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Health Board staff delve into dementia patients’ pasts in new drive to improve hospital care

A new initiative introduced by Betsi Cadwaladr Health Board staff is using the life experiences of patients with dementia to help improve the way they are cared for in hospital.

The ‘Who I Am’ project piloted on Wrexham Maelor Hospital’s Heddfan Older Person’s Mental Health Unit has been credited with improving the mood of patients with dementia and reducing their anxiety and agitation during their hospital stay.

It has proven so successful that it is set to be introduced on Older Person’s Mental Health Units across North Wales, while other health boards in Wales have also expressed interest in using it.

As part of the Who I Am project, Heddfan Unit staff work closely with family members to collect information about a patient’s past in order to gain a better understanding of what that person was like before they developed dementia. This includes information on their personality, career history, music, diet, leisure interests and what is important to them.

The information is then recorded on a two page document which is easily accessible to all staff and is displayed prominently on the patient’s case notes to assist other health or care professionals who may become involved in their care.

Staff then use this information to engage with patients and to tailor therapeutic activities based on their past experiences and interests, helping to reduce levels of anxiety and agitation.

The initiative was founded and created by Lynne Morris, an Occupational Therapy Technical instructor at the Heddfan Unit.

“At the heart of every person is a story, a history of their life and their personal identity,” explained Lynne.

“As people develop impairments and illness this does not mean that they forget their past experiences or achievements.

“We can understand a patient’s current treatment from their medical case notes, but there’s nothing in there to tell us who they are or why they might behave in a certain way. We need to know the person behind the impairment to engage effectively”

“Patients with dementia can typically remember events and experiences from the distant past better than the immediate past, and they can often try and find some meaning in something they have done in the past.

“Finding out what it is from their past that is making them behave in a certain way can help us begin to engage positively with them.

“For example, the family of a recent patient they told us that their loved one was a school headmaster who was happiest when he was marking textbooks. We were able to use this information to start engaging with him positively and finding appropriate activities for him.

“We’ve had family members in tears because they have been so thrilled that we are taking these steps to get to know who their loved ones are.”

Steve Catherall, Occupational Therapist at Heddfan added: “When patients are perceived to be aggressive or challenging they’re actually communicating a need that we don’t always understand.

“Unfortunately, due to the level of impairment, some people with dementia cannot tell us what’s going on. The Who I Am document can assist in encouraging positive engagement with people with advanced dementia in order to reduce their anxiety.”

The initiative has also been introduced for Heddfan Unit patients experiencing anxiety and depression, with similar positive feedback.

Who I Am will be introduced on Older Person’s Mental Health Wards across North Wales in the next few months.

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