Northern Trust leads innovation in dementia care

The Northern Trust has developed CLEAR Dementia Care, an innovative new assessment and intervention model which is changing the way people living with dementia are treated and giving them a better quality of life. Health professionals in Northern Ireland and the UK and beyond are recognising its unique success and ability to transform dementia care.

The model was developed in response to challenges that staff in care homes face when providing care. People living with dementia can present with behavioural and psychological symptoms that staff can find hard to understand. These behaviours are often a sign of distress the person experiences as they try to cope with the daily challenges of living with their condition. CLEAR Dementia Care aims to understand the behaviour in the context of the person and their environment, identify any unmet needs and then try to make changes so these needs are met. This gives staff a better understanding of the person so they can give the best possible care and also improves the experience of the person with dementia. There are other models to help understand behaviour in people living with dementia, but this model is unique in how it helps carers to accurately record behaviour and support them to implement change.

The model was developed by the Northern Trust’s Dementia Home Support Team which is made up of clinical psychologists, social workers, nurses, occupational therapists and support workers who understand the wide range of needs of those living with dementia.

Dr Frances Duffy, Consultant Lead Clinical Psychologist for Older People at the Northern Trust, explained:

“We need to see the world through the eyes of people with dementia in order to support them effectively and to reduce distress.

To do this, the model looks at five key areas; cognition, life story and personality, emotional and physical wellbeing, activity and environment and relationships. Assessment includes observation and discussions with the person with dementia, care staff and other significant people in their life. Behaviour record charts are used to get a sense of a ‘day in the life of’ the individual. These charts are tailored to the specific behaviours of the person with dementia and are used to help understand their behaviour in the context of the environment.

Dr Duffy continued: “When we know what is causing someone to behave in the way they are, we can then implement solutions – and more often than not they are about small, simple actions.”

This highly effective model has given a new outlook and is transforming how care is given to people living with dementia in our care homes and training is now being carried out across the Northern Trust. Feedback from those living with dementia in care homes and their families has been extremely positive.

Janet O’Hara, whose mother, Mrs W, was diagnosed with vascular dementia earlier this year, said: “After a period of illness, and some spells in hospital, my mother received this unexpected diagnosis of early onset dementia. From being an 83-year-old living independently at home, she went into a nursing home and the Dementia Home Support Team got involved.” She added: “Ann-Marie was so helpful to us and to mum. It was very difficult for my mother, but Anne-Marie got some routines in place and listened to the things we knew about mum to help her settle. For example, every day my mother went to buy the paper and now she has it delivered to the home. She also always had her hair done and was particular about what she wore. So the staff were asked not to just put out her clothes but to ask her if she wanted the black or brown trousers that day.” Janet O’Hara added that the Dementia team’s approach had made a lot of difference to the family. “It’s reassured us and we know they’re always at the end of a phone.”

A son of a person with dementia who received care from the Dementia Home Support Team said: “I want to let you know what a wonderful job you have done with my father. The change in him is unbelievable. I have my old dad back. Not someone that was constantly angry, cross and unable to communicate in any way.”

The Dementia Home Support Team has plans to develop the model for people living with dementia at home and for inpatients in hospital.

The CLEAR Dementia Care model has been presented at the UK Dementia Congress in Birmingham, the Regional Dementia Strategy Implementation Group and published in the Journal of Dementia Care. It has also recently won the Alzheimer’s Society Innovation of the Year Award 2016 at the Dementia Friendly Awards.

Page last updated:15 December 2016