3.2. Explain when it may be necessary to refer to others when supporting individuals with dementia

This guide will help you answer the NCFE CACHE Level 2 Award in Awareness of Dementia 3.2. Explain when it may be necessary to refer to others when supporting individuals with dementia.

Supporting individuals with dementia requires a multifaceted approach. Dementia is a progressive condition affecting memory, thinking, and social abilities. It is really important to understand when it’s necessary to seek help from others. This ensures that individuals with dementia receive the best possible care and support.

Understanding the Role of Various Professionals

Different professionals are involved in dementia care. Knowing when to involve them can make a significant difference. Here are some key roles:

General Practitioners (GPs)

• General Health Issues: If an individual exhibits symptoms that may signify a general health issue, such as recurring infections or sudden weight loss, contact their GP.
• Medication Management: Changes in behaviour might be linked to medication side effects. A GP can review and adjust prescriptions accordingly.
• Diagnosis and Monitoring: Regular assessments can track the progression of dementia. A GP can arrange these tests and interpret the results.

Specialist Nurses

• Complex Medical Needs: Specialist dementia nurses, often referred to as Admiral Nurses, can provide support for complex medical issues.
• Care Planning: They assist in creating detailed care plans tailored to the individual’s needs.
• Education and Support: These nurses educate family members and caregivers about dementia, helping them understand and manage the condition better.

Social Workers

• Social Needs Assessment: If an individual’s social care needs change, a social worker can reassess their situation.
• Safeguarding: They intervene if there are safeguarding concerns, such as financial or physical abuse.
• Support Networks: Social workers can connect individuals and families with local support groups and resources.

Occupational Therapists

• Daily Living Skills: Occupational therapists help individuals maintain independence in everyday activities.
• Environmental Adjustments: They suggest modifications to the home environment that can make it safer and more accessible.
• Adaptive Equipment: These professionals recommend and train individuals to use adaptive equipment that can aid daily living.

Psychologists and Psychiatrists

• Mental Health Concerns: Dementia can often lead to depression, anxiety, or severe behavioural changes. A psychologist or psychiatrist can provide the necessary support.
• Behavioural Interventions: They develop behavioural methods to manage symptoms effectively.
• Therapy and Counselling: Both the individual and their caregivers can benefit from therapeutic interventions to cope with the emotional aspects of dementia.

Physiotherapists

• Mobility Issues: Physiotherapists can help maintain mobility and physical function.
• Exercise Plans: They design exercise routines tailored to the individual’s capabilities and needs.
• Fall Prevention: Important for reducing the risk of falls, which is common in individuals with dementia.

Speech and Language Therapists

• Communication Difficulties: These therapists provide methods to manage and improve communication struggles.
• Swallowing Problems: They assess and recommend interventions for swallowing difficulties, which are common in advanced dementia stages.

Identifying Signs for Referral

Recognising when to seek help is important. Here are situations warranting referral to a specialist:

Changes in Behaviour

• Aggression or Agitation: If an individual becomes increasingly agitated or aggressive, it may indicate unmet needs or pain. Referring to a psychologist or GP can help address these issues.
• Withdrawal: Significant withdrawal from social activities might require the involvement of a social worker or psychologist to understand and manage underlying causes.

Cognitive Decline

• Rapid Decline: Sudden worsening of cognitive functions could signal underlying medical problems. Immediate referral to a GP is necessary.
• Specific Cognitive Changes: For instance, new language difficulties might call for a speech and language therapist’s evaluation.

Physical Health Concerns

• Unexpected Weight Loss: Unexplained weight loss can signify underlying health problems, necessitating a GP referral.
• Mobility Issues: Increased difficulty moving around should be referred to a physiotherapist.

Emotional and Psychological Health

• Signs of Depression: Symptoms like persistent sadness, loss of interest, or changes in sleep might necessitate a referral to a psychologist or psychiatrist.
• Anxiety: High levels of anxiety, especially if they’re affecting day-to-day activities, should be addressed by a mental health professional.

Caregiver Stress

• Caregiver Burnout: Signs of burnout in family caregivers can lead to poor care for the individual with dementia. Referring caregivers to support groups or counselling can mitigate this.
• Respite Care: Sometimes, a social worker might arrange temporary respite care for the caregiver to rest and recuperate.

Procedure for Referral

Knowing the procedure for making a referral is just as important as knowing when to do it. Here are the general steps:

1. Recognise the Need: Identify the signs that indicate a referral is necessary.
2. Consult with the Individual and Family: Discuss concerns and the need for additional support with the individual and their family.
3. Contact the Appropriate Professional: Reach out to the relevant professional, whether it’s through a direct contact number or a formal referral process.
4. Document the Referral: Keep detailed records of the concerns, the rationale for the referral, and any actions taken.
5. Follow Up: Ensure that the referral has been received and acted upon. Follow up on the outcomes and any further necessary steps.

Example answers for unit 3.2. Explain when it may be necessary to refer to others when supporting individuals with dementia

Example 1:
In my role as a care worker, I supported Mr. Johnson, who was in the moderate stages of dementia. Over a few weeks, I noticed he became increasingly agitated and aggressive, especially during personal care routines. Despite using various dementia-friendly techniques, the situation didn’t improve. I referred Mr. Johnson to a psychologist for behavioural therapy. The psychologist developed a tailored intervention plan, which included both cognitive-behavioural strategies and support for the family, significantly reducing his agitation and aggression.

Example 2:
While supporting Mrs. Thompson, I observed sudden weight loss and a noticeable decrease in appetite. Understanding that unexplained weight loss could indicate underlying health issues, I referred her to her GP. The GP conducted a thorough check-up and discovered a thyroid imbalance that was contributing to her symptoms. Appropriate treatment was then provided, which improved her overall health and helped manage her weight better.

Example 3:
During my weekly visits to Mr. Patel, I realised he was struggling with daily tasks such as dressing and using the toilet independently. His mobility had noticeably decreased, and he was at higher risk of falls. I referred him to an occupational therapist, who assessed his daily living skills and suggested adaptive equipment, such as grab rails and a raised toilet seat. These modifications in his home environment were essential in maintaining his independence and safety.

Example 4:
Ms. Green, whom I supported, started showing signs of severe anxiety. She would often express irrational fears and was constantly worried. Realising the necessity to address her mental health, I referred her to a psychiatrist. The psychiatrist evaluated and prescribed anti-anxiety medication and recommended regular counselling sessions. This comprehensive approach helped alleviate her anxiety and improved her quality of life.

Example 5:
Caring for Mr. Wilson, I noticed he was increasingly withdrawn and showed less interest in his favourite activities. He barely communicated and seemed very low. Suspecting depression, I referred him to a psychologist. After several sessions, it became clear that Mr. Wilson was indeed battling depression. The psychologist implemented a therapy plan which included cognitive behavioural therapy and engaging him in social activities. This significantly improved his mood and social engagement.

Example 6:
Mrs. Evans had advanced dementia and began experiencing severe swallowing difficulties, posing a risk for choking and aspiration. I referred her to a speech and language therapist. The therapist conducted a detailed assessment and recommended a modified diet with softer foods and specific swallowing techniques. She also provided training for the family and other caregivers, which greatly reduced the risks associated with her swallowing difficulties.

Final Thoughts

Referring to others when supporting individuals with dementia is important for providing comprehensive care. Understanding the roles of various professionals, recognising signs that indicate the need for referral, and knowing the referral process can ensure that individuals with dementia receive the best possible support. Always keep communication open with individuals and their families to ensure that everyone involved is informed and comfortable with the care plans.