Conference presentations

The majority of presentations from the conferences can be viewed here. They are in PDF format  -  see how to access PDF files.

Improving Hospital Care for Older People: Summit event October 2012 and Call for Action

The RCN held a Summit Event on 26 October 2012 in partnership with Age UK, MacMillan Cancer Support, the NHS Institute for Innovation and Improvement and NHS London.  

Invited delegates from 25 organisations met in London to discuss key issues and concerns, to identify good practice and latest thinking, and to form consensus on some key areas for action. Outputs from this event are being widely disseminated with the aim that they will support sharing good practice, trigger action to improve hospital care for older people, and inform future planning, commissioning and delivery of hospital care for older people. The summit identified seven key themes that must be addressed in order to make hospital care for older people fit for now and the future:

*top priority areas

Speakers from the RCN included: Dr Peter Carter, Chief Executive and General Secretary; Janet Davies (Chair); Nicky Hayes (Older People’s Advisor) and Rachel Thompson (Dementia Project Lead). Invited speakers included: David Oliver (National Clinical Director for Older People); Juliet Beal (Director of Nursing: Quality Improvement and Care, NHS Commissioning Board) and Norman Lamb (Health Minister).

Slides from the conference presentations can be downloaded here.

The Call for Action is available to download, see: Improving hospital care for older people: a call for action (PDF 569.4 KB).

Older people’s nursing: current challenges and future potentials March 2012

The RCN Older People Forum conference Older people’s nursing: current challenges and future potentials was held on 20 March 2012.

The conference programme highlighted potentials for addressing key challenges facing older people’s nursing through developing new approaches, partnerships, environments, tools for care or ways of working. The conference illustrated how services for older people in acute hospital, care homes and community dwellings are developing to improve early intervention.

The presentations are arranged under the following headings:

Older people's nursing

Older people’s nursing - current challenges and future potentials (PDF 307KB) - Nicky Hayes
This presentation sets the context and describes the work done by the RCN working with nurses across the UK to explore what is needed to provide safe care for older people on hospital wards and to identify the staffing thresholds and the underpinning factors necessary to support safe and dignified delivery of care for older people. Key messages and recommendations from the new RCN guidance on safe staffing launched at this conference were presented.
You can read the guidance at Safe staffing for older people’s wards: RCN summary guidance and recommendations (PDF 412KB).

Creating places that flourish – the essential role of the gerontological nurse (PDF 4.14MB) - Professor Brendan McCormack
“The role of the registered nurse in gerontology has always been contentious ... Whilst some commentators would argue that the role is ill-defined, task orientated and often poorly executed, it is my contention that irrespective of the model or place of care deliver, there is an essential role for the registered nurse”.  There is increasing evidence of the need for care settings to be ‘flourishing places’ and this presentation identifies the role of the registered nurse in facilitating places that flourish for all. 

Care of older people

Commission on improving dignity in care for older people in hospitals and homes (PDF 337KB) - Jenny Pufkey
This presentation describes how the Commission was established, its members and the focus of its work. It outlines the different sources of evidence that informed the Commission and presents the key recommendations made in the ‘Delivering dignity’consultation  report for hospitals and for care of older people generally, and what the next steps will be.

A new approach to the assessment of acutely ill older patients: the frail elderly assessment (PDF 620KB) - Fiona Howell 
“The Frail Elderly Assessment Unit (FEAU) has a clear philosophy of improving the care provided to frail older people within the acute setting. It is staffed by health professionals with extensive experience in the care of older people and who are committed to ensuring that best practice and innovation are developed and sustained within the Unit ….. The overall objective was for the Acute Hospital Trust, in partnership with local health and social care organisations, to deliver the specialist acute care that frail older people require in order to achieve their optimum functional capacity.  Subsequently, the Frail Elderly Assessment Unit (FEAU) provides rapid multi-disciplinary team assessments by Consultant Geriatricians, Specialist Nurses and members of the therapist team”. As a result this “prevents unnecessary admissions, and ensures timely and appropriate transfers of care to either a specialist acute elderly care environment, or an alternative community setting when required”.

Spirituality and older people (PDF 357KB) - Sue Royce 
This workshop aimed to introduce the concept of spirituality and to encourage the use of spirituality in work with older people, to help improve and achieve true holistic care. The workshop explored why spiritual care has become so neglected and why nurses can find it difficult to embrace spirituality.

