The Edith Ellen work in partnership supporting people with Dementia, one of our Partnerships is with The DMAT team
The DMAT Team have kindly agreed to us using their article Observing People Living with Dementia at Mealtimes which provides a useful download for Observing People with Dementia at Mealtimes.
When I was working as a
dietitian in the NHS one of my roles was visiting people living with dementia
in care homes. The hardest part of my job was getting them to eat! I tried many
interventions over several months, talking to the staff and relatives as well
as the dementia residents in the care homes. Despite putting dietetic
care plans in place many of them continued to lose weight.
I therefore decided to try
a new approach and over a few days I simply sat in the dining room and
observed some mealtimes. I learnt more in these few hours than I had the last
few months working in the care homes. I observed many dementia related eating
difficulties and environmental problems that were contributing to the
person finding it hard to feed themselves and preventing adequate nutritional
intake. Since I did these observations I cannot recommend enough the
benefits of taking a step back from your normal way of working to simply
observe not only the person but the environment the person with dementia finds
themselves in. It is a skill rarely used in very busy caring settings nowadays
but it is a vital skill in dementia care. I think the article by Beth Britton
called ‘Harnessing the power of observation‘ describes the
importance of this skill brilliantly and is really worth a read.
I realised that until these
environmental and behavioural eating difficulties were resolved my dietetic
advice would not be effective. This became my motivation for creating the
first version of the DMAT in 2011. The DMAT works in 3 stages with the first
stage being the observational stage. A carer would use the DMAT ‘Initial
Measurement Form’ to observe a mealtime and record the eating difficulties
observed.
The DMAT Initial Measurement Form is
free to download Please take a look and share with those involved in
the nutritional care of people living with dementia
The DMAT Initial
Measurement Form helps carers to identify which environmental issues and
eating difficulties are preventing the individual from consuming their food.
The DMAT has not undergone psychometric evaluation for validity or reliability
but provides a much needed resource to quickly and easily capture the most
common eating difficulties an individual with dementia may present with.
Feedback from pilot projects of the DMAT suggest it takes 7 minutes to
observe someone at a mealtime and record all the eating difficulties.
Once the carer has gathered
this initial observational information they enter the results into the online
DMAT system which will automatically provide a range of interventions to
choose from. The carer can simply tick the box of the interventions
they wish to implement and the DMAT system will generate a care plan based
on this. The care plan will show which mealtime eating difficulties have
been identified and what interventions are to be implemented to overcome
these difficulties. Everyone caring for the individual will then have a care
plan sheet explaining how to help make that persons mealtime more dementia
friendly.
The aim of the DMAT is to
reduce the amount of mealtime eating difficulties and also improve the
independence of the person at mealtimes. This can help the person feed
themselves for longer and maintain their nutritional status therefore improving
their quality of life.
IMPORTANT PLEASE NOTE –
When using the ‘DMAT Initial Measurement Form’ if you observe any ‘Oral Difficulties
and Behaviours’ that are thought to compromise the safety of an individual
(i.e. you witness signs of aspiration) when eating or drinking, please liaise
with a speech & language therapist (SLT) immediately. If you are unsure of
the warning signs for swallowing difficulties please discuss with a SLT or
refer to your local guidelines and policies before using the DMAT. When
using the online DMAT system you will be reminded about
the importance of not delaying referral to health
professionals for further advice if certain eating difficulties are witnessed.
The DMAT does not try to
replace the advice from a healthcare professional. Nothing can better the
personal advice from an expert tailored
to the individual. Instead the DMAT tries to provide common
sense, practical and cost effective solutions to mealtime problems based
on the available evidence.
*The
DMAT is not a substitute for good clinical care*
No comments:
Post a Comment