Southern Cross Response to Issues Highlighted by Panorama on 3rd December 2007

Southern Cross Healthcare has been developing a very proactive dementia strategy for over three years. This approach teaches nurses, care assistants and managers employed by the group to see the person first and the dementia last.

At the very core of this strategy is person centred care – an approach that vilifies pharmacological interventions unless it is used as a very last resort.

As the UK’s biggest care provider, Consultants in Dementia are employed to advise on dementia care and lead the strategy that we refer to as a Triadic Approach to Dementia Care. Triadic because it consists of three major components:

1. Training, research and development – the only way in which a high level of care can be provided to people with dementia is to train those supporting them, and this may include relatives and carers. In addition, research into alternative interventions and development of such, for example, psychotherapy, will serve to reduce the reliance on medicines.

2. Environment – a person’s environment has a huge impact on his/her behaviour. We therefore ensure the living and leisure environment for people with dementia is conducive to their existing strengths, knowledge, competencies and needs.

3. Holistic, individualised care based on existing knowledge, skills and competence rather than simply need – Southern Cross Healthcare instil the philosophy that people live with the experience of dementia. Each individual is exactly that: a unique, dynamic, ever changing self (Carl Jung). People are encouraged to use existing abilities and care strategies and interventions are based on ability, not need.

Training in dementia care is essential for anybody supporting people with dementia and who live in our care facilities. Southern Cross Healthcare works closely with the Alzheimer’s Society to deliver their Yesterday Today Tomorrow training package.

Whilst medication is sometimes necessitated, Southern Cross Healthcare advocates that this must be part of a whole care approach and as a very last resort. Antipsychotic drugs should only be given to treat psychotic symptoms, and never to manage behaviours that challenge the services.

We wholeheartedly support Professor Ballard’s comments made during the programme. In summary, he reported findings from his research that Antipsychotic drugs have no benefit on behavioural symptoms, have lasting side effects and increase mortality rates. Southern Cross has recently agreed to support Professor Ballard in further research.

Finally, a total lack of adequate training for people supporting those with dementia has led to an over reliance on these medicines for behaviours that challenges the services.

Southern Cross Healthcare leads the way in dementia care. Their message is simple and clear: Dementia care is a specialist area and it must be recognised as such. Once this happens, a greater emphasis will be placed on training and person centred care. Medical interventions will be needed only on an emergency basis. Malignant psychology will be rare, a high quality of care will become the norm.

Dr D J Nightingale
Senior Consultant in Dementia
Southern Cross Healthcare