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20 May 2012

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Residential
and Nursing Care

Bradford Project Blog

Dear Relatives,

Please find below information on the work being done at Nightingale in conjunction with the Bradford Dementia Group (BDG).

The focus of this work is in one unit at a time, and all information here relates to projects currently ongoing in Sherman Unit.

I expect to add a new post once every one or two weeks. Please feel free to email me with any questions or concerns you may have, at alisekirtley@nightingale.org.uk

Many thanks and best,

Alise Kirtley

Project manager, Culture Change

Switchboard: 020 8673 3495

For information on Bradford Dementia Group, please visit their website, or contact Tanya Little at t.little1@bradford.ac.uk or at 07919 213911

Wed 25th April, 2012

Dear Relatives,

I am sorry to inform you that we are postponing the Residents' Forum that was due to be held this afternoon.

I scheduled it accidentally at the same time as the new music club that has been started the last couple of weeks. The music club is very popular and it's important we have all residents and management present at the forum, so I will reschedule this on Friday and let you know when the new date is.

More soon,

Alise

Mon 23rd April, 2012 : media of interest

Dear All,

Just to let you know that tonight at 8.30pm on BBC 1 is Panorama Undercover: Elderly Care, which will I'm sure be of interest.

Also, an organisation called music and memory has a powerful video on their homepage that you may well have come accross, and which is really beautiful to watch: http://www.musicandmemory.org/

Enriched care planning continues, slowly but surely. It's an honour to get to know the residents on Sherman in so much more depth. Thanks for your time to those families that have attended so far, and I look forward to continuing to meet more of you over the next couple of months.

More soon,

Alise

Thurs 5^th April, 2012: Passover

Dear Relatives,

I am on annual leave as of later today, until Monday 16^th April. There will therefore be no updates to this blog during that time.

Also during that time there will be limited use of the pantries on Sherman.

Projects will start up again as usual following the festive period, and there’s plenty more on top of the usual to come, too!

I wish you all a happy and enjoyable Passover,

Alise

3^rd April, 2012: Residents’ Forums on Sherman Floor

Dear Relatives,

On Wednesday April 25^th we will have our first Residents’ Forum for Sherman Floor. This will be an introductory forum in which we will ascertain the model for the future meetings; who should lead the forums, what kinds of topics will there be, who will minute them, etc etc. All residents living on Sherman will be invited, and Agota (activity coordinator), Roshni (unit manager), the staff and I will facilitate this and future meetings, supporting as much as necessary, and making sure anyone who has a comment can be heard.

Please let me know if you have any questions or concerns about residents’ forums. We have found that it can be an empowering process for residents to go through – once they realise that suggestions and requests they make are indeed listened to, appreciated and actioned.

More soon,

Best,

Alise

30^th March, 2012 : Excellent progress to report

Dear Relatives,

I am very happy to report that we’ve got some really fantastic things happening on Sherman now. It’s still early days, but these are the kinds of indicators that a real culture change is indeed in progress…

Staff are eating with residents regularly now at mealtimes, and enjoying good conversation while they do so
‘Daily update notes’ in care plans are being done one resident at a time, whenever possible while sitting with the resident and chatting about how they feel their day is going
Training around enriched care planning (ECP) has been completed for many of the staff and practical work is now underway, with our first two ECP sessions with relatives completed
Staff are using the beauty & needlework room every week to do manicure sessions with some residents. More plans for this space have been made and I’ll update you as we go forward
Similarly the music room has been discovered by a few more independent residents these last couple of weeks, so that’s often got someone in there with their feet up and a tape on. (Bear with me while I replace the record player – one’s been ordered!). Furthermore, after Passover we’re launching the ‘Sherman music club’ – lead by one of the residents – in which there will be a different genre/composer/topic chosen, and the group will listen and discuss music, facilitated by a staff member
Every shift a senior carer now spends 10 minutes sitting and having tea and a chat with a resident
Most staff on Sherman have now been informally interviewed by a volunteer, around their own hobbies and interests outside of work. These are now getting paired up with residents’ preferences as we discover them, with lots of plans for a variety of activities on their way
Those horrible-looking medicine trolleys are a thing of the past! Medicine is now administered from the storage cupboard (where the trolleys are kept), one resident at a time

Please feed back to the staff any and everything positive you’re seeing on the unit. And as usual, please keep questions and concerns coming my way.

Exciting times!

More soon,

Alise

19th March, 2012: Lots going on!

Dear Relatives,

Lots this week to update you on….

