Authors (including presenting author) :
Cheung SY(1), Sze YMS(1), Chan WM(1), Ho YSC(1), Lam CM(1), Tsang KW(1), Yuen MYK(1), Ip PWP(1)
Affiliation :
(1) Medicine and Geriatrics, Shatin Hospital
Introduction :
According to the Department of Health (2021), there are ~18% of people in Hong Kong aged 65 and above. In Medicine & Geriatrics wards, there are over 90% of our patients with age 65 and above in 1-day point prevalence and over 30% of them was diagnosed with dementia. Some of them might develop behavioural and psychological symptoms of dementia (BPSD) as they were admitted into hospital with unfamiliar environment. Therefore, diversional therapy is vital to provide a person-centred environment to dementia patients (Digby, Williams & Lee, 2015). In 2021, we worked with Health Resource Centre(HRC) to promote Dementia care in SH M&G department by providing different kinds of dementia toys, standardized education pamphlet, and establishing “Dementia Passport” to understand patients’ background, preference and routine. Our existing robot therapy combines with these to promote a dementia-friendly culture for M&G patients.
Objectives :
1.To facilitate nursing care for dementia patients through diversional therapy. 2.To minimize BPSD in patients by providing activities in daytime. 3.To empower carers of dementia patients after discharge. 4.To promote person-centred care by “Dementia Passport”.
Methodology :
1. To promote the use of “Dementia Passport” upon patients’ admission. 2. Arranging daytime activities for dementia patients. It can promote sleep at night and thus minimizing the possibility of developing sundown syndrome by means of providing dementia toys, robot or sensory stimulation gadgets. We had 2 robots in M&G department since November 2020. In 2022, robots were extended to 6 paired wards. Robot therapy aims to promote fall prevention, medication safety, infectious diseases outbreak reduction announcement and provide reality orientation and diversional therapy as well as entertainment to our patients with dementia in wards. Over 95% of patients was satisfied with the robot and had positive feedback throughout their hospitalization. 3. Providing standardized dementia education pamphlet to empower carers in community upon discharge. Timeline: 3Q 2021: Proposal preparation; Gained support and exploring funding resources; Present to HRC about the proposal; 4Q 2021: Gained support by HRC; Provide staff training to promote the awareness in dementia care; 1Q 2022: Implement the project in SH M&G; The project was interrupted due to COVID-19 pandemic, resumed in 1Q 2023. 2Q 2023: Evaluation “Dementia passport”: For promoting the understanding of patient to provide appropriate diversional therapy, "Dementia passport" will be issued upon admission. This can provide a channel to let us know dementia patient’s background, preference and routine, thus facilitates care during hospitalization. Dementia toys in SH M&G wards: Under the support of HRC, different kinds of toys were purchased to provide diversional therapy for dementia patients in daytime. Besides, visuospatial perception and fine motor coordination can be trained throughout the process. The coloring and practicing books can provide art therapy, which promotes relaxation in their hospitalization. Furthermore, HRC volunteers had made some sensory stimulation gadgets to relieve dementia patient’s pressure towards unfamiliar environment. Dementia education pamphlet: HRC sponsored in producing dementia education pamphlets for patients upon discharge. It is to empower carers by giving resources to them after discharge, thus minimizing the chance of rehospitalization due to caring problem. The pamphlet includes information as the followings: - Sign and symptoms of dementia - Management and caring tips - Financial planning - Advanced directives - Advanced care planning - Home-based cognitive training games - Community resources
Result & Outcome :
The effectiveness of the programme would be evaluated in 2Q 2023 by means of the followings: 1.Utilization rate of “Dementia Passport” 2.Utilization rate of Dementia education leaflet 3.Voting of the most favorite dementia toys by staff and patients 4.Restraint rate
