Wellbeing and Dementia Services
Paul Gaskell - Wellbeing and Dementia Services DirectorWelcome to our dementia pages. I hope you have found it interesting so far. My name is Paul Gaskell.
Kieun Kwon - Associate Director of Wellbeing and Dementia ServicesMy name is Kieun. I am Director of Wellbeing and Dementia Services at Runwood Homes and a member of the Dementia Services Team with responsibility for an allocated number of homes.
- The word Dementia describes a set of symptoms that may include memory loss and difficulties with thinking, problem-solving or language.
- Dementia is caused when the brain is damaged by diseases, such as Alzheimer's disease (the most common type) or a series of strokes.
- There are over 200 types and sub types of dementia.
- Dementia is progressive, which means the symptoms will gradually get worse.
- Each person is unique and will experience dementia in their own way. The different types of dementia tend to affect people differently, especially in the early stages.
- These vary considerably depending on the type of Dementia, how long the person has had their disease and the individual.
- The most common symptom is memory loss. Often memories from long ago are retained, yet what happened that morning may be completely forgotten.
- Other common symptoms include -
- Impaired judgement.
- Difficulties with abstract thinking.
- Faulty reasoning.
- Inappropriate behaviour.
- Loss of communication skills.
- Disorientation to time and place.
- Walking, motor, and balance problems.
- As Dementia progresses these symptoms will worsen, and the individual will need more and more support.
- Symptoms for an individual may fluctuate during the day. Ability to perform a task can also vary.
- Runwood believes in Dignity for everyone every day. There is an ongoing campaign, and in your home there is a dignity board which shows the theme of the month.
- Dignity must be at the centre of everything we do if we are to achieve high quality, person-centred care and support.
- It's important that people with dementia are treated with respect and that their dignity is maintained. It is also important to remember that a person with dementia is still a unique and valuable human being, despite their illness.
- Dignity focuses on the value of every person as an individual. It means respecting other’s views, choices and decisions, not making assumptions about how people want to be treated and working with care and compassion.
- We can show our respect to people by listening carefully, guarding modesty and going out of our way to offer choice at every opportunity. Choose the words you use carefully, when taking about what we do to help people: e.g. "feeding” is something we do to our dog; we help Doris with her breakfast.
- The feelings and emotions of someone living with dementia are as strong and real as anyone else’s; some say they are stronger.
- Living with dementia can involve many difficult feelings: frustration, anger, sadness, fear, embarrassment.
- While living with dementia is undoubtedly a challenge, people with dementia experience positive feelings too. Positive relationships and communication help to enable positive feelings.
- When faced with someone who is displaying behaviour we don’t understand, look for the emotion and respond to that.
- It is very important to know as much as possible about the person you are supporting. In this way you will understand them much better. Read their life history, and speak to family members.
- We tend to think of communication as talking, but in fact it consists of much more than that. A large proportion of our communication is non-verbal, which takes place through gestures, facial expressions and touch.
- Listening and watching – this is most important. Listen carefully to what the person is saying, and give them plenty of encouragement. When you haven’t understood fully, tell the person what you have understood and ask them if this is right.
- Speaking – Speak slowly, calmly and with short sentences. Allow time between each sentence to give the person time to process what you are saying.
- What to say – Try to be positive. If asking a question, try one that results in a choice between 2 things, or a yes/no answer if the person is struggling. Never contradict or use controlling words (shouldn’t, can’t).
- Body language – A person with dementia will read your body language, perhaps better than the words you are saying. Never stand too close or stand over someone to communicate: it can feel intimidating. Instead, respect the person’s personal space and drop below their eye level.
Negative feelings which can result from the symptoms of dementia and these feelings can be stressful, particularly if the person is struggling to understand the situation they perceive themselves to be in.
- Stress is a natural reaction to a situation which is potentially hazardous or threatening. We all experience this.
- Someone with dementia may be experiencing something we can’t see, and which may not be ‘real’. E.g. a stranger coming into their room, needing to get home, being lost in an unfamiliar place. They may not even have the words to explain what they are worried about.
- They may react with very strong emotions, and become angry, even physical. Remember that they are responding in a normal way to a situation which they perceive as real.
- Be kind, calm, patient and reassuring; listen and watch carefully. Respond to the feelings they are showing you. Like a detective, try to use everything you know about the person, and can see & hear, to work out what is happening for them.
- Let them know that you are there for them, are really with them, and will do all you can to help. When they know this, try to distract with an activity, drink, walk, chore, music, phone call etc.
Mealtimes are the highlight of the day.
- We will do all we can to make mealtimes enjoyable, sociable and an occasion to really look forward to.
- The dining room, tables, equipment, and even background music need to be 100% ready when residents enter the dining room.
- Ensure people have exactly what they want and need, in the way that is best for them. Offer a visual choice, explaining simply what is being offered, to people with a dementia. Offer a taste sample if this helps. Allow plenty of time for them to decide.
- Once everyone has what they want, keep checking to make sure they are managing OK and are eating. If there any problems, sort it out very quickly for them. Then keep checking.
- Allow the mealtime to take its own time. Let there be no rush. Enjoy it. Make it a social time. This is the highlight of the day, after all!
Spending time in meaningful activities can continue to be enjoyable and stimulating for people with dementia at all stages of the condition. Taking part in activities based on the interests and abilities of a person with Dementia can also significantly increase their well-being and quality of life.
- Activity is not just about the organised events in the home. We can all look for opportunities throughout every day, to add a sense of purpose, fun or relaxation. All staff can take part in this.
- Activity can be anything which the person enjoys. This could as simple as sharing a joke, starting a song, a mini dance as walk along with someone, a short conversation about their favourite food, a quick neck-rub, putting some favourite music on, reading the horoscope from the paper, reciting a funny limerick/poem.
- Don’t forget the value of occupation. We all like to feel useful. Sharing daily chores can be fulfilling and enjoyable for someone living with dementia.
Try asking for help with bed-making, folding linen, pairing socks, dusting, hanging washing, drying up, serving biscuits, etc
- Different people will have different abilities and interests. Always ensure that what you are trying is right for that person, and is something they can do. Nothing is worse than asking someone with dementia to do something they struggle with.
- Remember that activity can involve some or all of the 5 senses: sight, smell, hearing, touch, taste. People will enjoy some more than others.
carehome.co.uk is an independent organisation that 'rates' care homes throughout the U.K. based on reviews which the public send to them. carehome.co.uk display these reviews on their website and send them to us to show on our homes' own web pages.
If you wish to know what people think of our support for those living with dementia look at these independent reviews. Select a home from the location search box on our main webpage. Click on the picture of the home selected and then click on the yellow tab 'Reviews' on the right.
At Runwood Homes we believe in the importance of good design to assist our residents living with dementia to feel safe, comfortable and at home. We aim to follow the principles that good design should;
- compensate for disability
- maximise independence
- enhance self-esteem and confidence
- demonstrate care for staff
- be orientating and understandable
- reinforce personal identity
- welcome relatives and the local community
- allow control of stimuli
Some features have an effect on peoples feelings, and we like to emphasise these in order to enhance feelings of comfort and safety. These features include;
- small size or the feeling of small areas
- familiar, domestic, homely in style
- plenty of scope for ordinary activities (unit kitchens, washing lines, garden sheds)
- unobtrusive concern for safety
- different rooms for different functions
- age-appropriate furniture and fittings
- safe outside space
- single rooms big enough for lots of personal belongings
- good signage and multiple cues where possible
- use of objects rather than colour for orientation