Care homes focus

Leaving home for good: family carers experience of an older relative's entry to care (PDF 670KB) - Dr Assumpta Ryan
“The experience of entry to long-term care is a major life event for older people and their families. It usually follows a lengthy period of family caregiving and as a result is characterised by a range of conflicting emotions such as guilt, relief, anger, resignation and regret.  This presentation draws on the author’s research background in the field of family caregiving and entry to care. It brings together the findings from a range of qualitative and mixed methods studies with the overall aim of improving the experience from the perspective of older people, their families and the nursing staff involved in the placement”.

Is person centred care enough? Experiences of implementing and promoting person and relationship centred care using the Senses Framework in a care home (PDF 604KB) - Serena Allan
This presentation describes care at a 70 bedded care home for older people with a visual impairment and aims to show “how using the Senses Framework to implement a relationship-centred care approach has not only enhanced the care experience for older people and their families but has also, through inclusive practice and cultural shift, led to increased job satisfaction and confidence amongst staff”.

Caring for and caring about: a remedial care model for use in care homes for older people (PDF 2.13MB) -  Deidre Wild with Sara Nelson, Ala Szczepura and Angela  Kydd
This presents the ‘Caring For and Caring About’ model first published in 1989 and revised in 2012 (Wild et al 2012), with its developmental rationale and conceptual underpinning. “As a guide to promoting remedial practice, the model’s emphases are upon: thinking before doing, resident inclusion rather than carer control, and an interdependent caring relationship rather than one of recipient dependency”. Using a scenario set in a care home with a fictitious resident, the presentation demonstrated ways of using the model in practice to transform task orientated care towards a remedial approach and outlined the implications of staff adopting new ways of working.

Reference:  Wild D, Nelson S, Szczepura A, Kydd A. (2012) Caring for and caring about: A remedial model of care for older people in care homes. Nursing Times - accepted for publication October 2011.

Older people in care homes: Sexuality and intimate relationships (PDF 1MB) - Hazel Heath
Care home staff experience dilemmas and practical challenges in dealing with issues of sexuality for a range of reasons but organisational systems that do not take residents’ sexuality or desire for intimate relationships seriously can cause deep unhappiness. This presentation describes guidance developed by the RCN to help nurses and care staff work with issues of sexuality, intimate relationships and sex, particularly for older people living in care homes.
The guidance, published in 2011, can be downloaded at: Older people in care homes: sex, sexuality and intimate relationships: An RCN discussion and guidance document for the nursing workforce (PDF 421KB).

Dementia care focus

Nursing in dementia care : Current challenges and future potentials (PDF 917KB) - Rachel Thompson
This presentation explores the role of nursing in supporting people with dementia and their families, focussing on the experience of dementia and the challenges in providing care for those affected by dementia in different settings. It describes a range of interventions and looks at the role of nursing in supporting improvements. This includes work being supported by the RCN on improving care for people with dementia in general hospitals.

Improving dementia care in an acute hospital: partnership working in action (PDF 652KB) - Frazer Underwood with  Heather Eardley and Teresa Parsons
This presentation describes partnership working between Royal Cornwall Hospitals NHS Trust, the Patients Association and Alzheimer’s Society. “Working with third sector partners gave this acute hospital an opportunity to openly and honestly have reflected back, the true experiences people with dementia and their carers receive. This process will now progress service improvements to further enhance the compassionate care directed to this vulnerable patient group in hospital”. The paper presents “the background context and collaborative journey to achieving this ‘true’ experience of people in our care”.

Improving assessment and diagnosis of dementia in the acute hospital setting (PDF 160KB) - Michelle Parker with Dr Laura Madeley
The presentation describes a service from the diagnostic memory clinic at a district general hospital in the east of London which aims to assess and where possible diagnose people with dementia during their admission to hospital. The service is nurse-led and multiprofessional. The presentation aims to describe the value of assessment and diagnosis of dementia within the acute hospital setting alongside the benefits and challenges of working in a nurse led multiprofessional team in a service provided jointly by two healthcare trusts.

Making it happen - strategies developed and lessons learned in delivering an early intervention dementia service in Worcestershire (PDF 882KB) -  Carol Edwards with Jenny La Fontaine
The Early Intervention Dementia Service (EIDS) within the Worcestershire Health and Care NHS Trust commenced in July 2010 providing an assessment, diagnosis and intervention service where there are suspected early signs of dementia. Key priorities included the development of an evidence based approach and evaluation which included gaining the perspectives of people receiving a service. The presentation explores insights gained, and strategies to address service development, particularly around post diagnosis interventions. It also explores the planned evaluation of the service.

