Collaborating with teams to support a person with dementia

When we think about collaboration, we think about individuals working together towards the same goal. For support workers caring for an individual with dementia, the goal is to provide quality, person-centred care as the disease progresses. This collaborative effort extends to supporting other members of the healthcare team and the individual's whānau (family).

An essential part of a support worker's role is to be able to collaborate effectively with other people and organisations to support tangata and their whānau.

Working well together is not just about getting along with others. It is a far more complex skill that requires you to practice the positive attributes of a team member.

Let's look closely at the descriptions of some of these attributes:

1. Communicate constructively. When you collaborate with others your communication needs to be clear, direct, honest, positive and respectful.
2. Listen actively. Listening by absorbing, understanding and thoughtfully considering the ideas and beliefs of others. Part of listening is the practice of receiving the information and taking an appropriate time to respond without getting defensive or reacting negatively.
3. Be reliable. Keeping your commitments and doing your job to the best of your ability at all times.
4. Be willing to share information, knowledge and experience. Being a good, objective source of information, and keeping the healthcare team updated with the latest information.
5. Be discrete. A service user's medical information is confidential, and there is no exception. Discuss with Tangata, who you can relay and discuss information with to ensure the successful delivery of care and prevent unwanted surprises.
6. Be an active participant. Engaging in discussions and meetings and taking initiatives to support the service user, their whānau and the healthcare team.
7. Be cooperative. Look beyond individual differences to focus on what is best for the person being supported and solve problems or issues in positive ways.
8. Be respectful. Consistently act according to your values, be courteous and considerate towards the service user, their whānau and the healthcare team.

Activity - Knowledge check

A multidisciplinary team in dementia care is a group of professionals from different backgrounds who collaborate to provide comprehensive care for people with dementia. Each team member has specific responsibilities that contribute to the overall goal of improving the quality of life for those with dementia. By combining their diverse expertise, the team can create customised strategies for each individual's needs. Their role is crucial in assessing, diagnosing, treating, and supporting dementia patients, with a focus on compassion and involving family members.

According to the New Zealand Ministry of Health Guidelines For People With Dementia " Comprehensive dementia assessment requires multidisciplinary input; medical assessment alone is seldom adequate. Other key personnel are specialist nurses, social workers and occupational therapists. Depending on the particular case, there is often a role for clinical psychology, physiotherapy and speech-language therapy.”

Healthcare professional roles

These healthcare professionals work collaboratively within a multidisciplinary team to address the complex needs of individuals with dementia and provide holistic care, considering medical, psychological, social, and cultural aspects of the condition.

Leaving the care of a loved one with dementia in the hands of others can be a challenging decision. As a support worker in aged care, you play a pivotal role in ensuring that individuals with dementia transition from home to residential care as smoothly as possible. Equally important is the involvement of the client's whānau. Family members provide familiarity, knowledge, and emotional support that can significantly enhance the well-being of a person with dementia.

As a support worker, here are some ways you can assist families in supporting their loved ones with dementia and demystify the condition:

• Provide them with informational resources about dementia, such as booklets and materials from reputable sources like Alzheimer's NZ (available at your local Alzheimer's organisation or www.alzheimers.org.nz).
• Explain that even though a person with dementia may appear fine on the outside, they are living with a condition that significantly impacts their daily life.
• Clarify that dementia is not contagious, emphasizing that it could affect anyone.
• Suggest to visitors that they plan shorter visits and avoid overwhelming the person with too many visitors at once.
• Encourage visitors to bring activities that the person with dementia can engage in, such as simple projects or puzzles, or propose outings together, like going for a leisurely walk.

Communication Tips for Family and Friends

Helping your loved ones understand how to interact with someone with dementia is crucial. Here are some effective communication tips:

• Recognise Abilities and Understanding: Assist family and friends in recognising what the person with dementia can still do and how much they can understand.
• Initiate Conversations Thoughtfully: Offer suggestions on how to begin conversations with the person. For example, encourage them to make eye contact and say, "Hello Samuel, I'm Joseph. We used to work together."
• Avoid Correcting Mistakes: Emphasise the importance of not correcting the person with Alzheimer's if they make a mistake or forget something. Instead, encourage family and friends to respond to the feelings expressed or shift the topic gently.
• Plan Enjoyable Activities: Help family and friends plan enjoyable activities with the person, such as family reunions or visits with old friends. Video calls can also be a great way to connect. When the person is bored or confused and needs distraction, viewing a photo album together can be helpful. Family and friends can even create care packages, make photo albums, or prepare videos to send to the person.

Remind them to:

• Call or video chat during times when the person with Alzheimer's is most alert and engaged.
• Maintain a calm and quiet demeanour; avoid using a loud voice or speaking to the person as if they were a child.
• Respect the person's personal space and avoid standing too close.
• Encourage a two-way conversation for as long as possible, being patient when the person struggles to find the right words or express their feelings. Offer assistance without speaking on their behalf.
• Not take it personally if the person does not remember them, behaves unkindly, or becomes upset. Such reactions often stem from confusion rather than intentional actions.

