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14 August

Carrie’s card game gets staff and patients talking

Carrie Tyler card game
Falls CNS Carrie Tyler (l) and dementia/delirium CNS Chelsie Hearn (r) with Stan the falls skeleton

Falls clinical nurse specialist Carrie Tyler has created a card game that is being used across the hospital to aid the wellbeing of patients with delirium and dementia.

Either, Neither or Both features 100 cards with questions such as ‘Film or Book?’, ‘Comedy or Drama?’ and ‘Crisps or Peanuts?’ printed on them to encourage conversations between staff and patients.

Carrie, who previously made the news with her Tiptree Box activity tables, developed the idea with quality and safety administrator Su Marie and Kerry Hodge, lead pharmacist for falls and frailty.

“The cards are used for situations where staff are with a patient who has been identified as vulnerable because they are experiencing delirium or living with dementia,” said Carrie.

“These patients are in ill-being, which means they’re feeling stressed, isolated, very likely to not eat and drink, to be non-compliant with medication, to fall over, decondition and to have a worse survival rate within the hospital.

“By using some very innocent small talk – asking if the patient prefers roast of mash potatoes, or what would they chose between a day at the beach or a trip to a forest - the time goes by in a very meaningful way with no hostility.

“You are trained to know the value of communication but when it comes to spending time with someone and small talking, I thought this would be a useful tool because the patients would have muscle memory from using the cards. It makes the time with the patients more enjoyable and it stops us accidentally creating a custodial care pattern where you can look quite overbearing if you’ve run out of things to say.

"Eventually the patient will come out of their delirium, go into wellbeing and have a successful, and shorter, admission."

The pocket packs of cards have been funded by Mid Essex Hospitals Charity, with 200 sets costing £360. The team took two days to write the 100 questions, making sure they were age-group appropriate and non-ambiguous.

“I have been very passionate about caring for delirium effectively in the acute setting for a long time," said Carrie. "The cards give patients and staff common ground despite them being in different age groups and having experienced different cultures and upbringings.

“We’ve seen packs on the market costing £25 pounds each, so producing our own has been a far better use of charity money, and each set is reusable and wipeable. I’d like to thank the charity for their support.”

So far the reaction has been incredibly positive.

“Staff and patients have loved it,” added Carrie. “We’ve not had any negative comments. We’re hoping that it will go beyond staff and patients to be used by family groups as sometimes it’s hard to know what to say in an extended visiting time."