Person-centred care. It’s the new ‘buzz word’ for aged care, and it seems you can’t talk about aged care without it. But what exactly is it?
Person-centred care isn’t something that can be bought, or created with a fancy new building. It is more than just words on the pages of a policy document. It starts with a culture of change at Board and senior management level, and filters down to all staff within an organisation. The result is something you can see, and also something you can feel.
I recently visited our day centre, Mary Chester House, and that feeling was all around me. I’d like to share my experience with you.
Mary Chester House is located in Shenton Park, and although in the heart of the metropolitan area it is surrounded by natural bushland. The House, designed with dementia enabling design principles in mind, runs typical services such as day and overnight respite, social clubs and a Men’s Shed.
The people living with dementia who attend our Houses are known as our club members. Each member has a one page information sheet displayed in plain view, stating the member’s preferred name, likes and dislikes, and what occupation they once had. This gives staff, volunteers and visitors like me the opportunity to learn something meaningful about members. It reminded me that these are people who have lived full and vibrant lives, and this should be respected and acknowledged.
Each morning the staff, volunteers, and members meet to decide what activities they will do for the day. Some activities, such as outings, are planned ahead with members input. However, variety and spontaneity are encouraged.
On the day of my visit there was a partially completed jigsaw left out on a table, and a few rows of knitting – with needles still attached – sitting in a basket next to a comfy armchair. The piano was set up with the lid open and sheet music sitting ready, as if inviting passers-by to sit down and play.
In other facilities, knitting needles might be seen as a hazard to the resident’s health. An unfinished jigsaw puzzle a mess to clean up. A piano may be on view to ‘promote reminiscence’, but with a sign that says ‘do not touch’… which defeats the purpose of having the piano in the first place.
At our House, the jigsaw and knitting is an opportunity to bring about joy, for members to enjoy a favourite past time. The open piano an opportunity to invite music, singing and a great deal of spontaneity to the House. These simple activities also provide opportunities for members to connect with others over shared interests.
Consider the alternative… being ‘parked’ in a chair in front of a blaring TV, and left to fend for yourself. I don’t know many people who would choose that option.
When I visited, the intimate dining area held several tables and chairs, each set with real flowers in a real vase. I later learned that members took great pride in picking flowers from the garden to decorate the tables – just as they would have at home.
Members could choose where to sit to eat their meal and who they sat with, rather than being told where to sit. Cutlery was left out for those who wished to set the table, giving members the opportunity to do for someone else – rather than having tasks always done for them.
Too often, the everyday choices that we take for granted are taken away from people with dementia. This can slowly erode a person’s confidence, and lead them to eventually give up trying to do anything for themselves.
The kitchen was staffed by volunteers, the door was left open, and several members were in the kitchen helping with food preparation. You may be thinking, why would you let a person living with dementia into a kitchen with potential danger? To give that person the opportunity to engage in an activity that is normal and enjoyable. Staff and volunteers are all so intimately familiar with each member’s abilities, they know just how much supervision to provide. The potential risks are far outweighed by the look of satisfaction on a person’s face when they have helped to prepare lunch. And to date, we’ve had no burnt fingers.
Later, staff and volunteers sat and ate their meals with members – just like one big family.
The dining room led to a garden area, through doors that were unlocked and open, and members were able to move from inside to outside as they pleased. The garden was brimming with opportunities for members to be active, or to sit and relax, enjoying the sunshine and the sounds of birds from the neighbouring bushland.
A paved courtyard was set up with an ongoing communal mosaic project. A gazebo strung with fairy lights and covered with greenery invited members to sit and chat around the 10 seater table. A grassed area provided a seat for quiet contemplation – and a small cubby for toddlers from the mother’s group who visits once a month.
Around the corner I could see the Men’s Shed. On this particular day the sound of buzzing saws radiated from the Shed, and the nearby garden beds were a hive of activity as new vegetable and herb seedlings were being planted by members. Further along in another undercover area a serious ping pong match was underway.
It may sound risky supporting a person with dementia (who has also worked with timber all his life) to operate a drop saw, but worth the risk if it means that person can achieve the sense of achievement that only comes from creating something useful from a piece of timber.
Besides, it’s probably more risky to allow a person without dementia to operate drop saw if they’ve never used one before.
Throughout my visit one thing was clear. I was surrounded by smiles, laughter and life. It didn’t feel like a facility. It felt like a community. It felt like home. Our House is founded on the Eden Alternative Principles™, which focus on combating the loneliness, helplessness and boredom experienced by many people in aged care. Everything that happens at our House is guided by the ten Eden principles. While the safety of all members is paramount, our aim is to provide a home-away-from-home where people with dementia are respected and supported to make their own choices, learn a new skill or two and above all form friendships with others who are on the same journey.
A few months ago one of our club members passed away, and his wife wrote to us expressing her gratitude for our support. In her letter she said,
“My husband was diagnosed with Alzheimer’s back in 2007. Contacting Alzheimer’s WA was one of the best things I ever did for both my husband and myself.”
“I was lucky enough to get my husband into the wonderful Mary Chester House. He thoroughly enjoyed his three years there.”
“I know my years with Mary Chester House and Alzheimer’s WA were the cornerstone of my ability to cope with the gradual loss of a much loved husband.”
Our Houses, we have two more in Albany and Mandurah, truly embody person-centred care, and I am so grateful we can care for our clients in this way. Now that you know what person-centred care looks and feels like, when the time comes, be sure to insist on it for yourself or your loved one.
By Danielle Wrench, General Manager, Alzheimer’s WA