Talking about dementia with children and young people

Witnessing a loved one's struggle with dementia can be challenging for children, making it hard for them to comprehend the situation. Involving and communicating with children when caring for a person with dementia may be part of your role.

Activity - Quiz

Take some time to read this article about how young people might respond when a person has dementia. Then, answer the following three true/ false questions.

Activity - Scenario

In an elderly care facility specialising in dementia care, Sarah, an experienced support worker, demonstrates effective ways to engage families with dementia care patients:

Scene: In the facility's communal area, Sarah notices Mr. Wetere’s daughter, Emma, sitting with her father, who has advanced dementia. Emma appears uncertain about how to connect with her father, who seems distant.

Sarah: (approaching Emma) "Hello, Emma. I see you're spending time with your dad today. It's good to have you here."

Emma: (with a hint of uncertainty) "Yes, I wanted to visit, but I'm not sure how to interact with him anymore. He's changed so much."

Sarah: (compassionate) "I understand, Emma. Let's try something together."

Sarah encourages Emma to sit beside her father, holding his hand and softly speaking about their shared memories, like their favourite memories on their marae. She also suggests showing him old photos of whānau to trigger recognition.

As Emma engages with her father, Sarah offers a cup of tea and a biscuit, creating a relaxed atmosphere. She then brings over a board game, subtly involving other family members visiting nearby.

Sarah: (whispering to Emma) "Familiar activities like sharing tea or playing games can help spark connections. It's about cherishing the moments."

As the visit unfolds, family members join in the game, and Emma's father becomes more engaged, occasionally sharing a smile or nod.

As support workers in aged care residential homes and specialised dementia care, your role is multifaceted, encompassing various aspects of caregiving. In addition to providing emotional and social support to residents, you'll also be responsible for performing clinical tasks. These clinical tasks are essential to ensure the well-being and overall health of residents living with dementia.

Let’s review some common clinical tasks that you may encounter as part of your role:

Consider the following points in your reflection:

Carrying out your everyday activities and clinical tasks within your limits of abilities and knowledge is crucial in a support worker role.

It is essential for several important reasons:

Overstepping these practices

While support workers are committed to their roles, it is crucial for them to understand and adhere to their professional boundaries, staying within their limits and following established procedures and policies.

Everyone in your team should know where their role in the workplace ends, and someone else’s begins. For example, your role is to support the person as described in your job description and their personal plan. Your supervisor also supports the person and has been trained to carry out different tasks. Therefore, they will have different boundaries from you, the support worker.

Zone of helpfulness

The 'zone of helpfulness' describes the range of care activities that should be carried out by a support worker. As a support worker, you need to avoid slipping out of the zone of helpfulness. An under-involved support worker could be disinterested or even neglectful, whereas being over-involved with the client or their whānau can put both the client and the support worker at risk.

Source:NCNZ Guidelines: Professional Boundaries (flippingbook.com)

Activity - Scenario

Read the scenario below and consider the implications of overstepping role boundaries and the effect on the client and collaboration of the health care team.

Scenario: Task Boundary Breach in Aged Care Dementia Care

In an aged care facility specialising in dementia care, a support worker named Mya had been working diligently for several months, providing compassionate care to residents with various stages of dementia. Mya was known for her empathy and dedication, and she formed strong bonds with many of the residents.

One afternoon, Mya was assigned to assist Mrs. Kumar, a resident with advanced dementia who had difficulty with mobility and was prone to sudden outbursts of agitation.

On this particular day, Mrs. Kumar was having an especially difficult time. She had become increasingly agitated, and aggressive and refused to eat her lunch. Mya, concerned for Mrs. Kumar's well-being and wanting to provide comfort, decided to go beyond her usual duties.

Due to the facility being understaffed and very busy on this particular day, instead of seeking assistance from the registered nurse, who was responsible for administering medications and addressing medical needs, Mya took it upon herself to administer a sedative medication from Mrs. Kumar's prescribed medications to calm her down. Mya had observed the nurse do this before and believed it would help in this situation.

Unbeknownst to Mya, this action had a significant impact on the multidisciplinary team:

Medical Team: Mya's unauthorized administration of medication was a breach of the facility's protocols and legal regulations. The medical team, led by Nurse Emily, was responsible for medication management. This unapproved action could have serious medical consequences, and it jeopardised the medical team's ability to track and manage Mrs. Kumar's medication accurately.

Nursing Team: Nurse Emily was not informed about Mya's intervention until after the medication was administered. This miscommunication caused confusion within the nursing team, as they were unsure about Mrs. Kumar's medication status, leading to potential errors in her overall care plan.

Administrative Consequences: Mya's breach of her role boundaries had significant administrative consequences. The facility's management had to conduct an internal investigation, report the incident to regulatory authorities, and address any potential legal ramifications. This placed an added burden on the administrative staff responsible for ensuring compliance with regulations.

In this scenario, Mya's well-intentioned but unauthorized action had a cascading effect on the entire multidisciplinary team. It underscored the importance of support workers staying within their designated roles and the critical need for effective communication and collaboration among healthcare professionals in dementia care settings. To prevent such situations, ongoing training, clear protocols, and communication channels must be established and followed diligently.