A Decade Of Walking In Anothers Shoes

News
20 Sep 2018

Dementia educators: Front row (from left) Robyn Naish of West Coast DHB, Dr Susan Gee, lead researcher, Olive Redfern of Whanganui DHB. Back row (from left) Sharyn Creighton, Canterbury DHB, Alan Beasley, Canterbury DHB, Carole Kerr, Nelson Marlborough and national coordinator, Dr Matthew Croucher, Dementia Lead Clinician, South Island Alliance, Paula Hogan, Southern DHB and Sharon Matthews-Smith, Mid Central DHB.

Ten years ago, a local initiative to support rest home staff was introduced to help improve wellbeing and enhance care for residents with dementia. Today, it’s transforming dementia care in residential care facilities and home-based support services throughout the country. Walking in Another’s Shoes, a training programme based on a person-centred approach, aims to inspire and enable aged care staff to adopt different ways of supporting people with dementia.

The idea at the heart of the programme is asking the question – what is it like to walk in the shoes of a person living with dementia? The training runs over eight months, with one workshop each month that involves group work, discussion and role playing; supported by a one-on-one session between the facilitator and the student. Carole Kerr, dementia educator for Nelson Marlborough DHB and the South Island Alliance, says the participants bond as a group and realise that although they work in different places, they are all facing similar issues. “And over time, staff turnover in facilities where carers have completed the training has significantly reduced.”

Olive Redfern, a dementia educator based in Whanganui, educates caregivers, managers and registered health professionals in the programme. Maintaining person-centred care can be challenging in residential care, she says, and Walking in Another’s Shoes is very effective in creating attitudinal change. “It effectively opens up all communication channels to look at every aspect of care – bringing in family, general practice and medical to provide one team – so the person becomes the centre of it all. The programme creates an amazing framework to be able to do that.”

She says feedback has been consistent from caregivers, managers and students in general. “It’s an awesome, well-structured programme, which makes a huge difference to carers’ day-to-day practice. Educating people in Walking in Another’s Shoes is the best job I’ve ever had – I love working with aged residential care staff and seeing the passion they have for the job and the changes they make.”

Belinda Brown, manager of Southanjer Rest Home – a 24 bed dementia unit on the outskirts of Oamaru – says four of her staff completed the course over the past year and another four have recently enrolled. Belinda says she has since noticed improved communication between staff members, and improved interactions with staff and residents who may occasionally have behaviours that can be more challenging to manage. “Staff are able to think on their feet and think outside the box more easily, and I’ve seen improved confidence in how to manage different and/or difficult situations. I’ve also noticed greater contribution and a more positive team culture – in combination with other team culture training – as well as a changing focus of ‘task-orientated’ care to ‘resident well-being-focused’ care. It’s a great initiative and we hope to have all of our staff attend over the next couple of years.”

Dr Matthew Croucher, Clinical Director South Island Dementia Initiative, says most services aspire to best-practice, patient-centred care, but there is a gap when it comes to the ideals of person-centred care. “It’s the difference between finding the very best medicine at the lowest dose for ‘sundowning’ – also known as late-day confusion – versus working out how to best meet the human need that someone is trying to communicate when they try to leave their place of care to ‘go home’ at 4pm every day.

“Walking in Another’s Shoes is the gold standard programme that DHBs have invested in to kick-start an essential improvement in our models of care for people living with dementia. The programme focuses on service delivery to support wellbeing for those with dementia and also supports the South Island Alliance’s focus on person-centred care as a key goal for our region, which is demonstrated in the shared South Island model of care Dementia is Everybody’s Business.”

The programme was originally developed in Canterbury DHB in 2007, and the first cohort of training began the following year. It was soon introduced in other South Island DHBs and picked up by a number of DHBs in the North Island.