Personalisation and People with Dementia - Workshop Trevor Adams, Passionate Dementia Care

What makes a person, a person?

Present practice and training in dementia care is based on ‘person centred care’ as developed by Tom Kitwood, Dawn Brooker and others. We honour and value their work!

But !!!

Person centred care alone does not fully meet recent policy directives contained in Putting People First, ’ Quality Outcomes for People with Dementia: Building on the work of the National Dementia Strategy’ that highlight that people with dementia should be supported to make choices and have control.

Caring for our Future: reforming care and support (DH 2012)

•The health, wellbeing, independence and rights of individuals are at the heart of care and support; timely and effective interventions help to ensure a good quality of life for longer. • People are treated with dignity and respect, and are safe from abuse and neglect; everybody must work to make this happen. • Personalisation is achieved when a person has real choice and control over the care and support they need to achieve their goals, to live a fulfilling life, and to be connected with society. • The skills, resources and networks in every community are harnessed and strengthened to support people to live well, and to contribute to their communities where they can and wish to. • Carers are recognised for their contribution to society as vital partners in care, and are supported to reach their full potential and lead the lives they want. • A caring, skilled and valued workforce delivers quality care and support in partnership with individuals, families and communities.

Supported by the Dementia Action Alliance in the National Dementia Declaration (http://www.dementiaaction.org.uk/)

National Dementia Declaration I have personal choice and control or influence over decisions about me I know that services are designed around me and my needs I have support that helps me live my life I have the knowledge and know-how to get what I need I live in an enabling and supportive environment where I feel valued and understood I have a sense of belonging and of being a valued part of family, community and civic life I know there is research going on which delivers a better life for me now and hope for the future

Personalisation = person centred care (promoting well being) AND person centred practice (supporting people as they make choices)

person centred care Concerned with promoting sense of personhood and well-being in people with dementia through ensuring Rogers’ Core Conditions for effective counselling are: Unconditional positive regard Empathy Congruence ‘Positive person work’.

person centred practice Concerned with offering choice and control Increased agency ‘Person-centred thinking’ uses a range of practical tools and skills on a day-to-day basis to deliver more personalised services. ‘Person-centred reviews’ transform and replace the statutory required reviews in services to create person-centred actions. ‘Person-centred planning’ refers to processes for planning around an individual, which focus on creating a positive future and being part of a community.

Skills Boxes Passionate dementia care have developed four ‘Skills Boxes’ that draw on our own work and also that of others. Skill Boxes promote the full development of personalised support to people with dementia and their family carers, and allows the development of ‘dementia friendly communities within towns and villages and also care homes and hospitals.

Skills Box 1 Skills Box 1 contains skills that allow staff to offering respect and dignity to people with dementia so that they have a enhanced sense of well-being, self-worth and personhood. These skills draw on the work of Tom Kitwood.

Skills Box 1 Recognition Negotiation Collaboration Play Timalation   Recognition Negotiation Collaboration Play Timalation Celebration Relaxation Validation Holding Facilitation Creation Giving

Celebration … This is when a person celebrates being alive with joy and gratitude and occurs in formal situations such as a birthday party as well as informal situations such as whistling or singing.

Facilitation … This is sharing in gestures or the meaning of gestures that are offered by the person with dementia by knowing them well enough to enable their responses when pieces of action or conversation are missing.

Skills Box 2 Skills Box 2 helps staff include people with dementia within decision making between staff and family carers.

Skills Box 2 Removing unwanted stimuli Getting in the right position Promoting equal participation Demonstrating enabling communication Providing opportunities to talk Being sensitive to non-verbal cues Valuing and respecting contributions Overcoming poor communication Promoting joint decision making and care planning

Getting in the right position This is when the care worker sits near to the person with dementia so that they can see and hear each other.

Skills Box 3 Skills Box 3 helps staff support people with dementia to make choices and have control. This Skills Box draws on skills that passionate dementia care has developed with Helen Sanderson Associates in ‘Progress in Personalisation for People with Dementia’ by Trevor Adams, Martin Routledge and Helen Sanderson.

Skills Box 3 One Page Profile Important to/important for Defining staff roles and responsibilities Relationship Circle What’s Working/What’s Not Working Good days and bad days Life Story Appreciations Communications Chart Learning Log Matching staff

Skills Box 4 Skills Box 4 helps staff develop dementia friendly communities that are welcoming and create environments that are conducive to personalised support. This Skills Box has been developed with Liz Leach and Imagineer.

Skills Box 4 Circles of Support: developing support relationships. Connecting people with meaningful activities within their community Creating opportunities and accessibility for people with dementia in a community Highlighting communities of interest, communities of connections and local communities. Community Mapping Recognising that there is more to life the services Maintaining independence and control Reducing anxiety and disorientation, and promoting control.