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An Innovative ApproachtoQuality Dementia Care‘The McCusker Nurse’Copyright Amana Living 2013Karen Malone.RN. BSc.(Nsg.) Post Grad. MHN.Thursday 16th May, 2013
Dementia Carers are StrugglingAbout 300,000 Australians suffer from dementia, most livein the community cared for by their wife, husband or adultchildren totalling 200,000 carers (O‟Dwyer:2013).Struggling dementia Carers consider Suicide: A GriffithUniversity, QLD, study by O‟Dwyer 2013 states:“ one in four people who care for a family memberwith Dementia has considered suicide more than oncein the past year. Many also admitted they were at riskof attempting suicide in the future.”approximately 50,000 carersare/or have considered suicideO’Dwyer: 2013
The Vision From the time a diagnosis is made, the carer of everyperson living with dementia (PLWD) will be allocatedtheir own McCusker Nurse.to reduce Carer burdenclarify dementia services and informationreview options and facilitate referrals
Funded by The Service began as a trial in the North Metropolitanarea of Perth, Western Australia (WA). Funded by “The McCusker Charitable Foundation” for3yrs. Commencing in February and launched in June2010. With additional funding theservice will expand into : other metropolitan area into rural and remote regionsImage 1: http://mccamyyy.files.wordpress.com/2011/08/swan river map1.png?w 300&h 300
About the ServiceAIM:“Reduce carer burden as well as help them toavoid reaching a crisis point by providingexpert advice, information & education inrelation to Dementia Care.Irrespective of what or if they receiveCommonwealth Government Funded Serviceslinking to appropriate services as soon afterdiagnoses as possible.”
OBJECTIVES:Without duplicating an existing Nursing service – provide a free one-stop-shop of information for thecarer facilitate links to Dementia and Aged Care services review Dementia related risk factors of the carer andPLWD
GOAL: empower the carer to enable the PWLD to live athome safe and in familiar surroundings for as long asis practicable minimise premature admission into permanent care reduce hospitalisation
AwardsThe first of its kind in Australia, The McCusker NurseService has received several awards for innovation.These include The “Mental Health Good Outcomes Award 2012” forprevention, promotion and or early intervention Service orProgram (Edith Cowan University, WA) The “Aged & Community Services, WA (ACSWA Award) 2012”for new project innovation and best Practice
Access to McCusker Nurse ServiceThe service is available during business hoursMonday – Friday to informal carers of: PLWD mild cognitive impairment „MCI‟ or seeking adiagnosis The anticipated maximum case load was 100 clients To date 370 clients have accessed the service(June 2010 – May 2013).
3 Phase PromotionPhase 1 Key Stakeholder within the Aged Care and Dementiasector:ACAT AAWA CCRC WA Health and AgingPhase 2 Community Aged Care Providers:Variety of Service providers Day CentresPhase 3 Perth North Metro Medicare Local (GP Network):Practice Managers North of the river
The Service is Uniquely Positioned
Type of Support The type of „Carer Support‟ varies: a general phone call or enquiry home visit(s) face to face contact telephone follow up and more intensive support as situations ariseIt is anticipated after linking the Carer to appropriate servicescontact with McCusker Nurse will reduce.Although a small number of clients may feel the need for ongoingsupport.
ReferralsFromAged Care &DementiaspecificAgenciesHospitalsOsborne ParkSCGHHPH JHCACATRAILS NurseSocial WorkersMemory ClinicsGeriatriciansGP’sCCRCRAS SpecificServicesCarer FamilymembersAAWASupport enceAdvisoryServiceProvidersHACC CACPEACH, EACH-DRetirementLiving
How Clients Learnt About the Service Hospital Social WorkersLocal NewspaperGPFriendMiscellaneous 6%9%9%13%19%Internet: Community: DBMASCarer Groups: CCRC: AAWA ACAT Amana Living Services22%22%
Referral Groups
Assessment Tools - MCSI Modified Caregiver Strain Index: „MCSI‟ McCusker Nurse Satisfaction SurveyMalone: 2012 - Results from McCusker Nurse Satisfaction SurveyThornton & Travis: 2003 – Modified Caregiver Strain Index.
„MCSI‟MCSI is a comprehensive 13 question caregiver assessmenttool self administeredIt measures the level of caregiver burden a consequence ofproviding long term care to a disabled adult.Thornton & Travis: 2003 – Modified Caregiver Strain Index.
„MCSI‟ Question 1: 6mnth follow up Question # 1. My sleep is disturbed: (For example: the person I care for is in and out of bed orwanders at night)Thornton & Travis: 2003 – Modified Caregiver Strain Index.
„MCSI‟ Question 4: 6mnth follow up Question # 4. Caregiving is confining: (For example: helping restricts free time or I cannot govisiting)Thornton & Travis: 2003 – Modified Caregiver Strain Index.
Percentage Changes@ 6/12Dementia progressed, otherhealth issues plus .6.25%30%63.75%Combined Interventions: access toeducation, Support & ServicesThornton & Travis: 2003 – Modified Caregiver Strain Index.
McCusker Nurse Satisfaction SurveyOutcomes:ModeratelyMalone: 2012 - Results from McCusker Nurse Satisfaction Survey
McCusker Nurse Satisfaction SurveySurvey populationSurvey respondents100n 80 Q 3. How satisfied were you with: the Informationprovided?Very SatisfiedModerately Satisfied:Malone: 2012 - Results from McCusker Nurse Satisfaction Survey98.46%1.54%
McCusker Nurse Satisfaction Survey Q 6. Did you feel you were listened to?Very Satisfied:Moderately Satisfied:Malone: 2012 - Results from McCusker Nurse Satisfaction Survey98.43%1.57%
The Biggest difference the McCuskerNurse has made‘Having an understanding earand someone to bounce ideasoff. Feeling understood andsupported’‘A friend to share confidenceswith. In the background yetreadily available with a listeningear’‘Someone to ring and talk to’Malone: 2012 - Results from McCusker Nurse Satisfaction Survey‘The McCusker Nurse was able to support thefamily during a very difficult time withpractical suggestions and care for to the wholefamily as we are all part of thedisease’‘Has helped me to understand theproblems with coping withAlzheimer's’„Guiding me in the right directionto manage the everydayproblems‟
Do you have any Suggestions? More nurses are needed throughout the community. More PR on this service and more McCuskerNurses please!Malone: 2012 - Results from McCusker Nurse Satisfaction Survey
References: References Malone, K, 2010,McCusker Nurse Satisfactions Survey: Amana Living . Version 1: 2012. O’Dwyer, S, 2013,Carers with Dementia Contemplate Suicide, http:// ct,Griffith University QLD, Thornton, M., & Travis, S.S, 2003Analysis of the reliability of the Modified Caregiver Strain Index. The Journal of Gerontology, Series B,Psychological Sciences and Social Sciences, 58(2), p. S129. Image 1: http://mccamyyy.files.wordpress.com/2011/08/swan river map1.png?w 300&h 300
Questions
McCusker Nurse Contact Details: Telephone: Mobile: Email:(08)04179424 6393519253mccuskernurse@amanaliving.com.au Corporate Office: 541 Hay Street Subiaco WA
McCusker Nurse Satisfaction Survey Assessment Tools - MCSI Malone: 2012 - Results from McCusker Nurse Satisfaction Survey Thornton & Travis: 2003 - Modified Caregiver Strain Index. . Malone: 2012 - Results from McCusker Nurse Satisfaction Survey Very Satisfied 98.46% Moderately Satisfied: 1.54% Q 6. Did you feel you were listened to .
