Putting yourself in other people’s shoes

‘I was overwhelmed by how good it was! The training was very well constructed, productive and made everyone think,’ says Shobhna A Pabari, manager and proprietor of Community Careline Services, Havering Ltd, a domiciliary care agency.

‘Buz has a wealth of experience gained over the years and a unique way of putting things across. She helps you to put yourself in the shoes of people who have dementia.’

Shobhna found the training she undertook with Buz Loveday so stimulating and informative that she encouraged the organisation’s human resources manager, Jan Crease, to take part.

‘I absolutely agree that this training gives you a new insight into the world of dementia, Jan says. ‘It has really enabled us to open the eyes of our staff.’
Jan and Shobhna believe it is Buz’s truly person-centred approach that has made such a big difference to the way their staff are now working with service users with dementia.

‘Buz has a knack of making everyone feel that they are important – which includes the people doing the training as well as the service users. We try and model ourselves on her example when we deliver the training ourselves. I think this helps staff realise that all clients are individuals with personal needs and you have to reflect these in the care you give them,’ Shobhna explains.

Jan found the exercises around compiling a person’s life history very helpful.

‘It’s about finding out as much as you can about the service users, their family and their lifestyle. So you can create a care plan personalised to his or her needs,’ she says.
It is not just service users who are benefiting from the effects of the training. Jan explains:

‘Relatives can go through a lot of trauma because they feel they don’t understand their loved ones anymore. Buz has given us information which we can share with relatives, to help them understand what the person is going through and the reasoning that lies behind their behaviour.’

 

Shobna is the proprietor, and Jan the HR Manager, of Community Careline Services, Havering Ltd, a domiciliary care agency.

A life changing opportunity

‘This training was life changing for me. I’m from a social work background and I’ve worked with local authorities for about 25 years, but this is the best training I’ve ever done. This course really gave me an opportunity to consolidate my own knowledge and pass it on to others,’ says Ruth Lisk, Dementia Care Co-ordinator, based in the Diagnostic Memory Clinic at Shrewsbury Health Centre in Forest Gate, London.

Ruth is employed by Social Services but in 2005 she was seconded to East London and The City Mental Health NHS Trust. Her role includes providing dementia awareness training to colleagues and other staff.

‘That’s something I’d never done before and I had a bit of a panic,’ Ruth confesses. ‘Then I saw the course advertised in the Journal of Dementia Care and I’m so glad I did. Buz is unique. She really knows how to bring out the best in everyone. She uses the same person centred approach in her training that she encourages staff to adopt with service users.’

Using the role plays and examples she learnt on the course has helped Ruth to encourage the people she trains to draw on their personal experiences and see the world through the eyes of a person with dementia.

‘Just because a person has dementia doesn’t mean that their feelings have changed. Buz gave us some very useful scenarios to help us think how we’d react if we developed dementia. I know I’m someone who needs to walk a lot and I’d become very frustrated if I found the doors were locked and I couldn’t get out. Examples like that get staff thinking about the reasons behind people’s behaviour and what they are trying to communicate to you,’ Ruth explains.

Passing on the training has been a very rewarding experience for Ruth.

‘The materials are excellent and help you to bring out the best in others. This approach gives staff confidence to look at their current practice, in a non-threatening way. But it also recognises that looking after people with dementia is a very skilled job. I’ve discovered that I can really enjoy training other people. I want everyone to know that Buz’s course is excellent.’

 

Ruth is a Dementia Care Co-ordinator, based in the Diagnostic Memory Clinic at Shrewsbury Health Centre

Now we care the right way, instead of the hard way

Buz’s training has had a major impact on all of us. My staff and I recently received a letter that had been sent to our inspector by the relative of a service user who had sadly died a few short months after moving in with us. I think it really illustrates how much we have achieved through the training. Following is an extract from the relative’s letter:

“My aunt suffered from dementia and had been in hospital for four months prior to moving to Nora Chase House. She had lost many of her care skills and her confidence, was very confused and her physical health had deteriorated as she had lost interest in food, movement, etc. while in hospital.

