While many conditions require predictable care, dementia demands a personalised approach. Here Jane Pritchard, Admiral Nurse at home care provider, The Good Care Group, explains how their innovative care model addresses this need.
While many conditions require a predictable pattern of care, for dementia, there is no ‘one size fits all’ approach.
Because the symptoms associated are the result of many different causes including Alzheimer’s or stroke, dementia affects people in a variety of different ways. Factors include age, area of the brain affected, and underlying causes also play a part.
And of course, every individual is different, with a whole set of unique experiences and personality differences. This means that any dementia care model must take a holistic and person-centred approach.
At The Good Care Group, we also recognise as part of the model that family members have their own emotional needs to be met, and that our professional carers have a role to play in helping them to understand and adjust to the person living with dementia’s changing presentation.
To support this, we have developed the EVER model, standing for Engagement, Validation, Enrichment and Relationships, to help us ensure we deliver the best possible care for people living with the condition.
The importance of communication
Through EVER, we are supporting our professional carers to connect and communicate with clients through a variety of techniques including removing distractions, positive body language such as smiling, and ensuring carers get their eyes down to the same level as individuals, supporting them to feel more secure.
This also feeds into the validation aspect of EVER which is based on Validation Therapy, developed by Naomi Feil. This is all about acknowledging a person’s emotions and reactions as real and legitimate. People living with dementia can sometimes become agitated, and part of responding compassionately is by not seeking to correct the person, but to enter their reality. For example, if the distressed behaviour is directed at a family member, that person may wish to respond with, “I’m so sorry I upset you,” rather than challenging their emotions.
Family members and professional carers should also communicate regularly as dementia symptoms can change often. At The Good Care Group we have a carers community where family members and professional carers can collaborate via an online platform, updating one another on the outcome of visits, a person’s mood, or any physical ailments they might be experiencing.
Enrichment and relationships are key
In dementia care, there is a triangular relationship between the person living with dementia, their family members and professional carers. It’s about recognising that instead of it being about us as the professionals implementing our way of doing things, the focus should be on involving the family in the care of the person, while ensuring a person’s individuality is retained.
We have already seen positive outcomes from professional carers who have said that supporting their clients to take part in activities they enjoy, has transformed their relationships and increased their wellbeing.
When I spoke to one of our professional carers at The Good Care Group, Pauline, she said:
“I work with a 92-year-old man called Duncan who has Alzheimer’s and we create both a safe and enriching environment to allow him to thrive.
“We always carry a notebook and pen to write down things he is struggling to hear. This enhances his activities in noisy environments.
“He also takes part in a walking dementia football group which is his favourite activity.
“I personally leave at the end of my rotation, knowing I have done everything I can to make “living with dementia” the best it can possibly be.”
A process of continual learning
It’s vital that people living with dementia and their families are continually moving forward in their lives and relationships. Just because someone has received a diagnosis, this does not mean that they cannot enjoy life or learn new things.
Some people become more creative as an aspect of their condition, and we have worked with one individual recently who has learnt to knit after receiving a diagnosis.
By undertaking a relationship centred approach to care, professional carers can keep driving forward new approaches.
As part of the evaluation process, we will be looking at what has changed in their practice, and what kind of impact this has had day-to-day on the person and their family. Sometimes it’s the small things that make a big difference.
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