15 October 2012. Bookings are now being ... National Forum on 15 October in
Euston, London. Last year's event sold ... story work, and more. Staff in MSNAP ...
Welcome
Issue 06 August 2012
The London Olympics and Paralympics are here, and we have plenty of great achievements from our own MSNAP members. See below for the (long!) list of teams that have achieved accreditation since our last newsletter in January. This list also includes a number of teams who are now renewing their accreditation after 2 years, and even some who are moving up from being ‘accredited’ to ‘accredited as excellent’. Thank you to all our members for their hard work and the effort they put in to their review, whether being accredited for the first or second time. MSNAP has also released the Third Edition Standards, which now includes an optional module on psychosocial interventions. More inside the newsletter on the changes to the standards for this edition. In addition, the programme for the 3rd annual conference – the MSNAP National Memory Services Forum, has now been announced and we are taking bookings for delegate places. There was a high demand last year which outstripped the available places so book now!
T 020 7977 6644/4971 E
[email protected] [email protected]
In this issue… MSNAP Forum 2012
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New Standards
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Farewell to Emily
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Day in the Life of... 3 An Old Age Psychiatrist The Golden Years 4 Prose by Marguerita Storey Portrait of a Life
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Contact us
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Memory Services Register MSNAP, in collaboration with the Department of Health, is creating a Register of UK Memory Services. This will help to map the distribution of services and to find out what is on offer. This is independent from membership of MSNAP. We urge all memory services/clinics to register themselves at www.rcpsych.ac.uk/memory-services-register
Congratulations! The following services have been accredited by MSNAP since January 2012:
Accredited as excellent Mossley Hill Hospital Memory Service, Liverpool Albert View Memory Service, Lancaster Chester Memory Service, West Fylde and Wyre Memory Service Tower Hamlets Diagnostic Memory Clinic North East Lincolnshire Memory Service Burnham Memory Service Jersey Memory Clinic Caradon Memory Assessment Service, Cornwall Accredited Wirral Memory Assessment Service North Manchester Park House Memory Service St Helen’s Later Life and Memory Service Isle of Man Memory Clinic
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MSNAP National Memory Services Forum 15 October 2012
Farewell to Emily Doncaster
Bookings are now being accepted for the 3rd Annual Memory Services National Forum on 15 October in Euston, London. Last year’s event sold out with over 120 delegates from member services, non-member services and charitable organisations, and this year we have a bigger venue so we hope to build on the success of last year by creating a larger event with more networking, great speakers and a great venue! Presentations will cover aspects of assessment, diagnosis and care of dementia, as well as management of, and innovations in, memory services/clinics. This conference is for staff that work with memory services/clinics, related private/charitable organisations, people with dementia and carers. Key speakers include Professor Mike Kopelman on the variety of memory disorders from a neuropsychiatric perspective, Dr Chris Ball from DeNDRoN on dementia research, and Dr Daniel Harwood discussing reduction of antipsychotic use in people with dementia. In addition we have sessions on occupational therapy, end of life care, life story work, and more. Staff in MSNAP member services are entitled to 2 free places, with discounted additional places, and staff from non-member services or other organisations are offered reasonably priced delegate places. People with dementia and carers are entitled to free, or discounted, places. The event will be held at the Friends House, Euston Road; closest tube station is Euston or Euston Square. For more information on the day and to book your place, please visit our website: http://www.rcpsych.ac.uk/msnapforum
New MSNAP Standards The third edition of the MSNAP Standards has now been released. As always, member services should ensure they are aware of updates to the standards and this edition has some significant changes that members should take note of: Addition of pharmacological standards – the standards now cover the prescription and monitoring of anti-dementia and antipsychotic drugs. Addition of quality indicators – these are phrased in terms of percentages, for example the percentage of service users seen for their first appointment within 6 weeks of referral. These will not be used to inform a service’s accreditation status but will enable MSNAP both to benchmark a service against other services, and monitor performance over time. The domains chosen are considered to be key indicators of quality. Addition of psychosocial intervention standards – these new standards cover the provision of psychological and social interventions. This module is currently optional and separate from the ‘core’ assessment and diagnosis standards – so if a service decides to be reviewed against these standards, they will be awarded accreditation against the core standards, with a separate score for their performance against the psychosocial standards. There is no extra cost for participating in the psychosocial intervention module. The standards can be downloaded www.rcpsych.ac.uk/memory-network
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Emily Doncaster, Deputy Programme Manager of MSNAP, will be leaving in September to take up a Doctorate in Clinical Psychology at the University of Essex. She has worked with the Royal College of Psychiatrists Centre for Quality Improvement for over 3 years on MSNAP, the ECT Accreditation Service (ECTAS) and formerly the National Audit of Dementia. Under her influence MSNAP has grown into the successful project it has become, and she has constantly been thinking of new ways to improve our own systems and introduce fresh new ideas into the programme. She will be sorely missed both professionally and personally by the project team, and I’m sure by many of you as well, however we wish her all the best for the future. We have every confidence that she will be equally, if not more, fantastic at being a psychologist as she has been at working with MSNAP. Sophie Hodge will be taking up the Deputy Programme Manager role for MSNAP, ECTAS and the Home Treatment Accreditation Scheme (HTAS).
