Peter Barron meets a North-East nurse who is leading pioneering changes in the way dementia patients are treated

IT is almost 40 years since Janet Mortimer nervously embarked on a fledgling career as a trainee nurse – but her passion for helping others burns as brightly now as it did then.

Four decades on from those hesitant first steps into a vocational working life, Janet – one of the unsung heroes at the sharp end of the National Health Service – is the driving force behind a pioneering campaign to change how dementia patients are treated.

Janet may be small in stature but it’s clear after an hour in her company at Darlington Memorial Hospital that she’s big-hearted and fiercely determined to make a difference in one of the most challenging areas of the NHS.

And the ground-breaking initiative she’s leading is built on simple principles, not least the effective use of contrasting colours to help patients who are struggling to cope with dementia.

The campaign flickered into life when Janet was working on the hospital’s fifth floor as manager of Ward 52, the focus for acute medicine for older people. Although she enjoyed that phase of her career, she found it heart-breaking to see how distressed dementia patients became in an unfamiliar environment and she was convinced improvements could be made.

The opportunity came a few years ago, when she was invited to become part of the Dementia Collaborative, a team of mental health and social services workers, which had a new focus on “lean thinking”. “If you had an idea, you ran with it,” recalls Janet, still excited at the memory. “If it worked, it worked. If it needed tweaking, it got tweaked. Things started to happen.”

An initial step was to simply change the toilet seats from white to red. The rims around the toilet doors were also painted red, and the impact was immediate.

“For elderly people with dementia or sight problems, it’s hard to differentiate white on white and it was leading to incontinence problems, which are obviously distressing for anyone. But the change of colour made it so much easier for patients to identify the toilets and we saw an immediate drop in cases of incontinence,” Janet recalls.

Bedroom doors were painted blue, while rooms which were off-limits, such as offices, were kept white – the same colour as the walls. Pictures of toilets and beds were added to the doors, instead of word-only signs. A clearer, more colourful era had begun.

Last year, Janet was asked to step up when the elderly care services matron left. It took Janet away from Ward 52 but allowed her to concentrate on expanding the principles of the dementia campaign across the hospital.

“The problem was that dementia patients weren’t only being treated on Ward 52. Medical or surgical conditions bring patients in to different areas of the hospital – but it’s the dementia that causes the most distress,” she explains.

“Therefore, we needed to spread our ideas across the hospital and then standardise the signage across the trust.”

Red-rimmed doors are becoming the norm across the hospitals in the County Durham and Darlington NHS Foundation Trust, although it has since been decided that blue toilet seats are more resilient and cost-effective than red ones.

Although strong progress was being made, Janet still wasn’t satisfied. She entered a “Dragons’ Den” competition, arranged by trust bosses to encourage employees to come up with new initiatives, backed by business plans. Having seen how frustrating it could be for dementia patients not to be able to identify dates, her idea was to develop an “everlasting calendar” that it could be used year after year.

“We had a minute to pitch our ideas to a panel of judges from the trust, in front of a big audience, and I was terrified. I watched the others present their brilliant ideas and I thought I’d be the only one to be rejected. But as I walked to the stage, I said to myself ‘No, my patients deserve this’ and I just went for it.”

Janet pitched for £800 and was about to launch into an angry tirade when she was told by commercial director Tom Hunt: “I don’t think we can give you the £800 you’ve asked for.” But seconds later, she was kissing him on the head when he added: “We think it’s worth double that.”

The idea for everlasting calendars has since evolved into “orientation boards” which come with magnetic pictures, days of the week, months of the year and weather symbols, all of which aid patients’ understanding. The orientation boards, each costing £42 plus VAT, are in use across the trust. Janet made a public appeal for old photographs to be used with the boards and the response has been hugely positive.

Other aspects of the campaign include a finger food menu being piloted at Darlington to remove the stigma from dementia patients, who often forget to use cutlery. There’s also a sensory garden, funded through a grant from Starbucks and run by young volunteers. Janet wants to introduce “therapeutic volunteers” to sit with patients, reminisce with them, play dominoes, read books and keep them company.

All these simple steps add up to significant improvements in the way dementia patients are cared for in the North-East. “If I can make a difference to the life of one patient, that means the world to me,” says Janet.

She has, of course, achieved much more than that. Next year, she will clock up 40 years in nursing and, when her career finally comes to an end, this pocket dynamo of a nurse will be remembered for being at the heart of big changes for the better.

  •  Anyone who wishes to be a therapeutic volunteer can contact Janet on 07824 569369 or at janet.mortimer@nhs.net.