My first day. Visited the Dementia unit in Sussex Partnership NHS Foundation Trust to see PARO for the first time. Really exciting – I was instantly drawn to it’s eye movements and the way it reacted to me when I stroked it. I believe it had a therapeutic effect on me because I felt relaxed and watching it put a smile on my face! It was also nice seeing how the other members of staff acted around it. It was like having a pet in the room everyone was smiling and saying how cute it is.
Observed a ward round where different members of the multidisciplinary team (psychiatrist, specialist pharmacist, nurse, occupational therapist and assistant manager) worked together as a team. They decide the best plan for different patients starting from their medication to whether it’s okay to discharge them. This ward round was different to ones I had seen before because it didn’t involve going around the ward to talk to patients. In addition, as we went through the list of individual patients in all of them it was either the family member, nurse or social worker that was there to represent the patient and not the patient themselves. This to me was an invaluable insight into how things work in a dementia care setting.
Attended a meeting with the Care Home in Reach team. The team’s role is to provide advice, information and training for care homes that provide care to older people.
Shadowed a specialist pharmacist. Patients with severe dementia often are given drugs to manage their behaviour like agitation and aggression. Therapeutic measures that involve activities like music and colouring would be better because these drugs come with side effects leading to more drugs being prescribed in order to treat these side effects. I thought – this is where PARO could come in: a non-pharmacological intervention, no unpleasant side effects to it, some people may not be into colouring or music so PARO could be a good alternative to that.
Visited a nursing home and I had the chance to listen to some training that was going on about how to communicate to people with dementia.
Observed the pharmacist do a medication review of the patients in the home. I was amazed by the vast amount of medication all the patients were on.
Day 2(26/06/2015) at Dementia unit.
Met with the research team (Dr Dodds, a clinical psychologist, two occupational therapists (OTs) and a Masters student). We discussed who I would interview and how.
Observed one of the OT interact with a resident using PARO. I could see an immediate positive reaction as the resident stroked PARO and talked to him. This lady was once a health visitor and was gentle with PARO. She sometimes had a doll to care for. Another lady was quite restless but happy to have PARO on her lap. Another lady was asleep but woke up and was happy to receive PARO with her arm outstretched. She talked about her cat being “cat with colours” but found PARO heavy so she gave him back.
Met with my supervisor Prof Rusted and my mentor Molly discussed how I would achieve my thematic analysis. Later that day, attended JRA launch where I had the opportunity to meet and talk other JRA students and learn about the projects they were doing.
Went to a second Dementia Unit with OT to have a PARO session with the residents there. Interviewed OT for my PARO project. Observed PARO session. The first patient was visually impaired but could hear the sounds that PARO made. She talked about pets and joked that with Paro there was no mess to clear up. Another patient seem very relaxed when holding PARO and she talked to PARO and the other members of the group.
Interviewed 3 more people: the nursing assistant, another OT and a psychology graduate interning at the unit.
Met the OT at Dementia unit for a group session with PARO. We had two patients one male and another female that both showed interest in PARO but none of them were willing to interact with him. Another Patient that was male responded very well to PARO he stroked him and kissed him. It was very touching watching the gentleman interact with PARO you could see the emotion when he was engaging with PARO. He treated him as though PARO was real and he kept say “he’s beautiful”. I was moved to see how happy he was with PARO. It just shows the impact that PARO has on the emotional states of people. Had a one to one session with a patient who had hearing loss. This lady is usually alone in her room and doesn’t go out that much. We communicated to her through writing and signs. She responded very positively stroking PARO and we had conversation about pets. She was very happy that we came to see her. The next patient used to be a and was more interested in the technology side of PARO. He kept asking questions about how and where it’s made. Even though he passed on holding PARO he still found him intriguing. This shows you don’t need to interact directly with PARO in order for it to have its effect on increasing social interactions. I noticed that when PARO was brought to the lounge it became a common topic of conversation between both staff and residents. The lounge became a bit livelier with more people talking to each other; it was nice to see that.
Went to Dementia unit and spent the day with masters student and we worked on thematic analysis of the interviews that I had transcribed and the reflection forms written by the nurse and OTs from each PARO session they did. I initially didn’t have any experience of doing a thematic analysis so working with her make made it easy because I was learning from practising it with her. We worked on coding the transcripts and using the codes to develop themes.
Met with Dr.Penny Dodds at Brighton University and I told what I have been doing that week and some interesting themes that were coming out of the thematic analysis. We started the process of creating a mind map and a spread sheet from the codes I had extracted from the interviews and the reflections form done by the OT.
Went to Dementia Unit for another PARO session with patients. Most of the patients who interacted with PARO stroked him. PARO got staff members to talk about him. SO again, the seal helped communication for both patents and care staff in different ways.
We had a JRA get together which involved a speed date, barbecue and quiz. The speed dating isn’t actually dating but more about finding out about what other people’s projects are about. There was lots of drinks and my team lost on the quiz but it was great fun. It was a good opportunity to meet new people and I learnt quite a bit from the quiz.
More thematic analysis work and another group PARO session to observe. Our last patient was deaf so we went to her room and did a one to one session. We wrote down everything for her. She seemed happy to see PARO but didn’t want to hold him saying she doesn’t like to cuddle. We did a lot of laughing and she talked about her love for art and crafts.
Workshop day: It was an early start. Helped Dr Dodds (Penny) to arrange the place for the workshop. Went to Dementia unit to do my last interview on the OT. The workshop was for a group of practitioners involved in dementia care – people from Derbyshire and Coventry NHS care who were interested in learning more about PARO’s use and wanted to introduce PARO into their care homes. The people from Derbyshire were interested on how they could use PARO to decrease their falls rate at their care home. There was discussions about one of the biggest challenges at the moment of introducing PARO in NHS setting which is Infection Control. And one of the ladies from Derbyshire mentioned how they have lambs and farm animals come in their ward in Derbyshire because the residents there were farmers. At the end of the day the group came up with ideas on how they can move forward and gave their thoughts on what they have learnt and suggestions on how to improve.
Went to Dementia unit but it was busy that day and the OT had to sort out fencing around the facility. I talked with the administrator for a short while. The OT came back and we began the PARO session. At the end of the session I talked to the OT while she filled in a PARO reflection form. She told me what her day is like and what her job involves.
Attend an Alzheimer Society Doctoral Training Centre tea party at Sussex University. I had the chance to meet other students researching on dementia and learn about their projects, and also people who were caring for family members with dementia. Penny brought PARO over and everyone was excited to see it. I got asked lots of questions about it which was good because I knew quite a lot about PARO because I had spent the past weeks living and breathing PARO.
I did a presentation at my supervisor Jenny’s lab meeting. I was so nervous but it went well. I spoke about what PARO is, the research behind it and the process of thematic analysis, how I came up with the codes and the themes that emerged from it. I was given ideas on how I should go about making my poster. This is my last challenge after a summer research experience that gave me a taste of what a career in research is like.