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A Day in the Life of... Old Age Psychiatrist, Dr Chris Jagus Do you work solely in the memory clinic? If not, how much of the week do you spend in the clinic and what do you do for the rest of the time?
The Isle of Man is around 35 miles by 13 in size. It has a population of around 80,000 and an over 65 population of around 15,000. It is not, and never has been, part of the UK and has its own Government and Legal system. As the only Consultant in Old Age Psychiatry on the Island I am involved in all areas of Mental Health Care for Older People. I work very closely with a well-resourced, dynamic and very supportive multidisciplinary team. I divide my time up between inpatient, community and outpatient work. We have a small 8-bed acute inpatient ward which operates a mixed organic/functional service. I run two busy outpatient clinics per week, one centrally in Douglas and on alternate weeks one in the north and the south of the Island. I supervise Foundation year 2 junior doctors both as clinical and educational supervisor and I am also involved in service development and management. My other roles include acting as Clinical Lead for the Isle of Man Mental Health Act 1998, and Clinical Lead for Electroconvulsive Therapy. I also play a role in the Capacity Legislation group which is involved in working with the Isle of Man Government to draft Mental Capacity Legislation for the Island.
a keyboard player and vocalist in a 5-piece rock and pop band. When I get a chance, I enjoy walking and experiencing the stunningly beautiful landscapes and seascapes the island has to offer. What does a day’s work in the memory clinic involve for you?
We run two afternoon Memory Clinics per week. These are arranged after the patient has had a home visit by a Memory Clinic nurse and an Occupational Therapist to do a full battery of cognitive and functional assessments.
The patient and carers attend the clinic to see myself and the team for a full review of their medical notes, assessment results and a physical examination before we formulate a diagnosis. The diagnosis is delivered during the clinic and we will also put into place a care plan at this point. Anti–dementia drugs are prescribed at this appointment if appropriate but ultimately this is taken over by the GP with ongoing monitoring by the Memory Clinic. Involvement of the multidisciplinary team and other agencies is also initiated at this time. Each patient’s session lasts around an hour and gives ample opportunity to discuss diagnosis and treatment options. What made you choose psychiatry, and in particular old age psychiatry, as a career?
Outside of work, I have a wife and three children aged 16, 13 and 7, who take up a lot of my time! I am a keen musician, and I regularly play classical piano, along with being
I originally trained as a GP, but I was always fascinated by the mind and human perception so decided on a career in psychiatry instead. My first SHO job was in Old Age Psychiatry, and it inspired me to pursue this as a career. 3
What has been the most challenging aspect of your job?
In common with all Old Age Psychiatrists, I would imagine the biggest challenge lies in developing services to meet the increasing demand of a growing elderly population. The Isle of Man has its own particular challenges. We have no neighbouring districts or Trusts which we can call upon when we are struggling to find beds or placements. We must be self-contained as we cannot ship patients off to the UK for admission. This requires a significant degree of resourcefulness at times in how patients are best managed in terms of their risk when we cannot place them. What has been the most rewarding aspect?
Working with such a motivated, supportive and friendly team to enhance the quality of life of our patients. I feel very proud of the service we deliver. What has been the most valuable thing you have learnt through your job?
That life is there to be lived because it can so easily be irreversibly altered by conditions such as dementia. And also that I must never take for granted the beauty of the Island where I have chosen to work.
The Golden Years Prose by Marguerita Storey ‘Come along now Nellie, wake up, wake up.’ A firm hand grasped Eleanor’s shoulder. ‘Come along, I haven’t got all day.’ ‘Nellie’ why must they call me that, it is not my name, I keep telling them, my name is
the same. Today, as she did most days, she had transported herself away and back in time. She was strolling in the meadow behind the house. The house where she had lived for
Eleanor, Eleanor Parker. Eleanor Parker was not asleep, true, her eyes were shut because this was her escape route, escape from the dull stuffy room, from patchwork blankets, from reality. Why did people assume that the elderly must be wrapped around in coloured patches. Patchwork blankets and glacier mints. Always
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almost fifty years. The house she and Tom
too, they will probably pop over and see
bought soon after they were married. There
you when the weather improves. Well,
the children, Susie and Harry, had grown up.
