Marco’s social prescribing story : Professional training to best support clients with dementia

Marco is a social prescribing link worker who has recently started working in a PCN in London. He shares his insight into the dementia training he has undergone, as well as some tips to enhance professional skills to support clients with dementia.

As a recently appointed social prescribing link worker, Marco has undertaken some mandatory training:

“The National Association of Social prescribers is the only mandatory training at the moment that social prescribers have to do once in post. It is made up of, I think, 10 modules that you have to complete”.

He finds it surprising that:

“There’s nothing about dementia in it. Mandatory training is things like information governance, safeguarding adults, safeguarding children, resuscitation, preventing radicalization, conflict resolution, moving and handling, motivational interviewing, infection prevention and control, health and safety, fire safety, equality, diversity and human rights, and core skills. And that is the mandatory training”.

Marco also finds it alarming that while dementia is so prevalent, there are specific training modules on different populations but not on people with dementia:

“The social prescribing modules that everyone has to do haven’t got a dementia specific one, which I did wonder about because I think well, you’ve got young people, you’ve got armed forces, you’ve got cultural responsive practise, but to mention of dementia, which is huge”.

While mandatory dementia modules are absent, social prescribers can get dementia training if and when they choose to. Given the diversity of clients/referrals they receive, the decision to seek dementia training is often reactive, rather than proactive (i.e., it happens the first time the social prescriber receives a referral for a client with dementia).

The problem is that not all clients with dementia have received an official diagnosis or dementia might not be mentioned in the referral:

“I’ve had a case where I would try and get in contact with this lady quite a few times and she wouldn’t answer. But then she rang me at like 8:00 at night and on the referral, they didn’t mention she had dementia. I don’t think she knew she had dementia. She just she described the symptoms of dementia. It all clicked together, and I thought – oh, she has got dementia!”

Without proper training, Marco finds himself second guessing whether his client has dementia or not:

“It’s very, very hard, especially when people reach a certain stage of their life to know what normal forgetfulness is or what is normal changes in behaviour that come due to age and what is actually a dementia concern. I would say that we’re not particularly well trained to spot that”.

Therefore, Marco feels that there are a number of key areas to be addressed.
The first one is becoming aware about the different types of dementia, its common symptoms and presenting behaviours. In his view, basic training across the board is key, because social prescribers will approach the profession and clients with dementia with different degrees of experience, knowledge, and views on dementia:

“A 90 minute, 2 hour online course, which just kind of takes them through the basics, about how you speak to people who’ve got dementia and how it affects people, just to take a bit of that mystery out of it because, you know, link workers have all sorts of different experience when they come to the role and some may have experience of dementia, their families or whatever else, but some might not really”.

Part of the training should focus on challenges and barriers when working with clients with dementia and how to address these at different stages of the condition:

“Social prescribers often go unprepared to I think it would be really key to include things about what to expect and how to work with someone with dementia across the different stages of dementia. For example, how to approach someone. Because I think the first time that you meet someone with advanced dementia, if you’ve never worked with someone like that before it can be quite challenging”.

One core issue that Marco believes is important is to grasp the range of different experiences clients have about dementia and how to approach clients sensitively based on the degree of acceptance and preparedness they have to accept “dementia support”:

“Before I had my training, I didn’t know how to speak to somebody with dementia. I would take on a dementia referral, call the client and I would just say – hi, I’m calling regarding the dementia of… – I didn’t know that some people don’t want to hear the word dementia”.

Marco also thinks that it would also be helpful for social prescribers to know what the care pathway is once clients get a diagnosis of dementia. This could help them understand the range of resources that are available out there to address clients’ needs at different stages:

“For me, particularly with dementia, it would be to learn what is the pathway from me seeing a GP? This person’s got this and then then what is the pathway from there? How do they reach the conclusion of the diagnosis? And then from the diagnosis? What happens?”

There are some other opportunities for professional development that Marco finds very helpful:

“Refresher training every year, at least, should be done. The way it was done was actually helpful because it involved role play scenarios”.

In fact, Marco strongly supports the idea of learning through “real life” case studies:

“It is nice to have examples of the social prescribing for people who live with dementia. I think it is very helpful to see particular case studies because it just gives you more ideas on how you can talk to patients, how you can carry out your visits, what are the steps and strategies to consider when you are working with a person living with dementia”.

He continues that:

“I would have thought that a training module where you could incorporate a resource with hints and tips and case studies should be available. I think that’s how you could capture all the new social prescribers and potentially have that checklist there as part of that training”.

It was by listening to the stories, experiences, and views of many social prescribers just like Marco that we set off to co-design with stakeholders including people with dementia, caregivers and social prescribers the resource for social prescribers featured on this website.