Bringing Namaste Care to people with dementia at end of life in residential aged care services

Our project will address the need for a specialised program of care for people with dementia at EOL, by implementing the Namaste Care Program, a structured, non-pharmacological, person-centred group program that provides tailored, multi-sensory activities aimed at improving quality of life. Namaste Care has been specially developed for residents in the advanced stage of dementia, who may become agitated when there is too much stimulation. Namaste Care specifically stimulates a person’s senses to promote comfort and pleasure. Key activities of Namaste Care include options such as gentle face washing and face moisturising, shaving the “old-fashioned way”, hair combing/styling and application of makeup, if desired. Other key activities recommended within the program include hand and foot massage, range of motion exercises, reminiscence activities, interaction with seasonal scents, and other activities tailored to individual recipient preferences when these are known. The program is undertaken in a group setting, and includes family carers, staff and volunteers. The Namaste Care intervention will run for 2 hours, twice per day (am/pm sessions), 7 days a week for the duration of the project (6 months). Namaste Care champions from each service will be responsible for setting up the space and running the daily program. The space is prepared in advance and attention is given to creating a calm, relaxing and welcoming atmosphere. Natural light or low light is provided. Natural aromas are preferred including seasonal scents or an aromatherapy diffuser can be used. Gentle and relaxing sounds or music are used to create an atmosphere rather than providing entertainment. Relaxing visual images e.g. nature images, can be displayed on a screen or the presence of flowers or plants. Residents with advanced dementia are welcomed individually and made comfortable in a recliner chair. A soft blanket is wrapped around them. Pain assessments are undertaken with individual participants at the start of the session and levels of comfort are monitored throughout. A range of multisensory activities (initiated by staff, family or volunteers) are then provided throughout the session: • Expressive touch is used to communicate and connect with the residents, such as gentle face washing and hand massage. • Snacks and beverages are offered to the residents throughout the session so that residents can receive favourite food and drinks, and experience different tastes, textures and sensations. • Significant engagement items or items tailored for individual residents may be incorporated into the session e.g. personalised music, realistic dolls or animals or robotic simulations Towards the end of the session, residents are aroused through a change of music, lighting and aromas. • The Namaste Care Program will be implemented consistent with the implementation protocol for the individual site (developed in Stage 2). • Data will be collected on resident participants receiving the Namaste Care intervention by Namaste Carers running the program. Two documents will be completed by the Namaste carers, these are: the Namaste Care Record Summary and Namaste Care Session record summary. These documents capture the types of activities that the person enjoys (or not), and the observed behaviours of the person receiving care as well as a progress notes on the Namaste Care session. This data will be collected at T2 (week 2), T3 (week 4) and T4 (week 12).