Sport: have we forgotten it?

Sporting Memories

by Emma Harris

We’ve all experienced that feeling when our muscles remember how to do something we thought our minds had forgotten, perhaps riding a bike or swinging a tennis racket. We may assume that an individual with dementia soon loses access to these memories along with names, places or facts, but our motor memories (or muscle memories) are actually amongst the last parts of our brains to be affected by dementia. This means that an individual may still be able to recall movements stored long ago in their muscle memories. Lisa Krieger of Mercury News tells the story of Jim Byerlee, an 84-year-old living with dementia, who was taken to play golf by his care home staff. Jim was able to swing a golf club with all the accomplishment of a retired athlete.

The Sporting Memories Foundation
Intergenerational reminiscence with The Sporting Memories Foundation

Like Jim, everyone has been touched by sport in some way, whether playing it, watching it, on TV or attending live events. As Tony Jameson-Allen, co-founder and director of The Sporting Memories Foundation, says ‘You don’t have a choice, everyone has memories of sport’. Sporting Memories advocate the importance of sport, not only to keep older people active, but as a way to encourage positive emotions and a sense of community through reminiscence. They work with care homes, libraries and other communities to organise groups sessions at which older people can discuss their own experiences of sport. Sporting Memories provides resources and training to staff to help them trigger memories and draw on the positive emotional impact sport can have. As Jameson-Allen explains, ‘one of the best ways to spark memories is other people’s memories’; they focus on the strengths of people with dementia: their long-term memories.

Sporting Memories discovered that talking about sport motivated participants to be active, and now organises reminiscence sessions followed by physical activities, including walking, football and curling. Joyce, a 96-year-old erstwhile ice dancer, is one such motivated person. She was taken to an ice rink by a member of her care home staff and, by using an adaptive frame, was able to experience all the sensations of being on the ice again.

Physical movement can play a vital role in improving the quality of life of an individual with dementia. It encourages physical and mental stimulation, can prevent depression and assists with sleep. Many organisations have discovered the power of active care and the numerous ways it can be tailored for all ages and abilities.

Table tennis for dementia
The BAT Foundation offers a ‘drug-free’ therapy for Alzheimer’s Disease.

The Bat Foundation describes exercise, or more specifically table tennis, as a ‘drug free Alzheimer’s therapy’. As part of their research, a team of neurologists took MRI scans to compare the brains of people with dementia who play table tennis and those who don’t. The scans revealed that certain parts of the brain light up dramatically in those who had just played table tennis; the concentration and co-ordination required to play the game stimulates the hippocampus and can delay cognitive decline. As a result, they have designed a table tennis table specifically for people with dementia, using colour contrasts to aid sight and side panels to assist with play. Annie Ingram, a voracious player, comments, ‘I can do this, I’m loving it!’.

Another sport which appeals to all ages is swimming and is known to have a positive impact on people with dementia, particularly because water offers a feeling of being weightless, thereby relaxing the body. But a public pool may be a daunting environment for someone with dementia and their carer. The Dementia Friendly Swimming Project aims to make swimming pools a safe and welcoming environment for people with dementia. They work across the UK, creating a network of dementia-friendly pools by producing guidance and offering training to swimming staff to achieve this aim.

Dance, on the other hand, is an activity which can be brought directly into the care home. Alive!, based in Bristol, offer dance and movement sessions which focus on the potential this activity has to help older people express themselves when they are no longer able to fully communicate their feelings; it’s about using dance to interact with individuals through rhythm and music. Alive! also offer training programmes to staff to help them bring active care into their own care homes, and run ‘Active Care Forums’ across the South of England for anyone working with older people. Becoming a member of a forum is a great way to pool new ideas and share experiences, whilst also gaining access to training, support and resources on active care.

JABADAO is a somewhat more unusual organisation. SPAGOG, Seriously Playful Armchair Games for the Old and Gorgeous, is a league event which uses basic movements and games with the simple aim of making life better. This is how it works: JABADAO teach the games to carers to play with their residents, the carers return the scores to the organisation, and results are published online weekly so care homes, friends & family can see which team is leading. Two finalist teams play against each other for the famous SPAGOG cup. JABADAO specialise in creating activities for people in late stages of dementia, and offer training for carers to improve the non-verbal communications of these individuals. Contact JABADAO if you’d like organise a competition in your area.

All of the above organisations, and more – see links below – offer the opportunity not only to maintain or increase physical fitness, but to become part of a community and interact with others through a medium other than speech. As Tony Jameson-Allen says, ‘it’s about friendship and keeping people supported just as much as it is about sport itself’. When words are a struggle, it can be the things which do not require any words at all that can offer us the most support.

