The use of dolls in dementia care, effective therapy or insultingly patronising?

Gary Mitchell RN describes how he overcame his initial reluctance to see the potential benefits of using dolls as ‘an anchor in an ever-changing sea of uncertainty’ for some individuals with advanced dementia. In this blog, Gary offers some advice on how dolls might be introduced.

Read more…

Gary would be pleased to respond to any queries if you would like to email him on

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Access books, reminiscence boxes, activities and more…

[updated May 2015]

I was inspired to pull together this list of resources when attending a WhoseShoes event in Kent and heard about Kent Libraries’ wonderful list of reminiscence boxes and associated training.

A number of councils and other organisations offer a variety of dementia-appropriate books, games, activities and reminiscence or rummage boxes via libraries and other locations, for the use of care homes and individuals.

The list below just scratches the surface; if you are aware of services that we have not included please send details to

Most importantly, encourage them to list their services online! The internet is a vital source of information for people living with dementia and their families as well as care homes and organisations / individuals offering activities and events for people with dementia. If Google can’t find it, it’s going to be more difficult for people to get to hear about it.

Other sources of information

The International Federation of Library Associations and Institutions (IFLA), the international body representing the interests of library and information services and their users, have published guidelines giving practical recommendations on how to provide mental stimulate with books and other library materials. The publication also includes suggestions for library staff on how to tailor such services to the target population.

Other sources where these services may be listed are: Alzheimers Society…  Dementia Action Alliance…  Dementia Challengers…  Dementia Web

National Organisations

The Reader Organisation is a charitable organisation which runs Reader Groups in Care Homes and other locations.

Listening books is a charity providing an online and postal audiobook library service and also offers organisations their own mini library of 200 audiobooks to lend out to patients or residents or to play in communal activity areas.

Books on prescription is led by the Reading Agency  who worked with dementia healthcare experts, people with dementia and carer groups to select a list of 25 titles that provide support and advice for people with dementia and their carers. The titles can be recommended by health professionals and are available for anyone to borrow free-of-charge from their public library.

Regional organisations

Bolton offers free bulk loans of books for care and nursing homes on application to any library.

Bury has an impressive list of dementia-related titles.

Exeter Library, one of Devon’s Libraries, stocks a wide range of books offering advice and information on dementia.

Glasgow Museums has a wide range of themed kits available. They cover topics such as childhood and tenement life. Kits contain original objects, photographs and other material

Kent Libraries not only ensure they have a good stock of appropriate books, but also make available Reminiscence Boxes to care homes and people living with dementia, and provide training for staff on how best to use them as well. Contact or call 03000412413

Leeds Care & Repair offer a free service for family members and carers to borrow fun games and activities

North East Lincolnshire Library has a dementia specific section

Liverpool Museums As part of the House of Memories programme you can borrow a ‘memory suitcase’ which contains objects, memorabilia and photographs. The suitcase contains a range of objects relating to the past including Liverpool Overhead Railway posters / Music and fashion memorabilia / Picture books and games / Ford Anglia model car  Pre-decimal coins and pound notes. The memory suitcase is a free loan service which is available from Museum of Liverpool for up to two weeks at a time. Also available: dementia awareness training to give you the skills to run a reminiscence session.

March Museum (Cambs) has loan boxes, a resource which use original, and a few reproduction, artefacts as a stimulus for learning in schools, care homes and almost any social club or discussion group.

Newcastle Library has a dementia specific section

Norfolk libraries are marking Dementia Awareness Week with free workshops and new dementia book collections and have a collection of Reminiscence Kits and Packs

Nottingham are piloting reminiscence packs or ‘Memory Lane kits’ to support people with dementia and their loved ones.

Poole Borough offer a special library card which enables people with dementia to borrow books for up to six weeks, instead of the usual three, and they stock a  complete set of Picture to Share books. People with dementia can borrow audio books, music CDs  and DVDs free of charge (2 per visit) and take advantage of the free Home Library Service for people unable to visit the library themselves, and for carers.

Somerset Library has a dementia specific section.

Wiltshire run library memory groups in Mere, Pewsey, Purton and Warminster libraries every week. The sessions are free of charge and refreshments are provided. The groups offer an enjoyable, relaxing opportunity to meet others and stimulate positive memories. In addition, Wiltshire Council is launching a new collection of dementia books, available in libraries. The aim of the collection is to provide a range of information about dementia and how to support people to live well. The books will be available in Chippenham, Devizes, Trowbridge and Salisbury libraries, and will be available to users of other libraries through the normal loan process. For more information people should contact their local library.

Please supply further resources to be added to this list or updates to


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Twist-N-View Care Charts help Reduce Average Length of Stay in Community Hospitals

Having run a comprehensive trial for six months in one ward, Peninsula Community Health is introducing the Twist-N-View care charts into all 17 wards in their 14 community hospitals.

Peninsula is a not-for-profit Community Interest Company and provides NHS adult community health services to local people in Cornwall and Isles of Scilly. Sue Greenwood MBE, Dementia Lead at Peninsula, explains the background, how they conducted the trial and what the outcomes were.

