(Lynda, Diploma in Wellness Coaching Skills)
For this assignment I have chosen to research the impact of health and wellness coaching on dementia. This is a long term condition that I hold close to my heart, as I have recently started caring caring for my aunt who has dementia. The aim of the assignment is to look at what support is currently available for dementia patients and how health and wellness coaching can be of help.
Dementia is actually an umbrella term for a range of progressive neurological disorders affecting the brain. According to Dementia UK there are two hundred different types of dementia and the most common being Alzheimers, vascular, Lewy body, frontotemporal and mixed dementia.
Dementia mainly affects people who are older and after the age of 65 the likelihood of developing the disease doubles every five years. The Alzheimers Society reports that there are over 850,000 people in the UK living with dementia and according to NHS England there are around 540,000 dementia carers in England alone. NHS England claim that one in three people will care for a person with dementia at some time in their life. Interestingly, current figures show that only half of them are employed, with the other half being family and friends who adopt the role of primary care giver. Up to 66,000 have had to cut their working hours and 50,000 have had to leave work altogether. There is also an incredible economic cost and it is estimated around £23 billion is spent a year, which is more than the cost of heart disease, stroke and cancer put together. (NHS England)
When a person is diagnosed with dementia they must deal with many major life changes. However, this not only affects the person but also those closest to the person who may be a family member or friend, who adopt the role of primary caregiver. In most cases it is the caregiver that seems to be impacted the most in dealing with the disease. Therefore to only look at care for the person with dementia without looking at the needs of the caregiver is only half the solution. So when looking at health and wellness coaching for the person diagnosed with dementia, consideration for the caregiver must also be given.
According to Carl Margereson and Steve Trenoweth in their book Developing Holistic Care for Long-Term Conditions (2010) input from mental health services has generally been on an ad-hoc basis or reactive with referrals at a time of crisis. The Alzheimers Society also claim that decades of underfunding has also led to a costly and unfair social care system. However, it seems that dementia care has now become a key priority within the NHS and Government with ‘Challenge Dementia 2020’ launched in 2015. The aim was to set out that by 2020 NHS England would be the best country in the world for dementia care and research. (NHS England).
Interestingly, Oxford Health NHS Foundation Trust implemented ‘WHELD’ (Wellbeing and Health for people with dementia). This was a five year wellness programme for care for care home staff based on person centred care, with a non drug approach. The outcome of the findings was that dementia care improved with just an hour of social interaction each week and it also improved the quality of life and reduced agitation with patients.
Along with the NHS there are also social services and charities available to help patients with dementia and their families such as Dementia UK and the Alzheimers Society. However when it comes to health and wellness coaching it seems to be partly integrated into the service that is provided by caregivers such as Admiral nurses. However, what seems noticeable is that in such countries like America, where the healthcare is mostly private there are more independent companies specialising in wellness coaching for dementia. Such companies include ‘Engaging Alzheimers’ and they claim to help with such things as:
– Defining and setting goals for the person with dementia and the caregiver
- Help to better understand the disease
- Creates strategies to minimise symptoms
- Help to design a setting to reduce stress, anxiety, and guilt
- Develops solutions to on-going, dementia-related problems
- Increases caregiver confidence through support, structure and education
There are also companies such as ‘Elder Care at Home’ that specialise in ‘Coaching for Caregivers’ in America which include counselling, guidance and support.
As a wellness coach working with clients and families with dementia in the UK it would seem that they would need to have a clear understanding of the condition and perhaps be a specialist in this area if they are to work in a clinical way. However, it would seem possible as a more general wellness coach to provide specific coaching for the carer. As it is the carer who seems most affected by the condition, a wellness coach could have a positive impact on the carer and consequently how they care for the person with dementia. By providing a non-clinical and non directive approach they are able to help the carer by empowering them to take care of themselves and manage caring for the person with dementia. So in a way it could be said that the carer will then have the resources to ‘coach’ the person with dementia.
In conclusion, dementia is a long term health condition, that not only affects the person diagnosed with the disease but also the primary care giver. In the UK there seems to be a limited amount of individualised care for the carer, however this is becoming more widely recognised by the NHS. NHS England have also started to develop and implement Health Coaching training and programmes within different sectors of the NHS according to the Health Coaching Implementation and Quality Summary Guide (NHS England). However there seems to be a limited amount compared to America for individualised wellness coaching, particularly for carers. It would seem that well-being coaching for dementia, similar to that run by Macmillan Cancer Care (who run a free 6 week remote coaching programme) would be something that would be a great start, especially for those people on a lower income who perhaps cannot afford to have an independent wellness coach.
- Developing Holistic Care for Long-Term Conditions, Carl Margereson and Steve Trenoweth (2010)
- Dementia: assessment, management and support for people living with dementia and their carers, published 20 June 2018, NICE guidelines (9th May 2021).
- Dementia, NHS England (10th May 2021).
- What is a Dementia Coach, Engaging Alzheimers (8th May 2021)
- Eldercare at Home (8th May 2021)
- Dementia UK (10th May 2021)
- Improving wellbeing and health for people with dementia, Oxford Health NHS Foundation Trust (12th May 2021)
- Bristol Dementia Wellbeing Service (10th May 2021)
- Alzheimer’s Society (10th May 2021)