Resources:

The Bat Foundation
Deliver specialised table tennis Alzheimer’s therapy programme

Dementia-Friendly Swimming
Organisation working to make swimming pools across the UK welcoming for people with dementia

The Sporting Memories Foundation
Work with communities to organise group sessions to discuss sport

Dance and Dementia
Offer dance sessions to individuals or groups

Alzheimer’s Society: Exercise in the early to middle stages
Advice from the Alzheimer’s Society on exercise for those in early to middle stages of dementia

Alzheimer’s Society: Exercise in the later stages
Advice for those in later stages of dementia

Association for Dance Movement Pschotherapy UK
Resource to find dance movement therapist for individual or groups

The Transformative Power of Art

Beach Huts

by Emma Harris

For the average person, being given the opportunity to create and express themselves might inspire a sense of freedom and productivity; it might also be something we take for granted. For a person struggling with dementia, perhaps with weakening senses or an inclination to recede into themselves, the power of art and creativity can be transformative to their quality of life.

Worldwide, people are beginning to understand the importance of creativity for those with dementia. In 2015, the Alzheimer’s Society produced a guide to encourage arts venues to become more dementia-friendly, offering extensive advice on how to do so. Sir Peter Bazalgette, Chair of Arts Council England, says “There are 850,000 people in the UK living with dementia and, for many of them, the arts will be fundamental to enabling them to live well with their condition”.

James, Creative Minds
James, founder of Creative Minds, leading an art session.

James Cropper is someone who has grabbed this idea by the horns. James was caring for an older adult with learning disabilities when he discovered the power of arts and crafts.

“He just came alive,” says James after observing this individual’s love to create.

Inspired by how stimulating and energising art could be, Creative Minds was soon formed. Now, James and his community of experienced artists enhance the lives of thousands of people in care homes, placing emphasis on experimentation and allowing them the time and materials to create their own pieces of art work. And the benefit is not just emotional; as well as boosting self-esteem, James explains how creativity increases cognitive stimulation, improves dexterity and motor skills, and reduces stress and anxiety. Family members of residents have been impressed with the art sessions and notice a profound impact on the residents. Jane, a resident’s daughter, comments, “I believe these sessions provide far more to the individual than just an afternoon of fun”.

Creative Minds continue to develop their art sessions and have started encouraging the interaction of multiple generations by inviting primary school children to join in with art sessions at care homes. They aim to make art accessible to people of all ages and abilities, bringing their sessions to more and more locations.

Engage & Create, founded by Rachel Mortimer, uses art in a slightly different way. Using an iPad to display famous pieces of art, they facilitate discussions of art in care homes and encourage conversation amongst people with dementia. Rachel says that it is fascinating how people with dementia notice things in art that she has not seen before. Like James, she has observed first-hand how interaction with art can draw people out from their shells and improve well-being, not just during the discussions, but well beyond them.

In 2007, The MoMA (Museum of Modern Art, New York) set up an initiative to make art more accessible to people with Alzheimer’s, expanding their education programmes to assist health and art professionals in making art accessible to them. Today, they continue to encourage people living with dementia interaction with art through programmes (see link below).  Whilst a trip to New York to participate in one of MoMA’s dementia programmes may be a little tricky, Engage & Create bring discussions directly to the care home.

And they don’t stop there; Rachel’s ‘Ignite Programme’ offers a tailored training package to care home staff so that they themselves can lead discussions about art work, supported along the way by the Engage & Create team. An occupational therapist told the team, “that was one of the best training sessions I’ve ever had … it’ll change the way I work with people with a diagnosis of dementia forever.”

If you want still more proof of the power of art, take a look at this recent study on dementia and creativity, ‘Dementia and Imagination’. The project was studying how visual arts can impact people with dementia. As the research only ended in December 2016, full findings are yet to be published but the initial reactions are undeniably positive. Participants commented on the soothing environment and the sense of achievement they felt; findings also indicated that family members and carers were affected positively as the art sessions allowed them to get to know the residents better through their creations.

All of these ventures focus on what people living with dementia can do rather than what they can’t do. In turn, the people living with the condition learn to focus on these things as well, nurturing an environment of positivity, colour and creativity which has the power to significantly improve their well-being.

If you are aware of an organisation that should be included in our list of resources, please email the details to info@mycarematters.org.

Resources:

Creative Minds Offer practical art sessions across England

Engage & Create Offer art discussion sessions and training packages for staff, including The Engage & Create Ignite Programme

Creative Buddy is a social enterprise that provides mobile arts and crafts sessions for care/residential homes, day centres and community venues in Sussex.

Dementia and Imagination A recently completed scientific study on the benefit of art for individuals with dementia

Arts4Dementia  develops arts programmes to empower, re-energise and inspire people with early-stage dementia and carers through challenging artistic stimulation, to help them live better for longer in their own homes.

