Dr Reema Swarna is passionate about ‘getting it right’ for people with dementia. Under her leadership, the Birmingham and Solihull Mental Health NHS Foundation Trust Memory Assessment Service (MAS) is constantly trying to expand the support available for them, and their families, to live well with dementia.
That may involve reaching out to groups in the local community who might otherwise miss out on the best support and early intervention available or getting more people thinking about dementia and how to soften its impact.
When Reema, who trained in general medicine and neurology and has worked in psychiatry, joined MAS in early 2014 what struck her was the high proportion of English-speaking service users. In an area where half the population are from Black, Asian and Minority Ethnic (BAME) backgrounds, MAS receives just 10% of its referrals from these groups.
Even though MAS staff speak some languages in addition to English, and interpreters are available as well as translation support from family members, it was difficult to engage with older BAME people and assess them.
Reema felt she needed to do something, both to make the service more accessible and to overcome stigma and lack of awareness that could inhibit people from coming forward for help.
She and the rest of the team got together with BAME service users and their families to design, produce and feature in a 30-minute DVD in Urdu for the Hindi population explaining all aspects of dementia, including support available to carers. Sub-titles make it easier to understand for younger family members who have English as a first language, so everyone can watch together.
Even with £10,000 funding from Alzheimer’s Society, resources were stretched, with Reema and her colleagues having to find time for the project in the evening and at weekends. Now they’re sharing the film with the local community, including online through YouTube and GP surgery websites, and promoting it to Asian TV channels. The next step is to translate the soundtrack into Punjabi, Gujarati and Bengali to reach even more people.
The nature and success of this project reflects the constructive and mutually supportive culture of the 20-strong MAS team, says Reema. Her own management style and flexibility in how she engages with individuals helps set the right tone.
This is particularly important at regular MAS team meetings. With 300 referrals coming in every month, clearly the two clinicians on the service can’t see each service user personally. So everyone needs to talk through priorities and discuss care management plans. “Nobody should have inhibitions about contributing. It makes me feel good if we can discuss things openly,” says Reema.
She really appreciates the efficiency and willingness of her team, especially secretary Joanne Reidy. “I couldn’t take my ideas forward and do all the things I want to without their backing.”
And she believes what pulls them together as a supportive and committed team, and shapes what they do, is their shared commitment to put service users first.
MAS is constantly adding to the range of support it offers, and Reema works closely with other organisations and individuals who can help people with dementia and their families. For example, she works with Admiral Nurses based in the same building and has been part of a six-week dementia education programme for carers, and has also participated in special carers days.
MAS brings in Alzheimer’s Society dementia advisers to talk to service users and families about all the support available to them, including memory cafés, and has rolled out dementia training to local GPs.
The Next Steps initiative [insert hyperlink to case study] brings together a wide variety of local services to answer questions and deal with concerns from newly diagnosed people and their families.
Reema and her team also take the message more widely with an informal presence in public settings. She has organised dementia awareness events at different community centres across Birmingham and Solihull.
But for a team already busy with clinical work, finding the resources to do all these things means regularly going over and above their job requirements.
Not that Reema views it as a challenge. She’s always looking for new opportunities, particularly when it comes to the potential for preventing or at least postponing dementia.
Because of her experience she’s been invited to lead a research aware team, and has started recruiting people to a specific project on the genetic aspects of early onset dementia.
And she’d like to set up a prevention programme that educates young people about the links between vascular risk factors and dementia, and how, by reducing risk factors such as high blood pressure, poorly controlled diabetes and overweight, and implementing lifestyle changes, there is scope to postpone dementia.
Secrets of success
- Note and act on what you see happening in practice
- Involve service users and families so you meet their needs
- Promote what you do as widely as possible, both formally and informally
- Discuss things openly as a team and value the support you can give each other
- Build relationships with people and organisations with similar aims