Hello

My philosophy in dementia care has always been to treat the person I am involved with as if they were a close relative of mine. What sort of interactions would I want for my relative? How would I like them to be cared for?  The answer that comes to mind is: with compassion, love, understanding, dignity, respect, and recognition. These have been the driving force behind my care of people living with dementia, and the attitudes I hope to impart to my readers.

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I began my career as a nurse training at Royal Prince Alfred Hospital, Sydney followed by Midwifery training at the Royal Women’s Hospital in Melbourne.  If you had told me then that I would spend the majority of my nursing life looking after people with dementia, I would have laughed at you. That was the furthest thing from my mind.

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In the 1980’s, I began looking after confused old men in an open, sixteen-bed ward at Wagga Wagga Base Hospital. There, I first came across the name Alzheimer’s disease when I was reading an article about the Aga Khan’s wife actress Rita Hayward having dementia. I remember thinking sarcastically; “somebody famous gets senile dementia and they give it a fancy name.” 

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I left the hospital to work as a part-time, night duty Registered Nurse in a new aged care facility, the Mary Potter Nursing Home. There, I encountered more people in end stages of dementia, many calling out during the night, and I observed the use of psychotropic drugs to sedate and calm behaviours.

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In 1989, I applied for a job at Baptist Community Services’ (BCS) Caloola Aged Care Hostel in Wagga Wagga. My employment was as a personal care assistant, providing diversional activities for a group of twelve residents living with dementia. This was a new project in an open hostel. There were no locks on the inside of the fifteen exit doors; anyone could walk outside any time of the day or night.

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The full-time diversional therapist and I were sent to Sydney for a five-day course on dementia, and so began my dementia education and interest.  After a year in the project, the diversional therapist resigned and I filled her full-time position for a year before moving on to become the hostel manager for a further five years.

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By the end of that time, nearly half of the residents in the sixty-eight-bed hostel were living with dementia. Numerous changes such as door alarms on the rooms of those likely to wander and the employment of an awake night duty staff member had been implemented.

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In 1996, I wanted part-time work, and obtained a position with the Wagga Wagga Aged Care Assessment Team (ACAT) as the Alzheimer’s Dementia Counsellor. I went to Sydney for training with the Alzheimer’s Association, further updating my knowledge.

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After 12 months, a new full-time position of psycho-geriatric nurse was created in the ACAT, to which I was appointed.

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The local Health Service did not have a psycho-geriatrician in the area and a friend in Sydney suggested that Dr Sid Williams, who was visiting Tamworth as a ‘fly-in’ psycho-geriatrician, may be willing to offer a similar service in Wagga Wagga. So began a very informative working relationship with a wonderful teacher and mentor. Long drives to and from Tumut, Griffith, and other outlying towns provided excellent learning opportunities. To further my knowledge, I completed a Diploma in Psychiatry of Old Age at the NSW Institute of Psychiatry.

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In 1999, I was tempted away from the Psychogeriatric Nurse position to set up a new project with Baptist Community Services (BCS), an in-home respite service for carers of people living with dementia. I spent the next four years working in the community, managing the service, training staff and volunteers, assessing people living with dementia, and assisting their carers to obtain respite.

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During that time, I was also involved in a pilot project: Living with Memory Loss, run by the NSW Alzheimer’s Association and providing a twelve-week education and support program for carers and people living with dementia. After completing a Certificate IV [AE1] in Workplace Training and Assessment in 2001, I began teaching the dementia and palliative care subjects to Aged Care students at Riverina TAFE Institute. 2003 I was headhunted for another pilot project. The Wagga Wagga ACAT Manager asked me to apply for the Clinical Nurse Consultant position with the Dementia Behaviour Assessment and Management Service (DBAMS); now known as Dementia Behaviour Management Assessment Service (DBMAS). There, I led a multidisciplinary team of registered nurses, a social worker and a psychologist who travelled over the (now) Murrumbidgee Local Health District (an area 300 kilometres wide and 600 kilometres long), assessing people living with dementia who presented with behaviours that caused concern to caregivers and staff and providing solutions. We worked closely with Geriatrician Dr. Max Graffen and Psycho-geriatrician Dr. Sid Williams admitting clients to a sixteen-bed assessment unit, Yathong Lodge, where we assisted the staff by providing behaviour management support. My role also involved delivering dementia education to staff in aged care facilities and hospitals throughout the region. In 2014, I completed the University of Tasmania online dementia courses ‘Introduction to Dementia’ and ‘The Arts and Dementia,’ subjects which are part of the Bachelor of Dementia Care. I also wrote two videos scripts Dementia Delirium, and Depression and Behaviours of Concern for VEA. From the 1990s onwards, I have had the privilege of being a speaker in the concurrent sessions at the Australian Alzheimer’s Association (now Dementia Australia) bi-annual conferences, Hammond Care national conferences, the Australian Psychogeriatric Nurses Association conferences, and at the third International Conference of Dementia Services Development Centre (DSDC) at York, UK in September 2009.