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Stories and dementia in Harrogate

Posted Nov 07 2009 10:02pm

Paraorkut.com

I spent the earlier part of this week at the UK Dementia Congress where I had the privilege of presenting the results of a family project: "Collected Short Stories" which I completed recently, with Shaaron Caratella, the exemplary home manager of a Barchester home in south west London, Queens Court.

We did something quite simple in concept: buddied carers with the home's residents and their families to have conversations about the residents' life and times during their 'reminiscence bump' years (age 5 - 25). These exchanges led to their building autobiographical albums for the residents together. 

At the end we formally evaluated the project. All the carers come from different cultures and they have learnt some social and cultural British history and a little geography along the way and this has also helped to improve their relationships with those in their care – and one another. 

Earlier this year, the staff had participated in my REAL Communication workshops which explore reminiscence, empathising, enquiry and active listening in conversation, using the Many Happy Returns 1940s cards as the basis. This recent project has allowed them to practice what they learnt.

The outcomes from Collected Short Stories have been manifold. The residents' sense of value, well being and self-esteem rose and their alertness and sociability has increased. The families' appreciation of their loved ones, the carers and the home has been strengthened. The carers' work enjoyment, motivation and commitment has increased both individually and as a team. 

We also made a number of surprising discoveries about the residents, all of whom have moderate to advanced dementia. One such was a top dog breeder – despite there being no evidence of this either in her room or among her possessions. The family had a large archive of rosettes, certificates, newspaper cuttings from over thirty years of her work stored away, some of which can now be found in her room, as well as in her album that celebrates her achievements and helps her remember. 

The family had simply not understood that their mother's past is possibly more important to her now as her dementia advances. Why should they? People's understanding of dementia and old age is often predicated on the belief of many, articulated by someone to me recently as "oh that's just wrinklies losing their marbles, isn't it?". 

As this normally reticent resident commented to the carer, "you have done really well for me". The carer, who earlier in the project had been worried that asking questions was 'prying' and held that her relationship with residents should be more formal, now describes her relationship with the resident as "... more like being a grand-daughter". And as her confidence in her abilities has grown, so she has become more engaged with the rest of the residents and the staff team as well. 

The resident's daughter commented, "we are never short of conversation now. I really commend the home and Many Happy Returns for doing this – all residents and their families should have one of these books."

In the building of another album, one resident, whose family live some way away and who is intensely private, has been able to clarify earlier confusions in her memory of events in her life, using the pictures and words as triggers. 

As her carer said, to begin with, she was disappointed to be buddied with this resident, who had few pictures of her life and was very withdrawn. But the album has become the source of richer conversations, with illustrations of her life, from images of places and things about which she has spoken. These have also prompted other and deeper memories she had forgotten or had unintentionally misrepresented as a result of her dementia. 

This additional remembering has raised her self-esteem, saying "I really like to look at the book and can remember much better with it". Her relationship with her Caribbean carer has improved to the point where she has invited her to lunch.

Pain can complicate relationships as well as depress, but one team leader reports that when he encouraged one resident with chronic arthritis to reminisce about her life as a younger person, she says her pain"just seems to melt away".

Another pairing has delivered benefits to the family, who realised that they knew very little about their mother's life, growing up in a pub in the East end during the war. For the first time, they went to explore the area, photographed the house and brought it back for her to enjoy. 

"We always talked about our father's life" they said, "it was he who seemed to be the more interesting. But now we have become intrigued by our mother's experiences and this research has changed our relationship with her for the better." This altered dynamic is most evident in the family's interaction when they are gathered together, which is now more connected and meaningful.

As Shaaron commented on the project, "my residents are happier, their families are happier and my staff are happier, so it's win, win!" 

The senior carer said of the training and project, "I am grateful to Many Happy Returns for what you have given to me – tools for life both inside and outside the home – which I will never forget and which no one can ever take away from me."

Finally, let one resident express a most moving outcome, "I feel I am important to people again". More importantly, she is also more important to herself.

