Background People with advanced dementia (PWAD) live with an incurable syndrome leading to difficult physical and mental symptoms (Moens, Higginson & Harding, 2014. J Pain Symptom Manage. 48: 660; Sampson, Candy, Davis, et al., 2018. Palliat Med. 32: 668; James & Jackman, 2017). To alleviate these symptoms people with advanced dementia should receive palliative care tailored to their specific needs (Eisenmann, Golla, Schmidt, et al., 2020. Front Psychiatry. 11:699).
Namaste Care is a multi-component palliative care intervention for PWAD that has improved physical and mental wellbeing among this group (Stacpoole, Hockley, Thompsell, et al., 2014. Int J Geriatr Psychiatry. 30:702; Latham, Brooker, Bray, et al., 2020. Int J Environ Res Public Health. 17:6004 ). Since 2010 we have delivered the only Namaste Care Training (NCT) that is widely accessible to staff in Scotland. NCT prioritises comfort, meaningful activity, and connection and raises awareness that entry into Namaste care should prompt advance care planning (ACP) conversations.
Aims NCT aims to:
Introduce a range of non-pharmacological interventions known to improve physical and mental wellbeing in people with advanced dementia (Anderson, Deng, Anthony, et al., 2017. Crit Care Nurs Clin North Am. 29:519).
Highlight the importance of ACP conversations for people enrolled in Namaste Care.
Methods NCT was developed following literature review and service evaluation. It is subject to continuous improvement based on feedback, post-training evaluation, research, guidance, and national policy. Training includes sessions on identification of needs, non-pharmacological interventions, the promotion of a calm environment and guidance on ACP conversations.
Results Since 2010 NCT has been delivered to a wide range of health and social care professionals (n=350+) both in person and online. Feedback suggests that NCT has:
Empowered staff to take more responsibility for offering individualised non-pharmacological interventions to improve physical and mental wellbeing among people with advanced dementia.
Emphasised the appropriateness of advance care planning conversations for people enrolled in Namaste care.
100% of participants would recommend this training to their colleagues.
Conclusion NCT has offered staff practical ways to enrich and improve experiences of living and dying, producing reported benefits for NCT participants and people with advanced dementia. Although there is an appetite for NCT in Scotland, currently there is limited availability. A more strategic approach is now required and is under discussion.
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