A Year in the Life of a Dementia Consultant in Australia
In August 2017, my partner and I said good-bye to family and friends, boarded a plane to Melbourne and started a new life in Australia. I was both excited and very, very anxious. Not only were we living on the other side of the planet at least 24 hours away from everyone, but I was also to start a new position as a ‘Dementia Consultant’ for Dementia Support Australia; and, before one starts any new job, one wonder’s if they are going to be any good at it.
Previously in the UK I had established myself as a dementia trainer and was fortunate enough to be able to run my own company ‘Dementia Inspired’. This provided me the opportunity to work with and help many people around the UK; enabling those living with dementia to both have a voice in their local community and educate others in person-centred dementia care.
Coming into a specialist advisory role, supporting person-centred behaviour management, certainly had its challenges. Essentially, dementia consultants can be sent anywhere around Australia, sometimes within 48 hours for more intense cases, to be on-site in care homes to help both the person living with dementia and those that are caring for them. No easy feat, particularly when one realizes just how large the country is. However, somehow, they manage it.
What were the challenges?
At times, as one colleague recently put it, “you feel like you are trying to solve the impossible”; after all, none of us have magic powers and some cases can be so complex they can require days to observe and interpret behaviour. What Dementia Support Australia does do is provide consultants with this time; to get to know the person, time to speak to family, friends and those who support them 24 hours a day. Over time you build up a picture of the person affected by dementia and how best to assist them and help both reduce their distress and the affect this has on others.
One of the best things about the work is the focus on the person’s social and life history. It truly is an honour to be able to collect this information about people, hearing about all their wonderful stories, events and memories; some traumatic and some inspiring. It is from these life histories that we, as consultants, draw from to create person-centred, easy-to-read recommendation reports to specifically help that person and their carers.
How do we help?
The strategies provided aim to address both the responsive behaviours themselves and the management of them. Our recommendation reports list evidence-based strategies that are designed to help the carers to help the person; whether it be suggesting changes to the environment, engagement programs or the way in which one approaches the person. I often think of my colleagues and I as ‘dementia detectives’ – having to drill down to get the source of the issue and sometimes it can be the simplest of things that need changing.
For example, one gentleman, who will be referred to as Tom, would often become deeply distressed, usually in the afternoons, wanting to go home. A situation I am sure many of us in this line-of work are familiar with. Although Tom had been living in the care home for almost a year he would keep demanding to leave, stating that “there had been a mistake” and that “he wasn’t supposed to be there”. Staff at the home knew Tom very well and had even sourced him a rose bush that he could attend to in the garden, which he would find huge delight in looking after. Still, every afternoon, after taking his nap and leaving his room unaccompanied, staff would find it very hard to reassure and re-direct Tom; who would become panic-stricken and bang on windows and doors. Although staff continued to engage, validate and encourage Tom to rest in his room, he would soon again emerge, more distressed each time.
As a dementia consultant, being able to apply ‘fresh eyes’ to a situation can be extremely helpful. After meeting with Tom in his room, he informed me that it was time for his nap and would I mind leaving? I, of course, obliged and upon opening the door noticed something a little odd. I had been informed that Tom had been living at the care home for almost a year, however, on the back of his door, in bright, contrasting lettering, was a sign stating; “WELCOME TO YOUR NEW HOME!”
Perhaps in the mornings, after being assisted, the carers would escort Tom to breakfast and he may not always read this sign? Perhaps it was only when after his nap that he would have to open the door himself, read the sign and think, ‘What new home?’
It was reported to me recently that the care home in question removed the sign from the door soon after my visit and, almost like magic (but not quite), Tom is much happier and settled in the afternoons and continues to look after his rose bush.
Although twelve months ago I had my reservations about meeting the challenges of the role, I am pleased to say I am thriving as a consultant, being sent to across various parts of Australia and have had the good fortune to work with some truly wonderful and supportive colleagues who have helped me to help people like Tom. Of course, not every case is as straightforward as Tom’s but it goes to show that sometimes it can be the smallest things that really do make the biggest difference.