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Dementia appendices
Page contents: Victorian Dementia Advisory Committee Membership | Victorian Dementia Advisory Committee Terms of Reference | The Pathway of Dementia | Summary of Dementia-Care and Support in Victoria 2000 and Beyond Objectives, Actions and Implementation Opportunities
Appendix 1: Victorian Dementia Advisory Committee Membership
Mr Alan Hall, Aged Community and Mental Health, Department of Human Services (Chair)
Ms Dorothy Ayrton, Aged Care Assessment Services
Ms Sandra Davidson, Cognitive Dementia and Memory Services (CDAMS)
Ms Sandy Keppich-Arnold, Psychogeriatric Assessment and Treatment Service
Ms Janet Laverick, Inner East Community Options
Ms Lynette Moore, Alzheimer's Association Victoria
Ms Barbara Potter AM, Carer
Dr Richard Rosewarne, Monash University Aged Mental Health Research
Ms Imas Thompson, Anglican Homes
Dr Mark Yates, Geriatrician
Nominee of Australian Nursing Federation Victoria Branch-Ms Jill Clutterbuck
Nominee of Brotherhood of St Laurence-Ms Sally Ryan
Nominee of the Carers Association Victoria-Ms Maria Bohan
Nominee of the Commonwealth Department of Health and Aged Care-Ms Margaret O'Loughlin
Nominee of Ethnic Communities Council-Mr Hakan Akyol
Nominee of Health Services Union Australia-Ms Kairsty Wilson
Nominee of the Koori HACC Statewide Network Executive-Ms Bess Yarram
Nominee of the Municipal Association of Victoria-Ms Maureen Borghesi
Nominee of the Victorian Divisions of General Practice-Dr Alan Randell
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Appendix 2: Victorian Dementia Advisory Committee Terms of Reference
A Victorian Dementia Advisory Committee is being convened to help the Department of Human Services develop a dementia strategy. The committee will contribute to the development of the Department's policy and program directions by advising on appropriate responses to the care needs of people with dementia and their carers, including:
- Strategies for service delivery that ensures continuity of care.
- Strategies for improving the quality of care.
- Strategies for raising public awareness of dementia and providing community education.
Appendix 3: The Pathway of Dementia
Stage 1: Early Difficulties (Pre-diagnostic Phase)
The person may:
- Forget what they were just asked to do.
- Be confused about where they are.
- Become lost on a familiar route (such as the way to the local shops).
- Have a reduced attention span.
- Become repetitive in conversation.
- Be anxious or suspicious about possessions or the spouse/ carer's behaviour.
Stage 2: The Emergence of Significant Difficulties in Daily Living
The person may:
- Have problems recognising close family and friends.
- Invent stories to fill in blanks
- Have memories that are false.
- Have poor judgement and difficulty in thinking logically.
- Have trouble handling money.
- Experience difficulty in driving a motor vehicle.
- Forget the layout of their home.
Stage 3: Reduced Capacity for Independence
The person may:
- Have difficulty finding the right words in conversation.
- Have ideas (fixed or they are. or account for errors. temporary) that are not real
- Exhibit uncharacteristic mood swings or occasional outbursts of abusive language or violence.
- Wander around their home or away from their home at random.
- Become upset when faced with having to make choices.
- Need constant supervision.
Stage 4: Incapacity and High Dependence on Care
The person:
- Needs complete assistance with eating, toileting and often all personal care.
- May no longer recognise close family.
- May no longer do any of the activities that used to make them happy.
- May no longer talk.
- Probably suffers from the medical complications of dementia.
Source: Department of Human Services 1997, Dementia Care in Victoria: Building a Pathway to Excellence, Melbourne.
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Appendix 4: Summary of Dementia-Care and Support in Victoria 2000 and Beyond
1. Improve the quality of care by promoting measures and initiatives that relate to education and training needs.
| Actions |
Implementation opportunities |
| 1.1 Ensure access to Statewide training by supporting dementia training courses. |
A staged approach involving identifying the available dementia courses, identifying the workforce groups that require training, clarifying care settings and effectively targeting education resources (see 2.6 below). |
| 1.2 Facilitate the continuing availability of dementia related educational resources. |
A staged approach involving identifying current dementia training packages and general dementia education materials, and identifying material most likely to have an impact on educational needs. |
| 1.3 Promote the inclusion of dementia- specific education components in undergraduate and vocational education courses. |
A staged approach involving identifying current dementia-specific education components for undergraduate and vocational education courses across workforce groups, and promoting dementia- specific education. |
| 1.4 Support the establishment and maintenance of a dementia information clearing house. |
Development of the functional scope of a clearing house, and the identification of an appropriate sponsor. |
| 1.5 Expand and maintain the Alzheimer's Association Victoria web site. |
Ongoing cooperation with other web site links (and future web site developments) such as the Department of Human Services, the CDAMS, Aged Care Assessment Services, Psychogeriatric Assessment and Treatment Services and the Better Health Channel. |
| 1.6 Foster the development of cooperative dementia education activities for general practitioners through the Divisions of General Practice and the CDAMS. |
The review of the progress of the CDAMS to consider consistent Statewide principles for linking of general practitioners and the CDAMS in education activities. |
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2. Develop a better coordinated service system to respond to the needs of people with dementia, their carers and their families.
