Rose O’Malley centred care and the environment around people with dementia to reduce medication use and improve wellbeing.
Ever wanted to change the way everyone in your ward treats patients but just been too daunted to tackle the status quo?
Clinical nurse specialist Rose O’Malley transformed how her trust treated patients with dementia, reducing their reliance on medication and improving their wellbeing and care - and she continues to innovate.
Ms O’Malley trained at University Hospitals Coventry and Warwickshire Trust in the 1970s, and started working with older people.
“From my first day, I felt that things would be better if we could spend more time with those patients,” she says.
She has since worked in a nursing home and mental health institutions, and has retained her passion for working with patients with dementia.
“I’d see patients come from hospitals into the home and be on antipsychotic drugs and I’d notice a real difference in the way they were when we weaned them off medication,” she says.
So, on returning to UHCW as a liaison nurse for people with dementia in 2002, she was determined to make a difference.
“Patients were too often given antipsychotic medication and I knew there was another way. We could talk to patients, explain, reassure and give them an activity-centred day that was a positive experience,” she says.
Ms O’Malley encouraged ward staff to be flexible with visiting hours to ensure patients have maximum access to familiar people.
Relatives are offered a drink when they visit because this encourages the patient to see drinking as a social activity, and therefore maintain their hydration. They are also encouraged to eat with the patient.
Ms O’Malley introduced a “getting to know me” form, which helped staff find out patients’ personal interests, hobbies, likes and dislikes.
“Staff started to see positive changes from patient-centred care and spending time with patients and communicating with them,” she says.
Next on her to-do list was changing the environment. She was part of a team that recently transformed a sterile hospital environment into the warm, friendly and appealing Forget Me Not Lounge.
Working with the King’s Fund, they made signs to toilets and other facilities clearer to avoid confusing patients. The Memory Lane corridor shows photographs of Coventry and Warwickshire from the 1940s to the present day; they are hung at a height that is visible from a wheelchair and help anchor patients to times they felt safe.
Ms O’Malley has introduced specialist dementia training including talks, videos and printed materials to help all staff empathise with patients and carers. “Because patients with dementia sometimes come in to orthopaedic or surgical wards, all staff need to be able to relate to them,” she points out.
In addition, cognitive stimulation therapy and activities are run by coordinators. These include craft work, reminiscing about shopping or looking through history books.
“We don’t force anyone to do anything,” she says. “Some people just like to watch - but even then they are keeping their brains active.”
The trust has trained volunteers to support the activity coordinators, spending time reading and participating in crafts with patients who may not have visitors, so they are not bored or lonely but feel part of things.
“Our main role is to stimulate people,” says Ms O’Malley. “To wake them up, make them a hot drink, read the paper together. We can work to provide activities that stop them feeling fretful by making our ward more person friendly.”