A Day in the life of an Admiral Nurse

Consultant Admiral Nurse Amy Pepper shares what happens during a typical day and how she helps carers and families affected by dementia

8am

Every day is different and there are times when I have an early appointment to fit in with a carer who perhaps also works, but today I start my day at the office. My schedule is always busy so I like to have a bit of time at the start of the day to plan the coming week.

Today I’m collating some information that I will use in an education session with a carer later today, checking emails and catching up on case notes from a late visit last week.

10am

I’m in the car and on the way to my first visit today – it’s a new assessment so while I’ve spoken to the family by phone I haven’t met them yet. This family were referred to me as the husband has a diagnosis of Lewy Body dementia and he and his wife are struggling to come to terms with the hallucinations this is causing. Both are finding it frightening and the wife has become depressed.

I spend an hour and a half with the couple together, listening to their story and assessing both of their needs. By the end of the appointment we have built a good rapport and have made a plan together for supporting them both with care plans around understanding and coping with the hallucinations, managing low mood for the wife and working on the communication between them to help keep their relationship strong in the face of the dementia.

I leave feeling hopeful for them and with another appointment to see them in two weeks. The wife comments as I leave that this is the first time a professional has considered their needs as a couple since the diagnosis.

12pm

Time for a quick sandwich in the car as I drive to the local Community Mental Health Team. I meet with them and our Social Care Team once a month to discuss the cases where a joined up approach is needed to support families living with dementia.

During this meeting we discuss around 10 cases and make plans for them to get the right support from the right team. These meetings are a really important part of making sure families with dementia receive joined up and seamless care.

2pm

I meet with another carer at home. This is a lady I have been seeing for a couple of months now. Her father has a diagnosis of vascular dementia and she is struggling to support him around some of his more unusual behaviours.

She prefers to meet me on her own, while her father is at the day centre, as she feels she can be more open without him there. She is also experiencing depression and anxiety which make it more difficult for her to learn skills and coping strategies for her caring role.

We start by reviewing some of the exercises I gave her on our last session to help her manage her low mood. We also look at a behaviour chart she has been filling out for her father and use this to try and identify triggers and strategies that might help. I also use some of the information I prepared earlier to help her understand the vascular dementia and the effect it is having on her father.

By the end of the session we have been able to identify some strategies she can try when caring for her father and she is feeling a bit more positive. We make an appointment to see each other again in a few weeks to continue the work we started today.

I remind her that she can call me in between visits if things become difficult – it is important for carers to have a reliable person they can call if things become very difficult.

4pm

I end the day back at the office where I catch up with my Admiral Nurse colleague and we talk about the families we have seen today and I write up my case notes and catch up on emails and phone calls before the end of the day.

Dementia UK runs a national helpline and email service, Admiral Nursing Direct. It is staffed by highly experienced Admiral Nurses and is for family and professional carers, people with dementia and those who are concerned about their memory. Call 0800 888 6678 or email direct@dementiauk.org

Amy Pepper has been a qualified mental health nurse specialising in dementia since 2008. Since then she has worked with people and families living with dementia in a variety of settings including acute mental health, intermediate care, community and general hospital. Amy is currently working within the London Borough of Sutton where she has developed an Admiral Nursing Service, in partnership with Dementia UK, supporting families living with dementia as well as promoting partnership working and best practice across the locality.