Treating dementia — a new way of caring for the elderly
Sep 12, 2024
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Duncan McKellar, a psychiatrist and author of a pivotal report that led to a Royal Commission into Aged Care Quality and Safety, shares his insights on elderly care. He emphasizes the importance of understanding patients' life stories to improve their care experience. The conversation reveals emotional struggles families face, the toxic culture in care facilities, and innovative solutions like values-based recruitment. McKellar also discusses creative approaches in dementia care, including a musical inspired by his experiences, showcasing the transformative power of empathy.
Duncan McKellar emphasizes the vital role of understanding individual life stories in enhancing personalized care for elderly patients with dementia.
The establishment of Northgate House showcases how reformed environments can significantly improve emotional well-being and engagement of residents in aged care.
Deep dives
Emotional Connections and Early Memories
Duncan McKellar shares poignant memories of his grandmother, who suffered from dementia, emphasizing the profound bond they had despite her cognitive decline. He recalls that as a child, he did not fully grasp her condition, but felt a deep human connection that motivated him to stay nearby when family members suggested he wait outside. This relationship instilled in him a desire to understand aging and dementia, ultimately leading him to pursue a career in psychiatry focused on geriatric care. The importance of these early experiences illustrates how personal relationships and compassion can shape one's professional path.
The Oakden Report and Systemic Failures
Duncan was involved in the Oakden review, where a shocking discovery was made regarding how vulnerable residents with complex needs were treated at the facility. This institution was criticized for being a place where dehumanization and abuse were rampant, a situation worsened by inadequate staffing and resources. The revelations from this review led not only to the closure of Oakden but also to a broader examination of aged care practices across Australia. This report highlighted the need for a complete paradigm shift in how older individuals with mental health challenges are treated, from seeing them as humans with dignity to mere cases to manage.
Transforming Care Environments
After the Oakden facility's closure, Duncan became instrumental in establishing the Northgate House, aiming to create a more supportive and home-like environment for residents. This transformation involved removing restrictive practices like physical restraints and redesigning spaces to inspire comfort, warmth, and personal connection. As a result, the change in environment had an immediate positive impact on residents, with some finding their voices and motivation to engage again. This emphasizes the critical relationship between physical surroundings and the emotional well-being of individuals in aged care.
The Importance of Individual Stories in Care
Duncan developed the Life Story Project to better understand and connect with each resident, framing care around individual histories and experiences. This initiative has demonstrated that recognizing the personal narratives of residents leads to improved interactions and care strategies, enhancing both their dignity and quality of life. For instance, staff learned to tailor their approach to residents based on their pasts, which significantly helped to alleviate distressing behaviors. Such personalized care highlights the value of empathy and understanding in healthcare, reinforcing the humanity that should be at the forefront of elderly care.
Psychiatrist Duncan McKellar wrote the report that triggered the Royal Commission into Aged Care Quality and Safety. He has seen how care changes when we take someone's life story into account.
Duncan McKellar is a psychiatrist specialising in the care of older people with dementia and serious mental health conditions.
When Duncan first started working with these patients, he was shocked to find elderly people tied to chairs and left in locked rooms.
His advocacy helped trigger the Royal Commission into Aged Care Quality and Safety and he devoted himself to running a very different kind of care facility — one where everyone’s story is understood and respected.
This episode of Conversations discusses aged care, elder abuse, older Australians, aging, Alzheimer's, dementia, aging population, family dynamics, grief.
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