Many thanks to those relatives that managed to make it in to the Project Update Meetings last week. They're very helpful for me to understand how people are feeling, and action accordingly. I'll email out the combined minutes of these later this week
Memory Boxes have begun with Sherman residents and their keyworkers. These are shoe boxes that will, over time, become personalised boxes containing items that represent the owner. The items can represent past, present and future. To give you an example for me… I was born in Vienna, love to play piano, spend most holidays hiking, I’m addicted to chocolate and my dream is to sail around the world one day. So… in my memory box there might be a chocolate wrapper, a picture of hiking boots or toy/doll boots, a little model sailing boat, a piano or some piano music, a photo of Vienna or an Austrian flag, etc etc…
Talking of care planning… I am excited to announce that as of next week, I will be holding Open Surgery for one-on-ones with relatives around Enriched Care Planning. This will be 14.30 – 16.30 on Tuesdays. Please contact me (alisekirtley@nightingale.org.uk) if you would like to make an appointment during this time. I will need to make sure that one of the resident’s key worker is available to meet with us also. We will still make appointments for people outside of these hours – it just helps us with scheduling if there’s one definite weekly slot for us to meet in
The red wing pantry area is going to become the “BBC Lounge”. We’re still going to have a separate cinema area where we’ll show the classics with cornettos and popcorn, but this will be more a space around tv, news, broadcasting, and reminiscence. If anyone has items around this theme they’d like to donate, especially if it’s old-wordly, please bring them in
We opened the Tea Room on Sherman on Thursday last week, with great success! Many thanks to those that came along. We had dozens of residents attending, and it was a very jolly affair with Mr Smith cutting a ribbon, lots of tea, coffee and cake. The Tea Room is now available 24/7 for the residents to help themselves (with assistance when required) to tea, coffee and biscuits. (We will also be keeping breakfast cereals in there soon, for those residents that might get up really early and fancy a bit of breakfast before 8pm.) Also – the Tea Room is where the short order menu will mostly be used. Please when you visit, feel free to go with your relative into the room, help yourselves to drinks and biscuits, and order any short order menu items you’d like by asking a member of staff to call the kitchen with your order

Many thanks and more soon,

Alise

13th March, 2012: Empathy Dolls

Dear Relatives,

On friday we introduced Empathy Dolls to Sherman Unit.

There is a growing body of evidence around the therapeutic benefits of dolls. I would be very happy to meet with anyone wanting to learn more about the research behind their use, but for now, here are a few bits of information about the dolls that you will probably see sitting on chairs, or in the arms of residents on Sherman…

You can carry the doll, face front when approaching a resident, so they can see its face and may like to take it from you. Choice of holding a doll is entirely the residents’ decision and no-one should be given one if they don’t want one. This why the dolls are sometimes left around the place for someone to pick up if they would like to
Once the doll has been introduced and accepted by a resident it should usually not be taken away. An attachment may have been made and this could cause distress, even grief. A close attachment should be respected by everyone. A resident may like to take it to bed or have it at the table, or dress it. Some residents may give them names or call them ‘baby’ which is their choice we respect. Use the same name for the doll as the resident uses
The dignity of a resident is very important and if they feel happy stroking it or talking to it that is what matters. Sometimes it is difficult for relatives to get used to it – it may feel patronising - but for the resident, it is a response to feelings and comfort which is actually taking place. It is important not to make fun but recognise genuine comfort
·Mirroring behaviour is important, e.g. we need to give the same respect to the doll as the resident gives it. This may feel a little difficult but we let the resident take the lead as it may feel very real to them.
Encourage the sensory side, stroking the hair, tidying the clothes etc
Monitor levels of fatigue as caring for a doll can make them tired
Dolls are never used to persuade someone to do something – i.e. bargaining – as this can be very distressing
Positive reminiscence of ‘special years’ (eg when residents were young mothers or nurses) can result in improved well being and self esteem. Dolls can facilitate memory retrieval , validation and resolution of certain memories
Leaving a relative after a visit can be made a little easier, knowing they have a strong attachment to something which brings comfort and reassurance
Communication may be facilitated through the doll and maybe particularly helpful to those who have become withdrawn or depressed. It gives a focus to visiting, particularly if conversation is limited
Other roles and uses may be found. For example an ex GP was found to be examining the doll joints! This promoted conversation about his work place

Please feel free to discuss any concerns and reservations with me or the staff about empathy dolls.

Many thanks and best,

Alise

9th March, 2012: The beginnings of positive change

Dear Relatives,

I am really pleased to report that after quite a few months of feeling like we're treading water on Sherman, I am really sensing the beginnings of positive change on the unit .

