Authors (including presenting author) :
Tong MY, Tam YY, Chan OL, Ng YB
Affiliation :
Department of Medicine and Geriatrics, United Christian Hospital
Introduction :
Hospitalization is a great challenge to patients with cognitive impairment. Due to the busy, stressful and unfamiliar nature of the hospital environment, these patients easily undergo distress and prone to present with agitation or even confusion, which often lead to further health complication and prolong the length of stay.
Thus, with the chance of refurbishment of the Geriatric Ward 11A of United Christian Hospital, changes are made to create a Dementia-Friendly Ward to enhance service delivery.
Objectives :
- Establish a therapeutic environment with dementia-friendly elements.
- Develop a dementia-friendly nursing culture among ward staff.
- Enhance care and support for dementia patients and their caregivers.
Methodology :
1) Environment modification
- Create positive and relaxing environment:
a) A wall painting campaign was launched in ward. Ms. Polly Kwong, the drawing teacher of “father of fiber optics” Professor Charles Kao, was invited to kindly provide suggestions and guidance on creation of the cheerful and relaxing drawings throughout the activity.
b) Soft and warm colours are adopted in the ward design.
c) Adjustable and supportive lighting, matt and even coloured flooring to compensate visual deficit of the elderly.
- Enhance orientation:
a) Use of colour zone over different cubicles to support way finding.
b) Time orientation through artificial skylight, traditional calendars and large face clocks.
c) Enlarged signage to improve the legibility.
2) Ward staff dementia-related training
- Training sessions about dementia were delivered to ward staff to enhance their understanding about the disease. Contents included basic pathophysiology, signs and symptoms, possible behavioral and psychological problems of dementia. Scenario discussion and experience sharing among staff allowed them to understand more about the reasons behind the behaviour of these patients, and stimulate them to embrace a different approach to communicate with patients with dementia.
3) Enhance care for patients with dementia
- Allow flexible visiting hours for agitated patients to facilitate their caregivers for accompany and ease their stress.
- Encourage caregivers to bring along some patient’s personal belongings (e.g. photos, small pillow) to create a more homely environment.
- Provide dementia care support to the caregivers. An information corner was set up to provide disease education leaflets and to introduce community resources in the cluster.
Result & Outcome :
Ward 11A has completed the refurbishment at September 2019. Dementia-friendly elements were applied to the ward design. And with the efforts of healthcare givers, patients and volunteers, wall paintings are made over 4 single rooms, geriatric behavioral unit and nursing stations. Positive feedback received from patients and their caregivers, as they all agreed that these dementia-friendly elements are able to enhance orientation, reduce environmental stress and provide them with a better hospitalization experience. 3 identical staff training sessions were held during November-December 2019. Over 90% of ward staff registered as “dementia friends” after the training. All staff agreed that the training provided practical information, which has increased their confidence in providing person-centered care for patient with dementia.
