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Both can co-exist with each other. Is it subjective depending on the needs of the family?

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Is there a difference between managing boundaries, and managing expectatons?

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There are many cases that do fit that representation, but many that are more challenging due to other services not understanding the AN role.

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This course has helped me to see that there is a difference between the triadic relationship and relationship centred care although both are linked with the same therapeutic principles.

I think it highlights that as a triadic relationship there is me having a therapeutic relationship with the person with dementia and the carer.

Whilst relationship centred care for me is about ensuring the principles of relationship centred care and Senses Framework are promoted amongst the people living with dementia, their family members and the paid carers within the nursing home, ensure all benefit from that relationship.

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Is a triadic relationship the relationships we have with the differing roles we all have, PLWD, carer, professional etc but RCC the approach that is used

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Similar - ie: values and aims are the same, but getting there very different

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No often our involvement fluctuates - wish is was as simple as the video showed

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Almost, my role is about working with the person living with dementia and their family. So providing /holding the space with warmth and empathy within a therapeutic approach.

I also have professional triadic relationships with GP and nurses.

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RM 4 - IT Systems not streamlined, unable to access information. Time consuming.

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Rm 3 - Challenges of Island living, in terms of rules and policies and 5yr living before being able to access long term care etc.

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The triadic relationship is fluid and mean so many different things, but essentially i feel it can be like a mediator at times, and advocate, a go between and also a source of comfort and reassurance for others.

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Bringing families together in difficult situations. Trying to see the situation through their eyes.

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Complex family dynamics, duplication of work

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Introduction of on line care plans takes far more time; proving care with audits.

More focus on task orientated care takes time away from this

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Two areas:

1. Working as an AN with the person living with dementia (resident) and the family member.

2. Supporting person living with dementia (resident), their family member as well as the paid carers within the home. Ensuring all parties benefit in some way from the relationship

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The use of a ECO MAP i find very beneficial and supports the triadic relationship

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Allied health professionals, GPs, Palliative care, family and voluntary services like Dementia hub

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It means working holistically to stabilise the family and the PWD situation, through education, support, listening and signposting.

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The relationship is key, whether that be in a triadic approach or a multi layered approach.

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Relationship centred implies multiple relationships whereas triadic only implies 3 people are involved.

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Similar but different, I feel relationship centred care feeds into and strengthens the triadic relationship

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all the rships and professionals are not shown in the triadic rship whereas the philosophy of RCC considers this

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RCC talks about all rships, triadic possibly sounds to simplistic now and puts people in a box..

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It would be an ideal representation with no complexities

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No, the video is very simple and positive of interventions. This usually isn't the case. My team doesn't really receive many referrals from GPs either.

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does not demonstrate the complexity of a triadic relationships and the challenges faced

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consider who is the host, admiral nurses may function differently depending on where they work

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The parts of a traditional triadic relationship can shift depending on needs

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person centred care pwd @ heart - different to triadic rship equal weight

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No, for all of us because our roles are different - emphasis on the relationship with the carer rather than the sole focus on the plwd

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RCC is a philosophy

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the cost to people for daytime activities

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many community services have closed for people with dementia so the challenge is meaningful activities

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Triadic by definition suggests a relationship that involves 3 parts/ people / organisations / services whereas relationship centred care can involve many more

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if only it was this easy, peoples needs change

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I think the professional relationship with the Carer and the PLWD begins as triadic and then morphs into relationship centred care

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From a helpline perspective - Generally is a true reflection listening to carer concerns, giving her validation, signposting to opportunities

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its a continuum not problem equals solution

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It's one of many forms and possibly the simplest

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Helpline- sometimes challenging due to usually only speaking to one person, spouse, son, daughter for instance. Advocating for the PLWD. Giving advice or signposting on only one persons side of the story. One off contact.

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Family, drs, sw, gps,solicitors -chaallenges can come if there’s conflict within the family or if a professional does not know the person well

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Often involves family members but can also include other health and social care staff and also solicitors

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professionals, other agencys, care staff,extended families, neighbours,friends, voluntary organisations.

