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Person-centred Cultures: Valuing All PersonsCommunication Toolkits in DementiaPerson-Centred Care Planning

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editorial teamI am very proud to introduce you to the first edition of Four Seasons Health Care’s newnursing journal - Care Home Nursing. As Head of Nursing at Four Seasons Health Care I amdelighted that we are able to showcase the wonderful and innovative work that our care homesacross the UK deliver so that we all may learn best practice from one another. Our ethos atCare Home Nursing is quite simply to improve the quality and experience of residents in our carehomes.In this inaugural issue we are delighted to share original articles from internationally renownedProfessor Brendan McCormack, Head of Nursing at Queen Margaret University Edinburgh & SarahRussell, Head of Research and Clinical Innovation at Hospice UK. Professor McCormack exploresthe importance of person-centred cultures while Sarah examines the importance of palliative carefor older people. I am also delighted to share an original article from Colin Sheeran, DementiaProject Facilitator at Four Seasons Health Care, on the importance of using communication toolkitsfor people living with dementia. Our editorial team have also put together a useful guide todysphagia which can be used for continuing professional development (CPD) as directed in themain text. Thank you to our contributors for our first issue. I hope you find these original articlesuseful to your nursing practice. If you are interested in writing or being supported to write a piecefor our journal please feel free to get in contact with our editor-in-chief Gary Mitchell via email:[email protected] <mailto:[email protected]>. As an editorial team we would bedelighted to share knowledge and examples of good practice so that others can learn andultimately we can enhance our resident’s quality of life. Also, if there is a topic or article that youwould like to see covered please also let us know!Special additional content, that compliments the contents of this issue, is available via SOAR in theNursing Community section. Please login to SOAR, join our Nursing Community and share yourthoughts & feelings what on you liked, what you found helpful and what you would like to seemore of in future issues. Last, but most importantly, thank you all for the wonderful work you doin our care homes each and every day!Joanne Strain, Head of Nursing Consultant Editor: Joanne Strain, Head of Nursing Editor in Chief: Editor in Chief:Gary Mitchell, Resident Experience Gary Mitchell, Resident Experience Care Specialist Care Specialist

Communication Toolkits inDementia Care communication toolkit it is a collection ofMany people will know about memory boxes objects and personal memorabilia to stimulateand how these can be used in dementia care. conversation and interaction with residents andThey are useful tool for reminiscence and relatives. While there are striking similaritiesmeaningful activity for people living with between a ‘memory box’ and thisdementia. ‘communication toolkit’, one key difference is that memory boxes are often related to theAs part of the Four Seasons Dementia Care past, while communication toolkits can also beFramework this theory has been taken a stage more about the present day.further. Just like a memory box, a

What could a communication tool kit include?A communication toolkit is personalised to thatindividual and as a consequence each one will,and should be, different. Some items that formcommunication toolkits are listed below:• Photos While this paper focuses on dementia care, it• Clothes- hats / ties / scarves should be highlighted that all care home nurses• Favourite snacks / sweets should seek to help all their residents develop• Medals communication toolkits – even if they do not• Certificates live with dementia. In order to illuminate the• Cards many benefits of utilising communication tool-• Music / playlist kits in practice the following two case studies• Games- cards / dominoes are presented.• Letters and postcards• Jewellery / makeup• Favourite drinks• Mobile phone / keys / wallet / mirror / hair-brush• Virtual message- voice or video recording• Anything else that is meaningful to theindividual.

case study 1The ‘virtual message’ is growing in popularity and can be a useful tool to use when residents askdifficult questions like: where is my wife? Or when can I go home? While there is a raging debateon the topic of telling white lies to people living with dementia for therapeutic benefit, care staffoften feel uncomfortable about how to approach these difficult questions. This is because thereare occasions that no matter how these questions are answered they may cause the residentdistress and diminish their quality of life.Now consider the case of William. William would regularly ask where his wife was just after shehad visited. She always left just after 3pm to pick to up their grandchildren from school and hewould repeat the question over and over, becoming more distressed and anxious as the afternoonprogressed. Instead of continually phoning his wife care staff suggested that she record a videomessage that the staff could play back to him when he became anxious. The following short videomessage was recorded onto an IPad:‘Hi Granddad, Nana Kate has just picked us up from school. See you soon’ As a result of thisshort video message, William often became less anxious and his episodes of distress diminishedover time. The simple recording of a short video message was an important component ofWilliam’s communication toolkit.case study 2Now consider the case of Elsie. Elsie, like many people living in the advanced stages ofdementia, did not eat well. She had been losing weight for some time and ate very little of hermeals. Elsie’s case was managed in the traditional way with many visits from multidisciplinaryprofessionals asserting the importance of maintaining adequate nutritional intake. However thesevisits did not make any difference as Elsie continued to lose weight.Elsie’s nutritional status did improve as a result of some person-centred additions to her owncommunication toolkit. Her toolkit included a bar of dark chocolate and a jar of her favouritecoffee. On one hand, by providing Elsie with food and drinks that she liked, there was a positiveincrease in Elsie’s nutritional status. In addition to meeting this physical need, Elsie also saw anincrease in her social quality of life; this is because of more opportunities for social engagementwith others.Elsie was a resident who didn’t often initiate conversation, but would join into conversations whenstaff sat with her and shared a cup of coffee and a piece of chocolate. Elsie’s communicationtoolkit also included 2 china cups and saucers from home. Through the sharing of her coffee andchocolate Elsie appeared to feel more purposeful in her interactions and more connected withinthe culture of the home.

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