The Difficult Discharge: How to Navigate

Learning Objectives

Lesson 1 – Introduction and Key Learning Objectives

This lesson outlines the key themes and learning objectives of the course. The structure and content of the following lessons are examined. The learner is also introduced to external factors that negatively affect dementia care and appropriate discharges, such as systemic issues in healthcare and insurance costs.  

On completion of this lesson the learner will:

• Understand the structure, content and learning objectives of the webinar
• Understand external systemic factors that may exacerbate the challenges outlined in the course. 

Lesson 2 – What are Difficult Behaviours?

This lesson explores the key difficult behaviours most commonly displayed by people with a diagnosis of dementia. The methods utilised to treat and manage patients displaying these challenging behaviours in hospital systems are examined alongside explanation of how these can create problems with discharging the patient to more appropriate care. The learner is also presented with an examination about the most common root causes of these behaviours. Strategies effective for minimizing challenging behaviours are also discussed, including advance care planning, medication review and multi disciplinary team involvement. 

On completion of this lesson the learner will:

• Understand the key difficult behaviours displayed by people with a diagnosis of dementia
• Understand the treatments and techniques used in hospitals to manage difficult behaviours, why these are often inappropriate for people with dementia, and how they delay or cause problems with discharge. 
• Know common root causes and triggers of challenging behaviours 
• Know effective strategies and life changes that can minimize the potential for difficult behaviours and in turn risk of hospital admission.

Lesson 3 – Pain and Dementia Only Communities

This lesson examines the role of pain as a trigger for challenging behaviours. Learners are presented with common pain behaviours and expressions displayed by people with dementia. The importance of treating pain and providing adequate analgesia is discussed in the context of avoiding a difficult discharge from hospital. This lesson also explores the role specialist dementia communities can play in challenging behaviour reduction and in turn hospital admissions. The services offered by dementia communities are outlined. 

On completion of the lesson the learner will:

• Understand the role of pain in episodes of difficult behaviours
• Understand how a person with dementia may express pain, and how this may differ from expressions of pain in people without dementia
• Understand the importance of adequate analgesia in managing challenging behaviours
• Know the role of dementia communities and the services offered. 

Lesson 4 – Case study

This lesson presents the learner with a case study, giving the opportunity for application of learning to management of a real life type scenario. 

On completion of this lesson the learner will:

• Be able to apply knowledge, critical thinking and problem solving to manage care of an elder displaying difficult behaviour, and advocate for their needs in regard to achieving discharge from hospital to an appropriate facility. 

Lesson 5 – Conclusion 

In this lesson Dr. Liz summarizes the learning from the previous lessons. Key points from each lesson are reviewed and broad themes relevant to managing and avoiding difficult behaviour and in turn difficult discharge from hospital are examined. 

On completion of this lesson the learner will:

• Consolidate learning from the previous lessons in order to generate further understanding of course content. 

Summary

This webinar explores expression, presentation, cause and management of challenging behaviours in dementia; and how these behaviours when not well managed can result in hospital admissions and subsequent difficult discharge. Learners completing the course will be equipped to manage and avoid this behaviour through efficient care planning management strategies, and advocate for patients requiring discharge from hospital. On completion learners are equipped with key techniques for regulating behaviours, circumventing potential triggers, avoiding hospital admissions and navigating appropriate discharge in the case of unavoidable hospitalisation. 

Learning Objectives

Lesson 1 – Introduction and Key Learning Objectives

This lesson outlines the key themes and learning objectives of the course. The structure and content of the following lessons are examined. The learner is also introduced to external factors that negatively affect dementia care and appropriate discharges, such as systemic issues in healthcare and insurance costs.  

On completion of this lesson the learner will:

• Understand the structure, content and learning objectives of the webinar
• Understand external systemic factors that may exacerbate the challenges outlined in the course. 

Lesson 2 – What are Difficult Behaviours?

This lesson explores the key difficult behaviours most commonly displayed by people with a diagnosis of dementia. The methods utilised to treat and manage patients displaying these challenging behaviours in hospital systems are examined alongside explanation of how these can create problems with discharging the patient to more appropriate care. The learner is also presented with an examination about the most common root causes of these behaviours. Strategies effective for minimizing challenging behaviours are also discussed, including advance care planning, medication review and multi disciplinary team involvement. 

On completion of this lesson the learner will:

• Understand the key difficult behaviours displayed by people with a diagnosis of dementia
• Understand the treatments and techniques used in hospitals to manage difficult behaviours, why these are often inappropriate for people with dementia, and how they delay or cause problems with discharge. 
• Know common root causes and triggers of challenging behaviours 
• Know effective strategies and life changes that can minimize the potential for difficult behaviours and in turn risk of hospital admission.

Lesson 3 – Pain and Dementia Only Communities

This lesson examines the role of pain as a trigger for challenging behaviours. Learners are presented with common pain behaviours and expressions displayed by people with dementia. The importance of treating pain and providing adequate analgesia is discussed in the context of avoiding a difficult discharge from hospital. This lesson also explores the role specialist dementia communities can play in challenging behaviour reduction and in turn hospital admissions. The services offered by dementia communities are outlined. 

