Story Series: Nykki Hetherton and Clare Squire
Nykki Hetherton, Dementia Clinical Nurse Specialist and Clare Squire, Community Matron both work within South London and Maudsley NHS Trust community mental health services for older adults. Here is their story about how they have supported staff, patients and carers over the pandemic:
"Earlier this year we worked with many people with dementia during the peak of the pandemic at what was an unsettling time. We already have an End of Life Working Party in SLaM that has focused on the needs of our population of people with dementia, and considers areas of care such as improving Advance Care Planning opportunities and ensuring that there is good end of life care if and when people need this.
:Our new focus at the start of the pandemic was not only to consider Advance Care Planning and EOLC for people with dementia but to learn from our experiences in this area and apply this more widely to a population of people under our care, who may have been affected as a result of the pandemic and being positive with Covid-19. We created a lot of online resources for our staff to access to help them feel more confident with this area of care and have also provided a dedicated email address for any queries as well as webinars for people to ask us questions.
"In regards to working with people living with dementia and their carers this has been anxiety provoking, not only for the concern of preventing the spread of the virus, but helping people to understand the need to remain in their homes and not go out as they usually would if possible.
"For our services the majority of clients were advised to shield or classed as vulnerable, and this meant that some relatives were not visiting them as usual. We needed to find new ways of working to ensure the ongoing mental health support for clients and their carers were maintained. Some patients had telephone reviews and in some cases we were able to use technology such as FaceTime or Microsoft Teams to offer virtual appointments. This was limited due to the level of progression of many of the clients we see, and for many some unfamiliarity with the technology. Generally we continued with safe face to face assessment/reviews where possible; wearing clear name badges over the aprons and ensuring everyone was prepared prior to a visit and explaining how this could take place."
Nykki has adopted the use of wearing a uniform tunic when she has been seeing clients in the community to try and help orientate them to the fact that she is a professional visiting them and so easily identifiable as a nurse. This seems to have really helped people especially if they have been isolated without family in attendance. For some people who have been behaviourally challenging with their relatives this seems to have alleviated the distress for the person with dementia. Nykki has also been able to help with relaxing activities such as applying cream to hands and feet.
We also obtained supplies from the Maudsley Charity to try and offer stimulation and distraction activities for people. This included large print puzzle books, playing cards, colouring books and jigsaws and also twiddle muffs. This has been particularly important at times when lots of other face to face statutory and third sector services have not been operating as they usually would, so at times stress for carers has increased as a result of people living with dementia not attending their usual activities.
The most important thing that we think when working with people who have dementia and their carers that everyone should consider is to continue to see that person as an individual, listen actively to them and their carers so that they feel you are supporting them and do what you can to help them feel that they can continue in their caring relationship.