“We recognised that personalisation of care is crucial if we are to meet the individual needs of the people we are delivering care to, but to offer that quality of care we needed to find a way of ensuring that staff had the information they needed about each person, particularly important when a person is unable to communicate their own needs and preferences.

“We were using our admission paperwork but this did not prompt staff to ask the questions that would inform us of the individual person, knowing who they are, what mattered to them and how they wished to be cared for and supported. The driver for Peninsula Community Health was a move towards treating people as individuals and not as a clinical condition. Working with the staff in the clinical area was challenging, however support and guidance and education enabled us to ensure the ward team owned the change that was needed.

“Care Charts UK’s Twist-N-View charts allowed us to design bespoke care needs for individual patients. The charts are easily accessible and available for the whole multi-disciplinary team. We introduced one to one educational interactive sessions to start to talk to the staff about personalisation of care and how the charts could be used to ensure that those really important conversations with the patient and the carer or family member could lead to better understanding of individual needs and what’s really important for that person. One way of doing this was for staff to complete a chart about themselves.

“The team have been supported in the adoption of the charts by specialists as well as peer to peer support and training. No change is easy to implement, inevitable barriers do have to be addressed, however the ward team have wholly owned this change and have been able to overcome some of the initial resistance to the change in practice.

“The feedback received from some staff was really exciting; the charts gave staff opportunistic moments to interact with patients. This was a new experience for some staff (Health Care Assistants, General Service Assistants, Therapy Support Staff and House Keepers) who may have felt reluctant to engage in conversation prior to the introduction of the charts. We have also been able to work in partnership with the 3rd sector in utilising the skills of volunteers in completing the charts.

“We were able to achieve the foundations we needed to build on around the introduction of personalisation of care. The charts allowed us to go beyond just a list of likes. What’s important to people goes beyond the information that is collected using admission paperwork which tends to concentrate on the condition or medical problem rather than the person. We were also able to understand what we could do to manage difficult situations that may arise, for instance what to do if someone with dementia became agitated or confused. Periods like this can very easily escalate and become very difficult to manage. If we could understand the person and understand what family members and loved ones do at home to manage this then we could better care for the people we were looking after and understand much more of the person we were caring for.

“Staff on the unit became involved in completing the charts; it allowed our Health Care Assistants, Housekeepers, Therapy Support staff and General Service Assistants to be a part of the care delivered to patients. In short, it connected every member of the team to the patient and recognised their value and the care they delivered every day to patients. This had never been validated before and was very well received on the unit. For an organisation this was a very exciting tool that enabled us to shift the agenda towards the Personalisation of Care at a much quicker pace than was expected. It also allowed those staff involved in care every day to validate their worth and feel included in the delivery of high quality care. Because we were able to fully understand the individual needs of our patients the introduction of the charts enabled us to reduce the time a patient needed to stay in hospital. We were also able to reduce the number of complaints and inappropriate referrals.

The return on investment is evident in numerous areas:

  • Raised the quality of care being provided
  • Increased positive outcomes for patients and families
  • Reduction in complaints
  • Reduction in episodes of distress and agitation
  • Being able to provide the right care at the right time
  • Reduction in average length of stay
  • Increased staff satisfaction / improved staff morale
  • Increase in staff awareness of personalisation of care
  • Better use of clinical time”

Steve Jenkin Chief Executive Peninsula Community Health

“The introduction of the Care Charts has enabled us to build a firm foundation within Peninsula Community Health in relation to the Personalisation of Care which is central to the way we want to deliver care and work in partnership with families and carers. Because the charts can be wiped off and re-used we are confident that the eventual cost will be a matter of pence per patient.”

Quantitative Data

Peninsula calculated that the financial saving as a result of reducing the average length of stay equated to more than 10 times the cost of the charts in a 6 month period. That’s over 1000% Return on Investment in 6 months.

Qualitative Data

Peninsula collected an extensive range of feedback from members of staff, patients and their family during the trial. Here are a few of those comments…


“It’s nice to know that staff can talk to mum about things which interest her when we are not here as we are unable to visit every day”

“This helps people to know the person”

“Gives staff a greater understanding, the care is good”

“This covers some really important information about my dad”

“Don’t see any problems with confidentiality”

“The more information staff has the better they can provide care”


“Information recorded about how patients drink tea is very relevant to my swallowing assessments”

“As long as care staff are referring to the information I think it’s a great idea, I will now be able to add safe swallowing advice in the additional notes section”

“Over all a good idea in light of importance of confidentiality”

“Great when gaining rapport and trust for assessments”

“Very good as I always like to know what someone’s occupation was, as well as interests when they were younger”

“No problem with confidentiality as they look like pictures”

“This is a good tool especially if the information is detailed”

“It’s a great quick reference especially as I don’t always know the patients well”

“Very informative, it was also a good way to interact with patients, and a great way of having a good understanding of their overall likes and dislikes and limitations etc.”


“Good, simple and effective” “Very positive way of promoting communication between staff patients and family members”

“Good idea and it brightens up the ward”

“The information is very good”

“Staff seem to talk to me more about things that interest me”

“It’s perfect”

“I have been in before but everyone seems to know more about me this time”

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