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Scenario 3: Guiding your clients and their carers through the dementia journey

Scenario takeaway

  • The dementia journey is complex with many unknowns. Your clients and their carers will ask you for help, guidance and clarity, such as where to go, what to do and how to manage?

  • The PRO helps this by creating the world’s first comprehensive dementia journey including system navigation, care strategies and more

  • It allows you to create individual client and carer profiles and journeys. This way, you can track their progress, guide them on what they need to cover now and what to expect next, and action suggestions instantly, such as Sharing.

Note, you don't need to go through the journey all in one go. People stops and starts over time.

You can watch the video below to learn more.

See transcript here.

Tasks to complete

  1. Think of a recent interaction where a broad question or an unmet  need  that you have identified in an assessment or review. Examples include driving, legal matters, palliative care etc.

  2. Click on the “All info” tab and browse the list of Topics that are relevant to your question or type in keywords to search. For example, “Driving and transport with dementia”, “Future planning: legal matters”, “Palliative and end of life care for people with dementia”, etc.

  3. Glance down the list of Sections to guide you in your questioning or next steps (don't forget to note the relevant Sections into the care plan).

  4. Save the Topic under “View as Drew & Clint” and guide them to these resources and Sections over time by Sharing or Mark Done.

Scenario transcript

Transcript
Background

 

Your client Clint and his wife, carer Drew are overwhelmed by dementia and asked you if they have done everything they could and what they should do next?


They are so scared about the future that they come to you for clarity on what to expect?

 

Such broad question is hard to respond to because the dementia journey can be long and very complex, leaving many professionals overwhelmed and confused on what to do, where to go and how to manage certain challenges?

Introducing the journey

(0 min 19 sec)

My Dementia Companion untangles this journey and has created the world’s first comprehensive dementia journey, which includes system navigation, care strategies and more.


It covers:

  • early stage matters such as diagnosis, understanding dementia, accepting changes, legal and financial planning, 

  • to other matters such as simple techniques to manage at home, driving, caring for carers, communication, the environment, 

  • all different types of change behaviours such as eating difficulties, repetition, wandering, haroding and more

  • to end stage matters such as advanced dementia, palliative care and moving into aged care homes.

Whilst the journey is not linear, almost all people impacted by dementia will experience the majority of these checkpoints.


So without a cure, the only way to live well is to guide Clint and Drew through this journey and empower them with the knowledge and skills to manage challenges.


This is the reablement approach that the Aged Care Quality and Safety Commission promotes.

 

How to use the PRO to help?

(1 min 39 sec)


You can access this dementia journey within the PRO app, by clicking on “All info” and then “Journey”.


This visualises the dementia journey for you To see what’s in each of the checkpoints, you can access them via the “List” view. 


Here you can see the whole journey as a list, with each of the Topics in the middle column as one of the checkpoints on the purple dementia journey, from early stages at the top such as getting a diagnosis and legal matters, to later stage Topic such as palliative care and a dvanced dementia, with all of the changed behaviour and daily challenge Topics at the bottom for easy access.

 

So, to guide Clint and Drew on what they can expect, what they need to do or where to go next, you can click on “View as” and select their profile.


Note, you can create profiles by clicking "+Client & Carer" tab.

Use the list of Topics in the middle column as a checklist for key items they may experience or need through their journey. When you click on the Topic card, Sections that comprise that Topic will appear, also acting as its own journey and checklist for you to guide Clint and Drew, e.g. the journey to get their legal matters sorted.


The counter for each of the Topic shows the number of Sections you have shared via email or Marked as Done when you have gone through it with them.  Blank circles are Sections either not actioned or not relevant, which doesn’t add to the counter.


Note, Sharing and Mark Done is covered off in a separate tutorial.


This allows you to see what you have helped them with in the past, such as Getting a diagnosis, Understanding dementia and Medications. 


It is also very easy to see how the journey is progressing and what remains unactioned by looking down the list for those without a full counter or any counters. So in this example, you can see there are still some steps to go in the financial matters Topics, and healthy living and ageing, and accepting dementia and changes may be the next part of the journey to cover off.

 

You can then click on the Topic and help them prepare.

Additional notes

(3 min 49 sec)

Note:

  • Some of our users actually show the PRO app to their new clients to inform them that they have a powerful tool called the PRO to help guide them through this complex journey. It gives the clients and carers reassurance that their care professionals has the tools they need to help them.

  • You don’t need to go through everything in a Topic because not everything may be relevant. This means that you can go back to simple techniques and check if other items maybe more relevant, such as cooking and managing meals.

  • Another reason why guiding your clients and carers through the dementia journey is very important is because if they have the all the appropriate strategies in place and are empowered with the skills along the way, their chance of developing acute changed behaviours or other challenges is lower

  • You can plan ahead for your clients and their carers and it also helps you work out plans to meet your clients needs whilst offering good evidence of your work for compliance purposes

  • All info in My Dementia Companion is evidence based, quality and up-to-date    because we only curate resources from reputable experts and organisations.

  • It is also important not to try to cover off every Topic and Section in one go. Dementia is a journey and things change. If things are not relevant, you can skip to other prompts down the list as part of person-centred care.

  • Don’t forget you can use the search function to find resources quickly.

  • We only provide you with prompts and do not replace your professional training and judgement. Please review the content and if anything is missing, let us know

  • Clicking on a heading opens or collapses that Section, or click on the “Collapse/     Expand All” button to collapse or open all Sections if you have too many Sections open. This can help you re-orientate yourself within the Topic.

Thank you for tuning in and we are looking forward to continuing to      support      you in the amazing work that you do!

Don’t forget to reach out to us if you have any questions.

Note

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