| Actions |
Implementation opportunities |
| 2.1 Review the progress of the CDAMS. |
Development of a framework for an independent review involving consumer/ referral sources and service providers. |
| 2.2 Establish regional liaison positions to develop and implement consistent referral protocols for those agencies that provide specialist information and services to people with dementia and their carers. |
The provision of regional liaison positions aimed at addressing local community needs, with links to a central coordination process to ensure the consistency of approaches and to help address inter- regional issues. |
| 2.3 Establish behavioural support resources to better respond to the needs of carers, families and residential facilities such as supported residential services and boarding houses. |
The augmentation of current dementia support services in metropolitan Melbourne and rural Victoria. |
| 2.4 Encourage general practitioners to use new Medicare Benefit Scheme items to fund the provision of dementia care planning, case conferencing and health assessments. |
For general practices with a significant aged practice population, a process of utilising the opportunities under the Medicare Benefit Scheme changes, for example by using specialist nurses/ support workers made available through either current community service providers (where co- location may occur) or the direct employment by the general practice of a case manager with experience in dementia care. |
| 2.5 Support the ongoing development in acute health care services of good clinical practice, care planning and coordination with community providers for people with dementia, their carers and their families. |
The identification of examples of good practice and initiatives in acute health care facilities which could contribute to ensuring a responsive service environment within the acute sector for people with dementia, through cooperation with appropriate departmental and sector stakeholders. |
| 2.6 Support the development of aged care and palliative care cooperative service responses in the delivery of palliative care services to people with dementia. |
Consideration of dementia- specific educational needs of palliative care staff in varying care settings in the implementation of action 1.1 (education and training needs), and cooperation with Palliative Care Victoria in considering the palliative care educational needs of services that provide care to people with dementia, their carers and their families. |
| 2.7 Develop service responses and resources that address the needs of low incidence and marginalised groups, such as people with Down syndrome and dementia, people with early onset dementia, and people with dementia from the Koorie community, from culturally and linguistically diverse backgrounds, and in rural Victoria |
The identification of issues for, and needs of, low incidence, marginalised groups and people with early stage dementia, and the development of local service work has already occurred to identify barriers to access and the development of appropriate service responses, improved service responses based on the current knowledge and models of best practice could be supported. |
| 2.8 Ensure service responsiveness to people with early stage dementia. |
The identification of support services for general practitioners, counsellors, financial/ legal advisors, specialist diagnostic services and social supports to provide appropriate responses for people with early stage dementia. |
| 2.9 Increase and maintain the availability of flexible social supports. |
The identification of current support services and support needs to help supporting services provide flexible social support. |
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3. Improve access to services for people with dementia, their carers and their families.
| Actions |
Implementation opportunities |
| 3.1 Increase the availability of counselling support services. |
The identification of impediments to the delivery of respite adaptable to people's needs, and the identification of best practice models so services can be supported in developing and establishing local strategies to provide flexible and quality respite care. |
| 3.2 Explore options to increase the availability and flexibility of short- term overnight respite and extended hours respite, and support the provision of respite models that are sensitive to people's needs. |
The identification of appropriate infrastructure to increase the availability of counselling along the entire pathway of dementia, with a beneficial statewide impact. |
4. Improve public awareness of dementia and access to community education and information resources about dementia.
| Actions |
Implementation opportunities |
| 4.1 Support the ongoing availability of dementia- specific information resources |
A staged approach involving identifying the material to be considered and being aware of the need for information along the entire pathway of dementia. |
| 4.2 Cooperate with VicHealth and other relevant agencies to develop common public messages about risk reduction and prevention of vascular dementia. |
A staged approach requiring the ongoing involvement of relevant stakeholders to identify how best to develop and target dementia specific public awareness strategies. |
| 4.3 Provide targeted community education about dementia. |
A staged approach involving identifying information and assistance and how they can be accessed, and making these details available. |
| 4.4 Support Alzheimer's Awareness Week. |
The identification of activities that can be undertaken in support of Alzheimer's Awareness Week. |
5. Maintain a partnership approach to the identification and development of appropriate responses to the needs of people with dementia, their carers and their families.
| Actions |
Implementation opportunities |
| 5.1 Sponsor workshops that highlight good practice in the delivery of services for people with dementia, their carers and their families. |
The development of service delivery topics that provide options to incorporate the needs of a diverse Statewide workforce. |
| 5.2 Provide ongoing support for community consultations about dementia care. |
The development of a framework identifying consultations, participants, techniques, outcomes, feedback, evaluation and links to the ongoing review of the Victorian Dementia Strategy 2000 and Beyond. |
| 5.3 Maintain ongoing review of the Victorian Dementia Strategy 2000 and Beyond. |
The development of a review process that identifies participants, strategy scope and timelines, and the incorporation of consumer consultations. |
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