A happy story today! A story that shows the wonderful outcomes that can be achieved through simple person-centred approaches 🙂
Regular readers of the “in my shoes” series will remember the heart-warming story of Winifred, told by Gill Bailey, from Helen Sanderson Associates. In direct response to a challenge from David Behan, the Department of Health’s Director General for Social Care, Gill and colleagues proved that it is possible for residential care homes to improve the experiences of residents living with dementia, including through the use of personalised ‘one page profiles’.
As you will know, I love anything that is simple and effective. I love things that put human values such as love and compassion centre-stage ahead of rigid processes and endless “stuff”. Here it is brilliant that the changes involve both residents and staff, and recognise their choices and relationships and, in consequence, enhance quality of life for all. I smiled when I spotted some new pictures of Winifred happily folding laundry and I invited Gill to give us an update…
Winifred lives at Bruce Lodge in Stockport where we are introducing Individual service funds for the 44 people who are living there, so we are learning with them about just how far we can go in personalising care homes supporting people living with dementia.
We are trying to work at two levels. Firstly, that people living with dementia direct their own support on a day to day basis. We therefore need to know what matters to each person (what is important to them) and what good support looks like. We record this as a one-page profile.
Secondly people have an upfront resource allocation that they can determine how it is used. Each person will have 2 hours of individual one-to-one staff time each month that they can spend however they want, doing something that is important to them, where they want (in home or community) and choose who they want to support them.
I shared Winifred’s story some months ago and here is an update.
Winifred can be heard singing and laughing as she helps clean up in the home. Despite always being warm, generous and loving, Winifred, was not always this satisfied and relaxed in her new home. Until she developed a ‘One Page Profile’ with dramatic effects.
‘One Page Profiles’ were introduced for both staff and people who live at Bruce Lodge to achieve two things. For staff, it enabled a greater understanding of each other and meant that each week team members spent time away from their day to day activities to do something that they personally felt was an important part of their role. For people living with dementia, the ‘One Page Profiles’ acted as a job description, allowing them to direct their own support and ensuring that the people providing the support understood what was important to them.
All staff at Bruce Lodge, including housekeepers and maintenance staff, produced their own profiles. This exercise allowed the people living with dementia to be matched well with the staff team and choose who they wanted to spend extra time with based on their interests and what was important to them. Winifred chose to spend her time with Beryl the housekeeper because she said she enjoyed helping out with the daily chores such as polishing, sweeping and mopping. Winifred’s two daughters and staff at Bruce Lodge helped uncover this by sitting down with her and chatting over tea and biscuits to inform the ‘One Page Profile’. They asked about good days and bad days, past and present. What was going well and what needed to change. What Winifred had enjoyed in her life in the past, and what she would do, if she could, in the future.
Winifred’s new relationship with Beryl and extra responsibility has had an extraordinary effect on her happiness and wellbeing. At home she would routinely clean the house, so before this was identified in the ‘One Page Profile’ as being important to her, a big part of her life and identity had been missing.
Maureen and Bernie, Winifred’s daughters, have noticed the change that the ‘One Page Profile’ has made to Winifred. She is happier, chatting more, using fuller sentences, sleeping better and is generally ‘’more alive’’. Maureen goes on to say; “The difference is astounding; mum was a housewife, a practical person who spent her life caring for her five children and our father, who died 20 years ago. Her desire to care for people was never blunted but the ability to do so was robbed from her and that left her very frustrated. These chores are helping her connect with other things from her past and are opening up new pathways in her mind. The first thing that we noticed had come back was her language – within a week of working with Beryl she was recalling words much better and introducing me to other people by name, whereas before she didn’t know who I was.”
Winifred now has enhanced choice and control over how she lives her life and how she is supported on a day to day basis. Winifred can often be found well into the evening, long after the housekeeper has gone home, sitting and folding the laundry – the photo here was taken late one evening as I was leaving Bruce Lodge – this has simply become the way she chooses to spend her time and the impact this has had on her happiness is evident for all to see. Not only is her smile lighting up her own room but she can be seen beaming all over the home as she reconnects with what she loves most; helping to look after others and bring joy to the people she lives with. Nothing makes her grin more broadly than pegging the washing out on the line on a fine breezy day – it doesn’t cost time or money its simply about knowing & acting on it – this gives Winifred meaning in her life – the team have created an environment that says there are plenty of jobs to do, the clean laundry is left in the basket & Winifred folds it. The wet washing is put in the same place each day & Winifred will spend hours hanging it outside or putting it over the maidens.
So we are supporting a normal way of living your life, which may give somebody a reason for being alive, which gets us moving away from those care plan boxes that often focus on a person’s physical needs without paying good attention to learning what matters to people – our quality of life is determined by the presence or the absence of those things that matter to us, those things which are important to us.
Gill Bailey May 2013