Innovative dementia care: telecare (PDF 1.3MB) - Dr Penny Hibberd
This presentation describes a project which was designed to test two telecare products within the dementia care environment.The first test was the use of biometric locks in a care home setting to see if they provide an enabling environment for residents. The second test was the use of ‘Freedom ‘SOS’ Fone’ with people with dementia who are living independently or with a family carer in the community. This device, which can make SOS contact with carers and/or emergency services, has the potential to aid an independent lifestyle for people with dementia who enjoy an outdoor lifestyle (dog walking, cycling, hiking, shopping).

I’m still here; using Montessori methods, the built environment and emotional intelligence to connect with people who have dementia (PDF 507KB) - Natalie Yates-Bolton
This presentation explores the findings of a Florence Nightingale Foundation Travel scholarship study tour undertaken in the USA, which was undertaken in response to the UK guidance to reduce the inappropriate use of anti-psychotic medication for people with dementia. The study used an ethnographic observational approach, where the observer spent time with the residents of six specialist assisted living centres in the USA which implemented an approach called ‘I’m Still Here’ (Zeisel, 2010); which is a multi-factoral approach to optimising the quality of life of people at all stages of dementia.
The three aspects of the ‘I’m Still Here’ approach that were studied were  a) the use of Montessori based activities for people with dementia, b)attention to the impact of the built environment on people with dementia and c) the impact of emotional intelligence in relationships with people who have dementia.

Reference: Zeisel J.(2010) I’m Still Here: A breakthrough approach to understanding someone living with Alzheimer’s. USA: Piatkus.

The introduction and development of champions in person centre dementia care within the states of Jersey, Health and Social Services Department. ‘Yesterday, Today, Tomorrow’ (PDF 1.16MB)  -  Rachel McBride with Elaine Jackson and Mo Boersma
This presentation describes the work undertaken by the Champions Group in Person-Centred Dementia Care within the States of Jersey Health and Social Services Department, demonstrating how the project work fits with current local and national policy around dementia care. The presentation discussing challenges and successes faced throughout the Project to date.

Workshop session: Understanding behaviour that challenges in dementia  ‘A model for practice’ … (PDF 722KB) -  Lesley Jones
This presentation demonstrates how a model was developed utilising a needs led approach to exploring behaviours that challenge and how the approach was implemented into practice within an NHS assessment ward for people with dementia. Supported by evidence from practice it discussed:
• the challenges that have been overcome in embedding this approach within the ward
• how the care teams view of behaviour that challenges was in itself challenged
• how the approach has enabled a greater understanding of the person, promoted person centred care, informed care practices, increased staff knowledge, reduced incidents and enabled complex discharges.

A retrospective case note audit of patients from nursing and residential homes dying with dementia in hospital (PDF 495KB) - Karen Waters
This presentation focuses on the findings of a retrospective case note audit of elderly nursing or care home residents with a diagnosis of dementia who died in acute wards of a large teaching hospital in England. The findings suggest that end stage dementia could be better recognised and questions are raised about appropriate end of life care in patients dying with dementia in the acute setting. Progress in the implementation of recommendations for practice is explored, including the role of Advanced Nurse Practitioners and the use of a scale to communicate severity of dementia.

Falls prevention focus

The FallSafe Project: Using a care bundle to reduce inpatient falls (PDF 1.25MB) - Frances Healey
This presentation describes a project which involved supporting specially trained FallSafe nurses to consistently and routinely deliver the assessments and interventions seen in the most successful research trials of fall prevention through a care bundle approach. The presentation aimed to equip delegates to replicate the FallSafe approach through providing them with an understanding of:

‘Falling Standards, Broken Promises’. National audit of falls and bone health in older people 2010. Challenges and potential solutions to reducing falls and fractures across the pathway (PDF 1.1MB) - Rachel King with Janet Husk, Jonathan Treml and Derek Lowe
This presentation discusses the national audit which highlights complexities and challenges of working the falls and fracture prevention pathway across primary and secondary care interfaces, and integrating both falls and bone health agendas within health and social care. It aimed to help participants: