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Developing your career in dementia care

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Career options fora mental health nurses are likely to expand as the number of people with dementia is predicted to rise. Emma Parsons looks at the skills needed to work in this area and the rewards it can bring.

Mental health nurses who choose to work with patients with dementia will find their career options expanding – the number of sufferers is predicted to top one million by 2025.
Dementia is a progressive illness with symptoms that include memory loss and a decline in reasoning and communication skills. It can include unusual and puzzling behaviour, which families can find hard to cope with. Of the 700,000 sufferers today, a third live in care homes.
A mental health nurse working in a care home for older people who are mentally infirm will give medication, counselling and physical care while building relationships with residents and their families.
‘This job needs people who really care,’ says Andrew Makin, nursing director of the Registered Nursing Homes Association. ‘You need passion to do the job, and with that passion you will thrive.’
Being a mental health nurse provides opportunities to try out the latest thinking in nursing. ‘You can bring a good understanding of delivering not only physical care but also psychologically minded care,’ says Ian Hulatt, mental health adviser at the RCN.
‘You can use interventions that are contemporary and specifically suited to people with dementia, for example programmes to deal with behavioural difficulties. Mental health nurses have a familiarity with any psychiatric medicines that might be needed. They also have the ability to see the person within the illness,’ he adds.
Other vital qualities, according to Mr Hulatt, include ‘good interpersonal skills’
and patience, ‘because a person with dementia can be somewhat challenging’.
‘Empathy and time to talk, tactile skills, patience and kindness are the real skills which work,’ adds Mr Makin.
Mental health nurses work with relatives as well as a team of professionals to plan care for a resident with dementia. ‘The relationship you build up with your client and their significant others helps to drive the optimisation of care. You’re working together as a gang for years, getting to know what works and what’s right,’ says Mr Makin.
The reward is being part of someone’s life: ‘You can say “I’ve made a difference”,’ he adds.
A general nursing qualification is also relevant as, in the later stages of dementia, physical nursing skills come to the fore. Nurses with dual qualifications are in an ideal position.
A registered nurse can do a one-year conversion course to become a mental health nurse. Courses specialising in this branch of nursing often require some experience of working with clients with mental health problems, be that paid or unpaid. Once registered, nurses are qualified to work with children, adults or older people with mental health problems in the community, hospitals or care homes. Next, they could join a community mental health team, as most people with dementia are cared for by these teams.
Qualifying as a mental health nurse is also a good route into management in care homes.
‘Registered mental health nurses will typically be found working at management level in residential dementia care,’ says an Alzheimer’s Society spokesperson.

‘I changed as a person and as a nurse after doing the conversion’

Working with residents with dementia is a challenging and enjoyable career for a mental health nurse, according to Emma Smyth.
Ms Smyth was a general nurse at St Cuthbert’s Nursing Home in Aldingham in the Lake District before taking a conversion course and qualifying as a mental health nurse earlier this year.
‘I changed as a person and as a nurse after doing the conversion,’ she says. ‘It gave me more confidence [and an] in-depth knowledge of medication, assessment and dealing with [challenging] behaviour.’
After the course, it was natural for her to return to the nursing home for older people who are mentally infirm where she had worked for 12-and-a-half years, and she has been promoted to senior staff nurse. The home has 43 clients, all of whom have dementia.
‘Dementia is not seen to be glamorous but I love it,’ she says. ‘It’s enjoyable when you know your residents really well. You get to know their likes and dislikes and build up a rapport with their families.’
Working with relatives and planning care is an important aspect: ‘We make it as personal as possible. We have one lady who loves swimming and she can be quite anxious but in the swimming pool she’s so relaxed. It is very rewarding to see residents calm and enjoying themselves.’
Ms Smyth is passionate about her job. ‘They’ve lived fantastic and full lives and end up with this cruel illness. We’ve got to help make their lives as full as possible.’
To improve residents’ quality of life she says it is important to view events from their perspectives.
‘Someone is coming in and taking your clothes off and doing intimate procedures, like washing you, someone you don’t know because you can’t remember them – the challenge for us is to see it through their eyes and provide them with their dignity, and calm them down to enable them to receive the care they need.’


When it comes to dementia, there is no shortage of courses

University-based centres like Stirling’s Dementia Services Development Centre or the Bradford Dementia Group offer everything from one-day training or bespoke packages for your team, to postgraduate qualifications.
At Stirling you can source trainers to give two-hour talks or take a distance learning MSc in dementia studies.
Charities like the Alzheimer’s Society also offer training. The Alzheimer’s Society’s Introduction to Dementia Care was one of the first nationally accredited courses of its type when it launched two years ago. It has a strong practical element but it also counts towards an academic qualification. The course can only be run in care homes that commission it but the Society aims to launch a distance-learning version in autumn 2008.
The problem is choosing which course to take as dementia training does not have a clear structure – reflecting the absence of clear career routes.
Alan Chapman, associate director of Stirling’s centre, advises that the best training addresses the care home’s culture, not just individual skills, and should help create a ‘bridge’ to the person with dementia. He says: ‘You need to have insight. You’ve got to move past the facts. A lot of courses present facts that are important but that has to be balanced with how workers respond to the person.’


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