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could be a 4 way or even 5 way rship in some of our settings...

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moving beyond Triadic to multi layered approach to relationships centred approach dynamic process in relationships

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navigating conflict fairly when carers views and perspectives are different

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changes and varies...

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Is triadic the right word?

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delays in treatment and interventions due to lack of knowledge from other professionals

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Often other professionals are involved giving advice they think is helpful but can cause problems down the line

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Relationships with families and carers in the role, however no access to professionals as model of care does not allow for this aspect of the relationship,

Working with complexities, variety relationships around dementia, emotional, physicals, social changes in roles, relationships

Challenges can be relating to funding implications health and social care funding impacting on relationships

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commitment from different professionals

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involving all perspectives

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Families come in all shapes and sizes - can involve neighbours, friends etc

Managing expectations

Challenging myths regarding dementia

Encouraging a bio-psycho-social model of care versus medical

where there is conflict in families can be difficult to manage the here and now and plan for the future

Where multiple co-morbidities exist families & PLWD see multiple Consultants and are often given unrealistic goals and the PLWD given challenging treatments and management plans and their dementia not considered when having consultations

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not just the triadic relationship with the admiral nurse families and carers have to contend with

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Working within a charity organisation can be difficult accessing/speaking to others in the statutory services.

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Family, professional carers, person with dementia, multidisciplinary team. Sometime professionals giving incorrect information or failing to manage expectations which causes family/ person with dementia distress. Can cause break down in trust, particularly when other services have a different view or opinion. Poor communication.

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It can be anyone in the relationship with the carer, other professionals, other family members, but primarily the pwld

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All family members, other services, professional carers - barriers can be expectations, family dynamics, and differences relating to what are considered common goals.

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Lots of agencies involved.

Children living in different areas.

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knowledge - legal and financial support

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It can be complicated! Sometimes too many people can be involved.

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conflict in familes

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expectations

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Managing families expectations

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Having PLWD and Carers on the caseload

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socio economic pressures

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Varies from family to family, person to person, is not static changes as dementia progresses.

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Sometimes the spouse defers to their children

Children have significant differences in opinions

Too many professionals involved and diagnosis of dementia not considered when offering treatment / management

carer often includes multiple carers

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It means balancing communication, managing different needs, ensure everyone feels heard.

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Triadic relationship has challenges depending on service design and operations some there may be no contact with professionals, needing to be clear on roles and boundaries in roles.

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managing complex family dynamics

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families not being near each other, moving away, can't afford to stay near families and loved ones

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Challenges are being able to advise in the moment but not follow up or develop a relationship with individuals

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no recourse to public funds

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carers and families abroad

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Mainly family carers, plwd and us as triadic relationship

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complexity in families

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wider familes

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working together with others with the same priority

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difficult in my current role as service is designed to offer education and training for care home staff

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sometimes no families, external professionals, can be no family, in my case carers in the care home

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AN > PLWD > and family or staff

Challenges: support various staff members - communication often a problem as staff turnover

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other professionals involved - the relationships.

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cascade education

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collaboration

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Kitwood, T. (1997). Dementia Reconsidered: the Person Comes First . Nursing Standard, 12(6), pp.32–32. doi:https://doi.org/10.7748/ns.12.6.32.s44.​

# data[].attributes.attachment_link.title
Person-Centred Dementia Care, Second Edition

# data[].attributes.attachment_link.description
What is person-centred dementia care, and how can it be used to improve care for people from diagnosis to end of life? How can we improve services in people's own homes, in care homes, in supported housing and in hospitals?

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What is Person-Centred Care? - DementiaHub.SG

# data[].attributes.attachment_link.description
Person-centred dementia care aims to enhance the wellbeing of persons living with dementia by meeting their psychological needs.

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BB Relationship Centred Care

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Providing valuable learning opportunities and resources to enhance your expertise as an Admiral Nurse, to support you in your practice and professional development.

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Professionally v Personally