Image: paraorkut.com

Paraorkut.com

I spent the earlier part of this week at the UK Dementia Congress where I had the privilege of presenting the results of "Collected Short Stories", a family project I completed recently, with Shaaron Caratella, the exemplary home manager of a Barchester home in south west London, Queens Court.

We did something quite simple in concept: buddied carers with the home's residents and their families to have conversations about the residents' life and times during their 'reminiscence bump' years (age 5 - 25). These exchanges led to their building autobiographical albums for the residents together. 

At the end we formally evaluated the project. All the carers come from different cultures and they have learnt some social and cultural British history and a little geography along the way and this has also helped to improve their relationships with those in their care – and one another. 

Earlier this year, the staff had participated in my REAL Communication workshops which explore reminiscence, empathising, enquiry and active listening in conversation, using the Many Happy Returns 1940s cards as the basis. This recent project has allowed them to practice what they learnt.

The outcomes from Collected Short Stories have been manifold. The residents' sense of value, well being and self-esteem rose and their alertness and sociability has increased. The families' appreciation of their loved ones, the carers and the home has been strengthened. The carers' work enjoyment, motivation and commitment has increased both individually and as a team. 

We also made a number of surprising discoveries about the residents, all of whom have moderate to advanced dementia. One such was a top dog breeder – despite there being no evidence of this either in her room or among her possessions. The family had a large archive of rosettes, certificates, newspaper cuttings from over thirty years of her work stored away, some of which can now be found in her room, as well as in her album that celebrates her achievements and helps her remember. 

The family had simply not understood that their mother's past is possibly more important to her now as her dementia advances. Why should they? People's understanding of dementia and old age is often predicated on the belief of many, articulated by someone to me recently as "oh that's just wrinklies losing their marbles, isn't it?". 

As this normally reticent resident commented to the carer, "you have done really well for me". The carer, who earlier in the project had been worried that asking questions was 'prying' and held that her relationship with residents should be more formal, now describes her relationship with the resident as "... more like being a grand-daughter". And as her confidence in her abilities has grown, so she has become more engaged with the rest of the residents and the staff team as well. 

The resident's daughter commented, "we are never short of conversation now. I really commend the home and Many Happy Returns for doing this – all residents and their families should have one of these books."

In the building of another album, one resident, whose family live some way away and who is intensely private, has been able to clarify earlier confusions in her memory of events in her life, using the pictures and words as triggers. 

As her carer said, to begin with, she was disappointed to be buddied with this resident, who had few pictures of her life and was very withdrawn. But the album has become the source of richer conversations, with illustrations of her life, from images of places and things about which she has spoken. These have also prompted other and deeper memories she had forgotten or had unintentionally misrepresented as a result of her dementia. 

This additional remembering has raised her self-esteem, saying "I really like to look at the book and can remember much better with it". Her relationship with her Caribbean carer has improved to the point where she has invited her to lunch.

Pain can complicate relationships as well as depress, but one team leader reports that when he encouraged one resident with chronic arthritis to reminisce about her life as a younger person, she says her pain"just seems to melt away".

Another pairing has delivered benefits to the family, who realised that they knew very little about their mother's life, growing up in a pub in the East end during the war. For the first time, they went to explore the area, photographed the house and brought it back for her to enjoy. 

"We always talked about our father's life" they said, "it was he who seemed to be the more interesting. But now we have become intrigued by our mother's experiences and this research has changed our relationship with her for the better." This altered dynamic is most evident in the family's interaction when they are gathered together, which is now more connected and meaningful.

As Shaaron commented on the project, "my residents are happier, their families are happier and my staff are happier, so it's win, win!" 

The senior carer said of the training and project, "I am grateful to Many Happy Returns for what you have given to me – tools for life both inside and outside the home – which I will never forget and which no one can ever take away from me."

Finally, let one resident express a most moving outcome, "I feel I am important to people again". More importantly, she is also more important to herself.

Image: paraorkut.com

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