Mum, I must be getting along, don’t like
She had loved that house and now she was
driving in the dark, you understand don’t
back there walking through the garden gate
you, see you soon. Oh, sorry, I have just
into the field behind.
remembered, won’t be able to come next
She could almost smell the heady fragrance of cowslips and wild thyme and feel the damp grass under her feet, now swollen with
month, going to Tenerife, forgot about that, sorry. Well, keep smiling, see you.’ ‘Now then Nellie, dreaming again,
lack of use. She made an involuntary
open your eyes, it’s 4:30, time for your
movement with them the picture was so
bath. You want to smell nice don’t you?’
real.
4:30. The middle of the afternoon, a bath in
Some days she would travel to the seaside with the children and paddle in the warm surf digging her toes into the soft sand, then jump the incoming waves. The children loved this.
the middle of the afternoon. Perhaps she will go away if I keep my eyes shut. ‘N-e-ll-i-e, I am losing my patience.’ That name again, why oh why must we be treated like naughty children. I would like to keep my dignity at least. I wonder what these young girls see. Do they imagine that our minds have already departed from our frail bodies? That we are just shapeless objects sitting in regimented lines like puppets. I suppose we do paint a strange picture, heads lolling, misty eyes gazing, fingers picking. We were like you once, we loved, we danced, we sang. Like you, we were PEOPLE not inanimate objects to be shunted around. Inside we are the same, only our bodies have changed. ‘Oh, pretty young girl, stay for a while, talk to me, tell me, is it spring outside? Are the daffodils through?
The children, where are they now? They are
Do the birds sing? Tell me. We cannot know
busy I expect with one thing and another.
these things you see, in this room. Stay
They could not be expected to visit more
awhile, please stay awhile.’
than once a month. She understood. Usually it was a flying visit, ‘hello Mum, you look fine, they’re looking after you then, still taking your pills are you? Good. Have you been out much? In the chair I mean. No, well never mind, you are in the best place, it’s very cold outside. By the way, Karen is expecting again, she sends her love, Peter
‘Nellie, I won’t tell you again, the water is already cold, my patience is wearing thin, and I am supposed to be off at six. I won’t tell you again, come along now, open your eyes.’ Eleanor’s eyes remained closed and there was a smile on her face. 5
Portrait of a Life Delivering care with compassion and achieving meaningful outcomes for people with dementia through ‘Life Portrait’ work is now commonly seen in care settings supported by ‘Portrait of a Life’, the multimedia toolkit for life story work. Memory services are often an early point in the person’s journey and it is at this time that a really positive difference can be made to support the wellbeing of the person with dementia and to recognise and involve family carers. For the person living with dementia it enables them to ‘tell their story’ and focus on positive touchstones, recognising strengths as opposed to highlighting deficits which may be identified during the assessment process. For the carer, the ‘expert’ role is maintained through the partnership approach and they are enabled to revisit positive aspects about the individual and the relationship. The toolkit provides a comprehensive ‘A – Z’ or ‘one-stop shop’ for life story work and is supporting many teams nationally working in a variety of settings. The toolkit was developed in South West Yorkshire Partnership NHS Trust with support from the Mental Health Foundation. The resource comprises a training DVD, short film, DVD Rom and a written guide. The team provide a one day training course for two ‘lead facilitators’ per toolkit and on-going support can also be provided. The team believe that ‘life story work is the key to person-centred care’ and there are now many inspirational outcomes resulting from this work. Admissions to hospital have been reduced and access to specialist services required less frequently. In community/memory clinic settings, delayed admission to long-term care is evident as well as appropriate prescribing of anti-dementia drugs and reductions in anti-psychotic prescribing. Staff report improved job satisfaction as they engage in meaningful and creative care planning, work in partnership with families, facilitate intergenerational work and deliver care with dignity and compassion. For further info please; Email:
[email protected]
Google: portrait of a life YouTube: PortraitofaLife1
Contact the MSNAP Team Emily Doncaster Deputy Programme Manager T 020 7977 6644 F 020 7481 4831
[email protected]
Sophie Hodge Project Worker T 020 7977 4971 F 020 7481 4831
[email protected]
email@address
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