
Relationships
Dementia = Symptoms
Cognition
Mood
Behaviour
Group of
illnesses
Person at the centre Person at the centre Person at the centre Person at the centre
Person at the centre Person at the centre Person at the centre Person at the centre
Strengths/resiliencePersonality
Health
Personal relationships
Life experience
Cognitive reserve
Faith
Satisfactions/Joys
Material resources
Social status
Wider social network
Person at the centre Person at the centre Person at the centre Person at the centre
Strengths/resiliencePersonality
Health
Personal relationships
Life experience
Cognitive reserve
Faith
Satisfactions/Joys
Material resources
Social status
Wider social network
Threats/lossesMemory/thinking
Future
Relationships
Emotions
Decision-making
Sexuality
Occupation
Living skills
Senses
Mobility/driving
Discrimination
Person at the centre Person at the centre Person at the centre Person at the centre
Strengths/resiliencePersonality
Health
Personal relationships
Life experience
Cognitive reserve
Faith
Satisfactions/Joys
Material resources
Social status
Wider social network
Supports and treatments: Information, advocacy, environmental mods,
transport, exercise, health care, social networks, counseling, ADLS
Threats/lossesMemory/thinking
Future
Relationships
Emotions
Decision-making
Sexuality
Occupation
Living skills
Senses
Mobility/driving
Discrimination
Enhance Neutralise
Next steps:
• Talk with colleagues and consumers
• Check the descriptions your agency uses & ask for review
• Check staff training - Cert III
• Give feedback to state & Commonwealth initiatives
Towards person-centred descriptions of dementia
for person-centred services
Geoff Jones
Dementia Consultant
gjones@silverchain.org.au
May 2007
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