A dementia diagnosis often comes with an inevitable loss of identity, coupled with confusion and shock to the system. These feelings can be exacerbated when a person enters a care home. How can you support residents to find their sense of self again?
New things are always hard. Put yourself in your resident’s position for a moment. Suddenly you are in strange surroundings, with nothing to remind you of home or your previous life.
It is an incredibly strange environment, and actually something that would be upsetting for anyone, though obviously much more so for those living with dementia, who might not have a clear understanding of why this change has happened.
In a strange environment, a world where they often know no one, everything combines to create a real and profound shock to the system. Add to this their problems with short-term memory and their decreasing ability to make sense of the present, and it can be a very traumatic, disorienting experience. “I often think of it being not unlike experiencing an earthquake, where suddenly, often with no warning, your bearings are lost, what you trust and know to be normal isn’t there anymore,” explains Chris. “You’re awash. At sea.”
It can be a serious struggle for many people, but there are things that you can do to alleviate this sense of unfamiliarity and to help people settle in. We’ve already looked at the changes you can make to their environment and personal space, but what can you do for them on a day-to day basis, and in your activities?
Familiarity is key. Reminiscence plays an important role in helping with this shift from the home to a care setting. Recalling past events or past memories, big or small, especially local ones, are all ways to reinforce a feeling of familiarity and safety. They can often be reminders of that person’s identity – a connection to a time when that person felt stronger, more important, more powerful, rather than this more reduced, dependant person that they seem in this current time of their lives. Perhaps they worked locally, or ran a local business? What do other people remember about this? How might they have interacted with this person in the past?
Life story work is vital in these early days. Not only is it essential for ensuring person-centred care and targeted activities, it’s also a great exercise for any new resident coming into the care home.
Life stories define who we are, help to shape our personalities and reactions to future experiences, and they build on our sense of self. There is a significant body of evidence confirming the benefits of using life story work when supporting people with dementia.
Add to this the wide range of products for gathering life story information in a range of formats – including books, memory boxes, photographic and digital albums – it is surprising that the use of this information remains seemingly underused.
Telling life stories is one of the significant ways in which individuals construct and express meaning in their lives and plays a large part in helping people identify themselves. (Angus, J. and Bowen, S.)
Life story work is an activity in which the person with dementia is supported by staff and family members to gather and review their past life events and build a personal biography. It is used to help the person understand their past experiences and how they have coped with events in their life. Life story records can take the form of a number of different media from a paper booklet or printed sheet, to DVDs, CDs, photo albums, memory boxes or a collage. How you choose to keep and present this vital information will be related to how you intend to use it, but whatever you decide, it should be as comprehensive and rounded as possible.
Life story work can help people with dementia share their stories and enhance their sense of identity. It can also encourage better communication and an understanding of the person’s needs and wishes. This information can then inform a person’s care and ensure that it is provided in a positive and person-centred way. (Dementia UK)
Next week: Top tips and tools for uncovering life stories.