person-centred care Person-Centred Dementia Care in Reality. What Can We Learn?

October 24, 2019

This week I had the pleasure of visiting Care UK’s Ferndown Manor. I was blown away by the environment within the home, not just the facilities, which by the way were amazing (including a coffee shop, bar, cinema room, hair salon, and fantastic grounds to name a few. I’ve been in care homes similar to this where the facilities are comparable to a top notch hotel, but there isn’t a homely feel, and walking the corridors it is rare if you see a resident or member of staff.  This wasn’t the case at this particular home, as well as having excellent facilities they had clearly designed the home thinking of the needs of the residents as individuals, with the ability to provide high quality care at a micro, individual care whilst still maintaining the highest standards as a care facility. This is often something which is hard to achieve.

It got me thinking about how we can learn a lot from this particular home (and others working in a similar way) in terms of what it means in reality to provide person-centred care, and it poses the question can you still run a high end hotel-style care home whilst also providing care that is tailored to the individual residents? My answer is yes, you absolutely can (and should!)

There is a common assumption still that when we move into a care home our identity is altered, we become less empowered to do the things that mattered to us when we lived in our own home; instead of doing things for ourselves, things are ‘done to’ us, we mourn the loss of the person we once were and instead take on a new identity, that of a care home resident, behaving the way we expect a care home resident to behave – sitting in a chair watching TV all day, with cups of tea brought at various intervals throughout the day.

OK, I’m generalising, but speaking with friends and family who don’t have experience of care home environments, this is still a very common assumption when in reality whilst some homes do operate in this way, the majority are striving to provide high quality, person-centred care, and really do put the individual’s needs at the heart of their care provision. Before I delve into practical examples of how person-centred care can be achieved let’s take a step back and explore what person-centred care means.

I know I say it all the time but as healthcare professionals we need to remember that there is still a person behind the  diagnosis of dementia, with their own individual personality, likes, dislikes, history, a rich tapestry of a life which they are still living. The Alzheimer’s Society highlights the following key points of a person-centred approach within dementia care:

  • Treating the person with dignity and respect
  • understanding their history, lifestyle, culture and preferences, including their likes, dislikes, hobbies and interests
  • looking at situations from the point of view of the person with dementia
  • providing opportunities for the person to have conversations and relationships with other people
  • ensuring the person has the chance to try new things or take part in activities they enjoy.

In this particular home I visited we can learn a lot from their person-centred approach. Although it had the hotel style feeling that many care homes have these days, there is a distinct feel that the home goes the extra mile to ensure that it remains just that, a home.

caring for the elderly musica music and well-being

The first thing that came to mind, was a presentation I head David Sheard give earlier this year on the importance of care homes feeling like a home, and the staff, residents and visitors feeling part of a family. If you haven’t already seen David’s video ‘We are Family’ I really recommend you watch it, it is a great representation of person-centred and relationship-centred care in action.

In David’s video they show the carers, residents and families sitting together for dinner. This style of dining is so important especially for residents that are used to social gatherings such as this. Within the care home I visited they have a separate dining area for residents who want to have dinner or afternoon tea with their own family. The Customer Relations Manager took real pride in this aspect, he spoke about how residents might have entertained a lot at home and were used to having their family around them, and so the care home wishes for this to continue. Just because you are in a care home it doesn’t mean you have to miss out on these important social interactions, and continue with activities you did in your own home. At the end of the day the care home is the resident’s home and therefore they should be able to use it in that way, likewise their family should also feel at home within the care home.

Each floor has its own kitchen area, with cupboards stocked with food should the resident wish to make something for themselves. Again, for residents who are used to cooking in their own home why should they be denied this once they move into a care home? However, with the fine dining provided it’s surprising the residents would have room to fit anything else in! The chef has recently won a national award, and they clearly take pride in providing the best quality food for their residents. For residents with dementia who may have difficulties understanding the menu the chef brings out two options plated up for the resident to see and then decide which one they would like. Likewise, the dining ware is adapted for residents with dementia or poor eye sight, using blue china plates to make it easier to see on the white tablecloth. White on white can be very difficult for someone living with dementia to see, and often results in food slipping off the plate. So a blue china plate with a lip can be easier to eat from, providing an edge for the person to push their food against without the food slipping off the plate. The use of china is so important, and feels more dignified than the plastic plates and bowls often used in care homes and hospitals.

The home has a full schedule of daily activities delivered in different areas of the home including the craft room and lounge areas. However the care staff also recognise that some individuals may not want to participate in group activities, if you are someone that has been used to living on your own and enjoys your own company why would you suddenly change when you move into a care home? Therefore residents are empowered to choose their own activities, participating in group activities if they wish, but are also free to enjoy a newspaper and coffee in the coffee shop or a wander in the beautiful gardens. Likewise, families are encouraged to take their loved one out for the day if they wish, again just because they live in a care home why should they stop doing the activities that they enjoy such as going out with their family for lunch?

There is so much that I learned from my time at Ferndown Manor, and the person-centred approach really resonated with me; as I’ve said before, it’s one thing to talk about person-centred care, but it’s another to embody it. I would love to hear about how your care home is putting person-centred care into practice, let’s learn from one another.