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Dementia Care: The Adaptive Response

Feb 2013
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A stress reductionist approach

The process of dementia makes the experience of day to day living an acute challenge.  This could be mediated with educated and timely inputs and where the caring contract may be negotiated to preserve both dignity and quality of life. 

The premise of the adaptive response model is that armed with the knowledge of human systems and their ability to adapt and adjust, and with a firm application and emphasis on person centred approaches to dementia care, then the experience can be enhanced, and living with one of the dementias can be made less traumatic.

This holistic approach proposes a method of using environmental and social psychology to maximise function in the individual and to minimise the negative and destructive elements of the perceived and real environment.

Sections include:

  • The biological domain
  • The psychological and social domains
  • Modern contexts of dementia care
  • Stress and adaptive responses
  • Adaptive response
  • Stress
  • Manipulating the social and built environments

The author, Paul T. M. Smith, is Head of Dementia Development for the 5th largest provider of care in the UK and a research fellow at Green Templeton College, Oxford University. He has developed his adaptive response approach as a result of years of 'on the ground’ experience and detailed research and collaborative work with leading academics as well as outstanding service leaders.

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Paul T M Smith

Paul Smith is a qualified nurse with 30 years’ experience. For the last 18 years he has specialised in the study and care of those living with a dementia and has gained graduate and postgraduate qualifications from a number of UK and overseas universities in this subject area. He has also received qualifications in psychotherapy and group psychotherapy and is a master practitioner of neuro- linguistic programming. He has worked across all three sectors of care and, almost uniquely, has worked his way upwards from RMN and CPN to senior nurse roles and into management and senior management and to his current executive status. Paul has worked as head of dementia development and care for the third and fifth largest UK care groups and on DoH projects, national guidelines and is part of the NICE stakeholder contributors pool and was a contributor to the creation of the national dementia pledge and is currently a member of the NHS Institute for Innovation and Improvement – Care Homes project and as head of mental health and dementia for HC-One group is running the FITS and GAS research project – a UK first in partnership with the DoH, the Alzheimer’s society and the University of Worcester.

Occupying executive positions across a number of the UK’s largest care groups, Paul has been able to study the application of various care models across hundreds of care homes, has shared the experiences of thousands of people living with dementia and their families and friends, and has developed award- winning teams and premises over the last 12 years. He has spoken and presented at national conferences and forums, has written and co- authored a number of articles and was a lead chapter contributor – on change management – to the MBA Book of the Year 2006, The New Culture of Activity Therapy for Older People, edited by Dr Tessa Perrin.

On top of all his working commitments Paul was greatly honoured to be a visiting research fellow between 2008 and 2010 at Green Templeton College, Oxford University. Paul was until recently the Head of Mental Health and Dementia for the UK’s newest and third largest care provider, the HC- One Group, where he lead in these areas for 15,500 staff members caring across 248 sites for over 12,500 people.