**4.2. Community**

Factor 4: Dementia education.

*Effective home support services for people living with dementia provide caregivers/families and clients with educational dementia-based resources and opportunities to attend educational programmes.*

*national dementia care framework, promotes staff education and training in dementia care, and main-*

Effective Restorative Home Support for Older People Living with Dementia and Their Caregivers:…

http://dx.doi.org/10.5772/intechopen.73165

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Enliven was viewed by many clients, caregivers and key stakeholders as a leading provider of home support services. To be a leading provider of restorative home support services for people living with dementia and their caregivers/families; Enliven leadership will need to ensure a strategic vision linking to appropriate policies and resources that facilitate the best services for dementia clients and their caregivers/families. Senior staff will also need to effec-

A number of staff noted that in order for Enliven to strengthen its position as a leading provider of community services to people living with dementia at home, senior management will need to increase expertise in dementia care, and that a specialist dementia-care position could be created to provide training and support for staff, thus building staff capacity. It was also noted by staff that given the limited budget for home support staff training, senior management will need to be innovative in the way they utilise (existing) resources to achieve best practice goals. Staff and key stakeholders discussed the importance of Enliven maintaining relationships with key regional stakeholder organisations, e.g. DHB, MOH, NASC, Alzheimers NZ, community health professionals and community groups. Many staff and key stakeholders remarked that Enliven is well positioned to engage with emerging DHB-facilitated dementia care pathways and to promote integrated community-based services for people living with dementia.

*Home Support Care: Effective home support services for people living with dementia employ home support staff with a positive and respectful attitude towards clients/caregivers and are well-trained in home* 

A majority of clients and caregivers remarked that the qualities and skills of the support worker staff they interacted with was an important feature of the Enliven home support service: for example, the support worker's ability to understand of the client's needs, the manner in which they interacted with the client, their ability to communicate clearly with the client/ caregiver(s), their knowledge of the client (e.g. what the client likes, their past and preferences); alongside the support worker's competency in undertaking various domestic, housekeeping and personal tasks. Effective home support staff also liaise with other home support staff who are working with the client (often through the client logbook), to ensure important client-related information is passed on, and that clients and caregivers are not required to

Restorative Care: Effective home support services for people living with dementia ensure staff

Enliven has a strong tradition of training staff in restorative care principles and there was an acknowledgement from staff that ongoing monitoring of restorative practices was required to uphold the quality of Enliven service provision. Key stakeholders also acknowledged that many aspects of the restorative care model are a feature of the national dementia care framework – although it must be noted that the national framework does not use the terminology

at all levels of the organisation receive education and training in restorative care.

tively share this vision/initiative with Enliven staff at all levels of the organisation.

*tains strong relationships with key regional stakeholder organisations.*

Factor 7: Workforce capability and development.

repeat themselves for every new worker.

'restorative care'.

*support care for people living with dementia and their caregivers.*

Numerous key stakeholders and staff discussed the importance of dementia education for clients and their caregivers/families during all stages of the client's condition. While Alzheimers NZ are the national provider of dementia-related education, there is opportunity for Enliven to work with Alzheimers NZ to expand this service for Enliven clients and their caregivers/ families. A staff member remarked that if Enliven employed its own dementia care specialist, then the organisation would be in a position to deliver dementia education programmes as a component of its integrated dementia care service.

With systematic dementia-care training opportunities, Enliven staff, at all levels of the organisation, would be in a stronger position to provide clients and their caregivers/families with dementia-related information. Staff would also be better positioned to know where to refer clients to for other allied support services.

Factor 5: Comprehensive community-based integrated dementia care services.

*Effective home support services for people living with dementia are integrated into regional DHBinitiated dementia care pathways and are predicated upon clients receiving a specialised Needs Assessment and Service Coordination (NASC) assessment.*

Key stakeholders and Enliven senior managerial staff discussed the importance of people living with dementia receiving a specialised dementia assessment as early into their condition as possible. An early diagnosis of dementia provides the dementia-affected person and their family with an enhanced opportunity to understand the cognitive and behavioural changes that are occurring, and increased opportunities to access available medical and social support services in an integrated manner.

Effective home support services for people living with dementia are (as funding allows) integrated into a comprehensive range of community-based services.

Enliven has developed a range of initiatives to support older adults within the community, including day programmes, walking groups, swimming groups, café conversation groups, men's groups, interactions with church volunteer groups, and home-share care programmes (to name a few). Staff and key stakeholders remarked that these community-based services are formulated to promote restorative-care for client wellbeing through physical and cognitive stimulation, and social connectedness within the community – and that there were opportunities for home support clients to more fully engage with these services.
