I am the Aged Care Physiotherapy Team Leader at the Royal Park Campus of the Royal Melbourne Hospital. My team services 84 Geriatric Evaluation and Management (GEM) beds and 12 secure GEM beds.
I was concerned about the information being provided to patients with cognitive impairment and their families about their prognosis (both in terms of mobility and discharge destination). In order to establish the extent of the problem we surveyed the knowledge of all physiotherapy staff across both the acute and subacute sites using The Dementia Knowledge Assessment Tool version 2.
The survey results revealed a significant knowledge gap amongst staff- especially in senior staff working in areas outside of Aged Care that feed directly into GEM (such as General Medicine). Initially we rolled out a physiotherapy inservice, then requested an increase in the undergraduate lecture time allocated to dementia in the Melbourne University Physiotherapy course (now in place). We also created a compulsory first year rotation through GEM for any new Grade 1 physiotherapists.
Beyond the initial physiotherapy interventions we had feedback from the multidisciplinary team that they were experiencing similar problems within their professional groups. From there we developed the full day multi-disciplinary dementia seminar- which was sold out (150 places).
Allied health professionals are now more likely to recognise cognitive impairment. As a consequence it is better managed at both the acute (especially in General Medicine) and subacute sites. Confusing and contradictory messages still occur, but much less frequently.