We're at the end of the second week since the start of quite a few projects, and the increase in momentum alongside increased support for the staff, is having a pleasant effect.

Today I met with a few relatives and look forward to meeting a few more on Wednesday at 3pm (in the lounge) to discuss these projects in detail. I will send the minutes out from both at the end of next week.

But just briefly for now...

- We have started the Enriched Care Planning project, which will take a few months to complete but so far has been well-received. Relatives will be contacted in due course to be invited to help with care planning - especially around lifestyle, personality and life story.

- Similarly as you know, we have switched to a new key worker system. Please expect key workers to be contacting you soon if they haven't already.

- The new short order menu has been used and will pick up it's frequency over time. Do remember to ask staff when you visit if you're interested, or indeed want to order something for your relative on Sherman.

I'm really happy to be receiving lots of emails from relatives with questions and ideas.. keep them coming!

We're on our way now - I can feel it!

More soon,

best,

Alise

29th February, 2012: Decorating sherman - part 1

Dear Relatives,

We have a tentative launch date for the ‘Beauty & Needlework Corner’ and the ‘Tea Room’ on Sherman: this is Wednesday 7^th March at 2.30pm

May I ask anyone with the following items to spare, please bring as much in as you’d like to on your next visit to Nightingale…

- Nail varnish

- Manicure sets

- Moisturisers for hand massages

- Costume jewellery

- Jewellery holders (eg jewellery box or hand sculpture for rings & necklaces)

- Display items re beauty (eg antique comb and brush, etc)

- Hat and coat stand

- Wool / thread / cotton etc

- Knitting needles

- Fabric rolls/pieces – literally any types

- scarves

- Anything relating to dress-making

- Pictures of beauty parlours / dress making

(I’m afraid I’m not at all an expert on sewing but really any items relating to textiles, needlework and beauty would be much appreciated!)

More soon,

Best,

Alise

24^th February, 2012: Short Order Menu for Sherman

Dear Relatives,

On Monday 27^th, we are launching a Short Order Menu for Sherman Unit.

This will be available between 9:00 and 18:30, and its aim is to maximise nutritional intake for the residents. It can be used as an additional snack, as an alternative option if someone doesn’t like any regular menu items, to ensure someone away at hospital over a mealtime can still order something extra if they’re hungry, and so on.

The menu items are based around what is quick to make, and what many residents have regularly asked for in the past.

We will do a formal review of use of the menu in one month, but check informally on usage daily at handover.

Best,

Alise

17th February, 2012 : Key Working teams and Enriched Care Planning

Dear Relatives,

A new key working system will go live on Sherman, as of Monday 27^th February.

Key workers working in small teams, led by a Care Coordinator, will be responsible for the planning, implementation and evaluation of enriched care for a small group of residents.

The aims of the new system are:

Key workers to foster strong, trusting relationships with their residents
Unique needs and desires of each resident to be met
Shared responsibility and effective team work
Reflective practice sessions around individual care plans
Strong lines of accountability
Regular communication with relatives

Each key worker will sign a charter, which will have their and the resident’s photos. Please see this charter here. The staff will be held responsible for fulfilling the promises on the charter, and as a group we will develop a detailed guide with requirements, suggestions and examples on how to do this.

For confidentiality reasons, I cannot post the resident and staff names in each key working team here. These will be available from the 27^th on the unit and in the mean time you are welcome to email me to find out about the your loved one’s key working team members.

In addition to the new teams, we will be introducing Enriched Care Planning. The key working teams will meet with me on a weekly basis to develop their residents’ Enriched Care Plans, step by step. These plans include lifestyle preferences, life story information and personality profiles, along with health information, all in acute detail. As mentioned previously, when these sections are being developed, we will be contacting you to ask for your help in gathering the information.

I will present on enriched care plans and key working teams in the next Bradford project meetings for relatives.

As usual, contact me if you have any questions!

Many thanks and best,

Alise

13th Feb, 2012 : Introduction

Welcome to the new blog! I hope this helps you to feel more in touch with the changes being made in conjunction with Bradford Dementia Group (BDG). Right now BDG's focus is on Sherman Unit, so all posts here are currently aimed at relatives of residents living on Sherman. Please email me if you have any questions or concerns about the content of these posts.

More coming very soon..!

Best,

Alise

105 Nightingale Lane London SW12 8NB Tel: 020 8673 3495

Nightingale Hammerson – Registered Charity 207316