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Caring for patients with dementia in imaging and radiotherapy

Dementia is defined as a clinical syndrome of cognitive decline that is sufficiently severe to interfere with social or occupational functioning. The largest cause is Alzheimers Disease.

Dementia is common and is increasing with an estimated 0.8 million (or one in three people) over 65 years old living with dementia. Almost all of these patients undergo imaging.

Given that 2.5m people are living with cancer and 50% of these would benefit from radiotherapy, the radiography workforce needs to be able to care effectively for patients with dementia within their department.

The SCoR has produced a specific guidance document containing lots of useful information for radiographers on treating patients with dementia.

Click here to read Caring for People with Dementia: a clinical practice guideline for the radiography workforce (imaging and radiotherapy)

This clinical practice guideline is a comprehensive set of evidence-based recommendations for the whole radiographic workforce caring for people with dementia and their carers when undergoing imaging and/or radiotherapy. It has been developed systematically using the best available evidence from research and expert opinion, including service users, and subjected to peer professional, lay and external review.

The guideline has recommendations for good practice for individual members of the radiographic workforce, service managers, academic institutions and the Society and College of Radiographers (SCoR).

Identification of a person living with dementia within a clinical imaging or radiotherapy setting

There are different types of identification scheme available and local healthcare provider organisations offer specific advice. Alzheimer’s Society have no specific view provided the identification schemes are in the best interests of the person affected by dementia and support the person to have a positive experience in the imaging or radiotherapy department. More information is available in the Alzheimer’s Society Hospital Care Factsheet:

https://www.alzheimers.org.uk/info/20046/help_with_dementia_care/40/hospital_care/2

You must not assume that the person does not have mental capacity because they have been identified by a scheme; especially as capacity is time and decision specific. The person must always be involved in their care as much as possible and as per the principles of the Mental Capacity Act (2005).

Alzheimer’s society appreciate the benefit of communication passports, they advocate the use of ‘This is me’ together with Royal College of Nursing: https://www.alzheimers.org.uk/download/downloads/id/3423/this_is_me.pdf . An identification scheme and communication passport can be used in conjunction where available. Hospital staff should be trained to use communication passports appropriately because they are designed to enhance the person’s experience and person centred care

NICE Guidance Dementia: assessment, management and support for people living with dementia and their carers

NICE guidance is now available online: https://www.nice.org.uk/guidance/ng97  

Sharing knowledge and good practice

Thank you to Nasreen Hussain, Julie Toms, Julie.A.Mills, Emma Warrender, Ann Jones, Cyndie Hunter, Laura Lees, Jenny Jones, Mark Harrison, Joanne Hogarth and Pam Mitchell for feedback. The sharing of good practice followed two study days: Caring for people with dementia in imaging and radiotherapy in 2015 and 2016.

Example actions:

Know who the dementia champions are in your department and talk to them for advice.

Volunteer to be a dementia champion – departments need a team of champions rather than one individual for sustainability in the future.

Dementia champions tell people about your role. Make posters for staff and patient noticeboards and include your contact details. Find details of your trust dementia lead, make contact with them and tell them about your good work.

Feedback any activities that you undertake around dementia work to your colleagues. Tell people what you’ve read on this page and links; share your learning.

Understand the key principles and use this knowledge; evaluate your practice and document if there are any changes you propose to make as evidence of your continued professional development.

Take the opportunity to ensure that new staff and students understand the SCoR clinical practice guidelines for dementia as part of their induction to the department.

Develop or maintain an up to date information pack for carers and patients living with dementia who intend visiting your department.

Resources available for staff training sessions include Guy’s and St.Thomas training video Barbara’s Story

SCoR dementia clinical practice guidelines

E-Learning for health resource (available free to NHS staff and undergraduate students): 

Contact your trust dementia champion or learning and organisational development department for details of local programmes.

Other useful links, publications and fact sheets are listed at the bottom of this web page.

Please share any knowledge and good practice that you have with other members of SCoR. Good practice evolves and we would like to keep information up to date. Tracy O’Regan will collate any examples of practice, updates, guidelines etc. that you think are good to share: please email Tracy. This page was updated on 18 April 2018.

Alzheimer's Society

The Alzheimer’s Society is the UK's leading dementia support and research charity, for anyone affected by any form of dementia in England, Wales and Northern Ireland. They provide information and practical and emotional support to help people live well with dementia, and they invest in world-class research with the ultimate goal of defeating it.

The Alzheimer’s Society also campaigns to improve public understanding of dementia and the devastating impact it can have, and make sure it's taken seriously and acted on by our governments.

Alzheimer Scotland is the leading dementia organisation in Scotland. They campaign for the rights of people with dementia and their families and provide an extensive range of innovative and personalised support services. 

Tim Beanland, Knowledge Manager, Alzheimer’s Society says “if you only read one book about dementia read Tom Kitwood”. Dementia Reconsidered: The Person Comes First (Rethinking Ageing) by Tom Kitwood (1997).

Links and useful publications

“This is me” is a simple and practical tool that people with dementia can use to tell staff about their needs, preferences, likes, dislikes and interests.

How to help people with dementia: A guide for customer-facing staff

Supporting people living with dementia to remain active

Supporting people living with dementia who are experiencing the loss of a loved one

Interesting technology/smart home developments for people living with dementia

NHS Education Scotland: Dementia Informed Practice Level; videos to support staff and students who require the knowledge and skills described

Stickman Communications is a small company run by cartoonist Hannah Ensor. The products use stickmen and simple phrases to break down barriers, challenge preconceptions, promote understanding and acceptance, and enable communication.

Playlist for Life - Personal Music for Dementia

Alzheimer Scotland: Advanced dementia practice model: understanding and transforming advanced dementia and end of life care:

Full report

Executive Summary
 

Helpful fact sheets

Understanding and supporting a person with dementia

Changes in behaviour

Dementia and aggressive behaviour

Communicating

Driving and Dementia

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