On completion of the lesson the learner will:

• Understand the role of pain in episodes of difficult behaviours
• Understand how a person with dementia may express pain, and how this may differ from expressions of pain in people without dementia
• Understand the importance of adequate analgesia in managing challenging behaviours
• Know the role of dementia communities and the services offered. 

Lesson 4 – Case study

This lesson presents the learner with a case study, giving the opportunity for application of learning to management of a real life type scenario. 

On completion of this lesson the learner will:

• Be able to apply knowledge, critical thinking and problem solving to manage care of an elder displaying difficult behaviour, and advocate for their needs in regard to achieving discharge from hospital to an appropriate facility. 

Lesson 5 – Conclusion 

In this lesson Dr. Liz summarizes the learning from the previous lessons. Key points from each lesson are reviewed and broad themes relevant to managing and avoiding difficult behaviour and in turn difficult discharge from hospital are examined. 

On completion of this lesson the learner will:

• Consolidate learning from the previous lessons in order to generate further understanding of course content. 

Summary

This webinar explores expression, presentation, cause and management of challenging behaviours in dementia; and how these behaviours when not well managed can result in hospital admissions and subsequent difficult discharge. Learners completing the course will be equipped to manage and avoid this behaviour through efficient care planning management strategies, and advocate for patients requiring discharge from hospital. On completion learners are equipped with key techniques for regulating behaviours, circumventing potential triggers, avoiding hospital admissions and navigating appropriate discharge in the case of unavoidable hospitalisation. 

Learning Objectives

Lesson 1 – Introduction and Key Learning Objectives

This lesson outlines the key themes and learning objectives of the course. The structure and content of the following lessons are examined. The learner is also introduced to external factors that negatively affect dementia care and appropriate discharges, such as systemic issues in healthcare and insurance costs.  

On completion of this lesson the learner will:

• Understand the structure, content and learning objectives of the webinar
• Understand external systemic factors that may exacerbate the challenges outlined in the course. 

Lesson 2 – What are Difficult Behaviours?

This lesson explores the key difficult behaviours most commonly displayed by people with a diagnosis of dementia. The methods utilised to treat and manage patients displaying these challenging behaviours in hospital systems are examined alongside explanation of how these can create problems with discharging the patient to more appropriate care. The learner is also presented with an examination about the most common root causes of these behaviours. Strategies effective for minimizing challenging behaviours are also discussed, including advance care planning, medication review and multi disciplinary team involvement. 

On completion of this lesson the learner will:

• Understand the key difficult behaviours displayed by people with a diagnosis of dementia
• Understand the treatments and techniques used in hospitals to manage difficult behaviours, why these are often inappropriate for people with dementia, and how they delay or cause problems with discharge. 
• Know common root causes and triggers of challenging behaviours 
• Know effective strategies and life changes that can minimize the potential for difficult behaviours and in turn risk of hospital admission.

Lesson 3 – Pain and Dementia Only Communities

This lesson examines the role of pain as a trigger for challenging behaviours. Learners are presented with common pain behaviours and expressions displayed by people with dementia. The importance of treating pain and providing adequate analgesia is discussed in the context of avoiding a difficult discharge from hospital. This lesson also explores the role specialist dementia communities can play in challenging behaviour reduction and in turn hospital admissions. The services offered by dementia communities are outlined. 

On completion of the lesson the learner will:

• Understand the role of pain in episodes of difficult behaviours
• Understand how a person with dementia may express pain, and how this may differ from expressions of pain in people without dementia
• Understand the importance of adequate analgesia in managing challenging behaviours
• Know the role of dementia communities and the services offered. 

Lesson 4 – Case study

This lesson presents the learner with a case study, giving the opportunity for application of learning to management of a real life type scenario. 

On completion of this lesson the learner will:

• Be able to apply knowledge, critical thinking and problem solving to manage care of an elder displaying difficult behaviour, and advocate for their needs in regard to achieving discharge from hospital to an appropriate facility. 

Lesson 5 – Conclusion 

In this lesson Dr. Liz summarizes the learning from the previous lessons. Key points from each lesson are reviewed and broad themes relevant to managing and avoiding difficult behaviour and in turn difficult discharge from hospital are examined. 

On completion of this lesson the learner will:

• Consolidate learning from the previous lessons in order to generate further understanding of course content. 

Summary

This webinar explores expression, presentation, cause and management of challenging behaviours in dementia; and how these behaviours when not well managed can result in hospital admissions and subsequent difficult discharge. Learners completing the course will be equipped to manage and avoid this behaviour through efficient care planning management strategies, and advocate for patients requiring discharge from hospital. On completion learners are equipped with key techniques for regulating behaviours, circumventing potential triggers, avoiding hospital admissions and navigating appropriate discharge in the case of unavoidable hospitalisation. 

Materials