What is being done?

A few years ago a successful bid was made to a nursing award panel to develop a social space on one older adult care wards through the provision of a 1950’s ‘reminiscence pod’. This pod is transportable, so has the flexibility to be moved should the location of the ward change. This pod provides a complete environment set in the 1950’s era with things to see, touch and interact with, which has proven to stimulate an individual’s recall and offers a wider experience to people with a cognitive impairment in the acute hospital setting.

The pod has helped to increase the wellbeing of people with a dementia/cognitive impairment and has provided an environment in which people can socialise during the day including mealtimes. This area has also provided an ideal environment for our work around standard 6 – promoting the contribution of volunteers. We have a befriending project which commenced in October 2012, which utilises volunteers to befriend and provide companionship to people with a dementia/cognitive impairment. The ward bays can be noisy and too distracting, so the reminiscence pod is utilised during befriending visits. A picture/ publicity and feedback about this pod is given below.

Through the trusts dementia work all clinical areas now have red drinking glasses as standard to provide a drinking glass with clear contrast to aid identification and independence. This has proved to make a significant difference to both older adults with sight impairment and those with a cognitive impairment, at very little cost and minimal effort.

In September 2012 the lead nurse for Dementia attended the King’s Funds two day workshop entitled ‘designing Hospital Environments for People with Dementia’. This was an amazing experience and enabled the planning of a project to improve the environment on one older adult admissions ward. The key message from the workshop was the importance of the provision of social spaces for people. In UHB this is a challenge as many day rooms have been taken out of wards. A successful joint bid (UHBristol and NBT) was made via the Bristol Clinical Commissioning Group to the NHS South of England Dementia Challenge 2012 to fund this project.

Work has since completed and has provided the following;

• A Social space brightly decorated with TV/DVD facility (this again has provided a more appropriate space for the befriending service)
• Improved way finding
• Each bay and cubicle doorway painted a different colour – this colour reflected on the kick / push plates on the entry door
• Clear visible ‘dementia’ friendly signage to toilets and bathrooms
• Hand rails to promote safety and minimise falls
• Placement of an additional set of doors so exit easily observed (painted same colour as surrounding walls)

What is new and different?

United Hospitals Bristol NHS Foundation Trust was the first acute trust to introduce a reminiscence pod to an acute in patient environment.

Day rooms have been taken out of many wards, so it has been a challenge to create social space, but it is being well used and appreciated by patients and their visitors.

What difference this seems to be making

The reminiscence pod is well used for patients to sit together at mealtimes, eat and chat. This has aided improved nutrition, hydration (as high risk patients can eat their meals here if they wish to supported by mealtime volunteers) and orientation. It has also provided an ideal area for the befriending scheme and the interactions between volunteers and patients.

Visitors/carers and families are also encouraged to use this space and do so, with many commenting on the value it brings to their loved one e.g. improved recollection of memories, communication and engagement.

The following is an excerpt from an account of an interaction using the reminiscence pod area

“On one occasion Mrs X from the next bed was offered to go to the reminiscence pod area and have a drink and chat with a befriending volunteer. Mrs X felt unsure initially as said she didn’t have anything to say. During the session Mrs X interacted with Mrs Y enjoying a drink and talking about the past. The volunteer used memory cards to start the conversation, however once they started chatting Mrs X starting talking about how she made her daughter’s wedding dress and then the ladies discussed fashion in general”

 

Ward 4 Environmental works

Since the ward has had this work undertaken the feedback from staff has been extremely positive and the area is in use every day. The first weekend that the area was ‘usable’ a gentleman with dementia who had been on the ward for some time who appeared withdrawn and communicated very little was introduced to the social space. The staff reported that access to this area resulted in a complete change in this gentleman’s demeanour. He started talking and laughing with staff and other patients and showed an interest in watching the rugby with one of the other men on the ward. This gentleman used the space every day following until his discharge. The environmental works on this ward have also had a positive impact on staff, in part due to the investment and recognition that work was required to improve the environment for their patients but also the use of colour has had the effect of ‘lifting’ everyone’s mood.