As part of the Queen Silvia Nursing Award’s ambition to capture the stories, challenges, opportunities and realities of working within the elderly people and dementia care sector, we have been honoured to draw upon the experiences of experts within our network throughout six countries.

Attendo is the Nordic’s leading private care provider, and has been a partner of the Queen Silvia Nursing Award Sweden program since 2019. In June 2020 Attendo Finland also announced a commitment to support the scholarship in Finland.

We caught up with Attendo Sweden’s Dementia Competence Owner, Eviyan Attar, for her perspective as a dementia trainer throughout the organization. Eviyan is a Registered Nurse and a Swedish Certified Behavioural and Psychological Symptoms of Dementia (BPSD) Trainer. She addresses her ever-growing passion to share knowledge in dementia and diseases of cognitive decline with her Attendo colleagues; the need for effective team work to assist in symptom control; and the challenges and opportunities that 2020 have presented in the company’s efforts to spread dementia knowledge to any facility with vulnerable populations.

(Previous interviewees from Attendo includes Martin Tivéus, CEO of Attendo Group as well as Virpi Holmqvist, MD of Attendo Finland.)

Eviyan – you have been working with older person and dementia care for quite some time. Could you please give us a little background in your journey to Dementia Competence Owner at Attendo Sweden?

I started my career as a nurse at the Kullens care facility in Ekerö (outside of Stockholm) where I really enjoyed working with team members and patients. In 2013, we adopted the National Quality Registry for Behavioural and Psychological Symptoms of Dementia (BPSD)  as part of our efforts to improve the quality of life for our patients, and provide symptom control. I became the first BPSD Administrator in Ekerö after 2-days of training and began incorporating the system within our daily operations. In 2014, I became a Certified Training in BPSD as well.

“…if you are open, curious, and see that knowledge actually helps your work and – most importantly – helps the people you are assisting, then the opportunities are endless
Eviyan Attar, Dementia Competence Owner, Attendo Sweden (Image credit: Eviyan Attar)

In 2017, when Attendo took over Kullens care facility, my manager gave me the opportunity to really spread my wings and share my knowledge on a wide scale. She encouraged me to share dementia knowledge throughout the entire Swedish Attendo organization, and I took that advice and made that change.

Today I’m responsible for elevating the overall dementia knowledge of our Swedish operations. I’ve travelled and met so many of my wonderful Attendo colleagues throughout the country. I am one of three Certified BPSD Trainer for Attendo in Sweden, and it is such an honor to spread this vital and important knowledge since we are so heavily involved in the care sector.

What is the National Quality Registry for Behavioural and Psychological Symptoms of Dementia (BPSD) Registry in Sweden?

It is well known that dementia disease impairs cognitive functions such as memory, language skills and thinking capacity; but it can also cause behavioural and psychological symptoms (BPSD). This can be expressed with anxiety, agitation, walking around, depression or hallucinations to name a few.

The main objective of Sweden’s BPSD registry is to provide a high quality of care and treatment for patients with BPSD, identify potential causes behind the BPSD, and track pharmaceutical usage. If these steps are done well by care teams, then it may be possible to reduce the prevalence of BPSD in these patients.

How does person-centered care work with the BPSD Registry in Sweden?

We know that the impact of diseases of cognitive decline is extremely individual. The same diagnosis can impact people quite differently. It is very important to take an individualized approach to each and every person within your care. And I have a strong belief that effective BPSD teamwork and strategies help care teams find ways to maintain a higher quality of life for their patients.

The premise behind BPSD is to not only know the patient but also his/her history over time. The team needs to follow and observe the patients carefully so they can map symptoms and changes. It is really an opportunity for care teams to reflect on and find root causes to what might be impacting a patient’s sleeping difficulties, anxiety or aggression, for example.

(Image credit: Attendo Sweden)

It is important to note that BPSD isn’t just about drugs or pharmaceuticals. If, for example, there is a patient with cognitive decline who is experiencing anxiety, you might want to consider long and hard before recommending  antipsychotic medication. Those medications might increase the risk for falls and confusion among other symptoms on top of the anxiety. Nor am I inferring that medication is not required, but if it can be substituted for care and nursing, then this could provide a strong alternative for the patient.

How has dementia training taken place at Attendo since the start of the COVID19 pandemic?

I can tell you that before the coronavirus, the interest within the organization was really growing. My colleagues could see that with more information and engagement, they were able to do a better job at work and develop their skills further. I have also pushed Attendo as well in terms of their investment in company-wide dementia knowledge levels. There are significant wins in terms of our care service, time and satisfaction levels when you lift competence levels; not to mention better life quality and happier patients.

2020 has been a tough year on so many people, especially my colleagues working within care facilities. Right now it is not possible for me to do BPSD training online, so we will revisit that in 2021.

But in the meanwhile, I have a number of activities ongoing including a very exciting pilot project at Attendo Vårdbo äldreboende in Vallentuna where we are trying to develop guidelines for Attendo-wide BPSD protocol.

How do you maintain such a high energy-level and passion for dementia knowledge and training?

I think this has actually deepened and expanded over time! The more I learned, the more my passion grew. I became excited about this new knowledge and wanted to share it with others.

When you don’t know about something, it is hard to get excited about. But if you are open, curious, and see that knowledge actually helps your work and – most importantly – helps the people you are assisting, then the opportunities are endless.

My character is very driven to learn more, do more, give more. I am very lucky to work and live a life where I can help a lot of people – not just patients but even colleagues. I saw an opportunity to help others and make a change for the better, so I went for it.