Dementia: Person Centred Thinking

I have been thinking for a while how we need to change the direction of our journey so Maureen is being enabled rather than looked after and kept safe.  This article from one of my Linkedin Networks is just what I have been looking for:

‘Simple changes make significant change for the person living with dementia.

One Page Profiles (1PP) are one of the Person Centred thinking tools that support the transition from people living with dementia being passive recipients of care to their being recognised as equal value members of society. They also herald a new progression, as services aspire to move beyond personhood towards citizenhood.

SCIE have a fabulous online tool that provides information, videos with Helen Sanderson and Michael Smull and a helpful step by step guide to completing you 1PP.

The 1PP is the visual outcome of semi-scripted meetings that are held with the person, their families and carers. But the real powerhouse of change and the arena for accomplishing that change is not the outcomes as much as the process undertaken to create that profile. The meetings offer a unique opportunity for relationships to deepen and flourish, with paid and family carers working in collaboration with the person to share understanding , skills and knowledge that might enhance the lived experience for the everyone involved.

One important difference between traditional person centred care and personalisation through 1PP is the inclusion of the experiences of the formal and informal carers. Not only do we seek to understand the experience of the person living with dementia, but we show equal respect to the qualities, aspirations and needs of members of too. In Dementia Reconsidered Kitwood reminded us that carers are people too. This sentiment seems not always to be present in all modern paid care roles with their minimal wages and maximum public scrutiny.

The 1PP process generates opportunity for real time problems solving that puts into action the previous rhetoric of the social model of disability. In short they offer a chance to develop solutions in a multi-focused forum to situations that cause challenge and concern to the person and those that support them.

I facilitated a meeting on one occasion for a gentleman who had lived in the care setting for just a few months. However, in all of that time the staff had been unable to successfully offer him any support to meet his personal care needs. Whenever they tried, no matter who amongst the staff, he would become increasing distressed. This distress was beginning to cast a shadow across all of his day. The initial remedy to this was that is daughter in law provided this support, much as she had at home for several years before he came to live in the home. At the meeting she said that, whilst she loved him dearly, she was hoping that she could start to withdraw this level of support so that she could visit and just enjoy his company, rather that feel responsible for his care.

We talked about how she was successful in supporting him and what she might do differently to the staff. She said that she didn’t know, but perhaps they sang the wrong songs. They sang songs together.

It is as simple as that.

They sang.

We asked what they sang together, and she said anything with bounce, Daisy Daisy was a good one, but be prepared to sing it over and over. The staff were skeptical at first, thinking that it was too simple, but as a team agreed to give it this a try. It worked immediately.

From that day on staff have been able to support this gentleman with all of his personal care needs. With staff providing this support his daughter in law has felt able to draw closer to him as he time is spent providing a deeper level of emotional support.

To achieve outstanding the CQC asks providers for evidence of a strong, visible person-centred culture where people are truly respected and valued as individuals and where they are empowered as partners in their care. The timely use of Dementia Care Mapping™ and Person Centred Thinking™ tools go some considerable way to providing that evidence.

Clover Care Consultants is able to support care teams and providers to evidence their practice and build on their successes’.

 Postscipt: I realise that this will take some working through but with my experience from a  Masters in Lifelong Learning and the Managing Change we’ve got a sporting chance



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