“I am delighted to report that within a couple of weeks at the home we saw a huge change in my aunt’s condition. She had regained control of her toileting needs and could manage these with support and reminders. She looked alert and healthy and staff reported that with company and encouragement she was regaining her appetite. On our visits she was always interested and animated. Even though her dementia remained, she always recognised us and was full of stories (some real, some rather fanciful) of her new accommodation. She was clearly happy and well looked after and, despite having lost her hearing aid while in hospital, beginning to play a part in the life of the home.

“Sadly, my aunt died due to heart failure after only three months at Nora Chase House. We were extremely glad that she had had those three months of being well looked after and treated as an individual. I cannot stress strongly enough how impressed we were, not only by the quality of care but the thought, planning and consideration that went into managing her dementia. Already, staff were working with her to explore and protect the memories she retained and to support those memories and knowledge of the world that appeared to have been lost. They spent time talking to use to gain as much knowledge as possible of her past, her interests and her hobbies. She reported with great glee some of the singing and dancing that the staff encouraged and led and she herself was beginning to remember old songs. Only the week before she died she sang to us a love song from the 40’s which none of us had heard before!

“We have, of course, expressed our thanks to Mary Crosdale (Head of Home) and to the staff there but I felt it important to let you know just how impressed we were by the level of care and commitment shown to my aunt. It is a great consolation to us to know that her last months were ones of peace, security and fun and that she experienced again the dignity that had been hers throughout her life.

“We are still using what we learnt from the training every day, and with all of our service users. I have attended many, many courses over my past twenty-one years managing a small care home and this was really and truly one of the best. I regret that I have spent so many years caring the hard way instead of the right way.

Mary Louise Crosdale is the Manager of Nora Chase House

Barts Health NHS Trust is the largest NHS Trust in the UK. A number of staff trained with Buz Loveday to become dementia trainers. They regularly deliver short training sessions on dementia to ward-based staff in Barts Health hospitals. These sessions are helping to raise general awareness of dementia; but improving care for people with dementia requires more than just awareness. Michelle Parker, the Barts Health Consultant Nurse for Older People, identified that a cultural change in the organisation of care, and in the beliefs and attitudes of staff was needed. Michelle decided to introduce in-depth training, to enable at least one staff member on each ward to become a Dementia Champion. She commissioned Dementia Trainers to create and deliver such a course.

Buz met with the Consultant Nurse to help her in identifying training needs, priorities, content and learning objectives for the course, and to gain an understanding of the framework within which the training would take place. Various initiatives and procedures had already been implemented and it was important that the Dementia Champions training course should integrate these and support staff in rolling them out – specific competencies were required to enable them to do this. The training also needed to address key areas of the Dementia Core Skills Education and Training Framework, which at that point in time existed only in draft form.

Based on the information gained, Buz created a bespoke course for Barts Health – the Dementia Champions Development Programme. By May 2016, 69 participants had already attended this course. Feedback has been 100% positive.

 

Following the training, the Trust provided ongoing support to the Dementia Champions, with regular meetings and quarterly one day updates. At the first of these updates the Champions were asked to complete a questionnaire evaluating their role and the impact of the training on their practice and that of others. Some of the outcomes and achievements shared by participants were:

• Role modelling and demonstrating the benefits of good communication with people with dementia
• Recognising evidence of delirium and pain that had been missed by doctors
• Advocating on behalf of people with dementia and ensuring that decisions were not made about a person’s future while their cognitive abilities were compromised by delirium
• Supporting people with dementia to make decisions
• Making changes to their ward environments to enable better orientation and less distress
• Supporting people with dementia to regain their continence and mobility
• Working out and addressing reasons behind behaviours that staff had been finding challenging and unmanageable
• Improving well-being of people with dementia through the use of activities
• Improving their own practice – e.g. being able to talk to carers about concerns and being more confident in communicating with people with dementia
• Improving the practice of others – e.g. by sharing their knowledge and giving feedback, support and encouragement.

The conclusion drawn by Barts Health was that the training was effective in equipping participants with the skills, knowledge and confidence to empower them to be Dementia Champions and make changes within their own practice areas. The course was initially commissioned to run three times in 2015; it has been re-commissioned to be delivered four times in 2016 –including community based clinicians as well as hospital staff. The aim is to ensure that a minimum of two people from every clinical area within the Trust have attended the course.