Equal Arts Offer training sessions for care staff and run projects encouraging creativity amongst people living with dementia

MoMA Information on how to make art accessible to people with dementia.

Alzheimer’s Society Dementia Friendly Arts report A guide for arts venues on how to become dementia-friendly

 

 

 

 

Two award-winning products… one fabulous offer

TNV Reminiscence 1950s

We are delighted to be partnering with Many Happy Returns to create the Twist-N-View Happy Memories Set for care homes and hospitals. We have adapted our Twist-N-View Display Care Chart so as to display and store a number of the award-winning Chatterbox Cards, and are now offering 6 Care Charts and a pack of 26 Chatterbox cards for just £77.60.

Not only does the Twist-N-View Happy Memories Set facilitate person-centred care by ensuring all those interacting with an individual are aware of their needs and preferences, but also provides the tools to encourage conversations and facilitate reminiscence sessions.

See more by clicking here..

 

Introducing Mycarematters…

Mycarematters

It’s already been an exciting year for Care Charts UK, seeing the adoption of our Remember-I’m-Me Care Charts by hundreds more care homes and hospitals, and receiving lots of positive feedback about the beneficial impact achieved by these simple, cost-effective tools.

We’ve also made a start on a range of products to help with the care of people living in their own home (we’re still looking for input on this from carers, both paid and unpaid, and those being cared for: please complete our homecare survey if you haven’t already done so.)

But there’s more to be done. I’ve been conscious for a while, now that we are working with increasing numbers of hospitals, of the difficulties faced by staff in collecting the information to go on a Care Chart. A number of hours, even days, might pass before nursing staff can build up a picture of the issues that matter to a person if they are unable to communicate these things for themselves. Even in that short time a person living with dementia might suffer trauma and discomfort purely because the information isn’t reliably available which would enable staff to allay concerns, meet a person’s dietary needs or understand what might look like inexplicable behaviour.

There is increased understanding of the value in treating the whole person to improve overall outcomes, and the power of Care Charts lies in providing quick, easy and reliable access to a person’s needs and preferences to assist in that aim. However, research suggests that nursing staff spend an average of 100 minutes per patient trying to collect the information that will help them provide that person-centred care.mycaredata note

So a few months ago I had one of those exciting lightbulb moments, with an idea that just seems so obvious I can’t believe it’s not already out there (not unlike my experience when I developed the first Care Chart for my husband Geoff). If we could provide a secure place online for people to upload their non-medical information, it could be made immediately available to all healthcare staff, cutting that 100 minutes by more than 90% and immediately improving the potential for better outcomes for both staff and patients.

In that moment Mycarematters was born, and in true ‘JFDI’ style (so often referred to by my friend Gill Phillips of @WhoseShoes’ fame), we’re about to start building the platform.

I want to reiterate the point that this is not about medical notes; there are others working on ambitious projects to digitise those, and they face many challenges. Mycaredata will focus instead on details like preferred foods and drinks, what assistance is required for a person’s mobility, why a particular routine is important and any other issues that matter to a person: reassurance for example that their pet is being cared for whilst they are in hospital, or that they need assistance to eat.

Uploading the information will be simple and straightforward, guided by a series of prompts, and it will be a quick and easy process for hospital staff to access it. We’ll be making use of the best encryption and data security software to protect the data (talktalk IT staff need not apply!) and the best news is that we’re going to try and keep it free for both individuals and hospitals.

If you would like to follow our progress you can do so at www.mycarematters.org and/or comment on any aspect of the project at info@mycarematters.org. I’m sure the end product will be quite different to what I was envisaging when I scribbled that first note to myself, but the aspiration won’t change: to improve the experience of a hospital visit for those people who struggle to communicate their needs, thereby improving their outcomes as well as those of the staff and of the NHS.

Supported by

BGV snip

 

 

Sight is precious

Jim took a lot of falls in 2012. His eyesight, dementia and arthritis were all conspiring against him. He’d wake up in the morning, forget he could not walk and think the lights had all been turned off.

We are introduced to Jim in a video produced by scie, dealing with sensory loss (see link below). The staff in the Cumbrian care home where he lives have had to learn to be very patient, and use concise, effective communication.  They try to communicate with Jim in a quiet area, so background noise doesn’t distract and confuse him.

It seems nothing can be done about Jim’s blindness, but that is not the case for many of those living in care homes and trying to cope with impaired vision. Whilst many homes diligently arrange sight tests for their residents, there are probably many more that do not see the need.

There is generally thought to be a correlation between dementia and sight loss, so a certain shrugging of the shoulders is inevitable, but dementia is already confusing enough for the person living with it so if there is anything that can be done to help them maintain senses like eyesight and hearing, it should be done.  Regular sight tests are important – it is possible to have an eye examination at nearly all stages of dementia  – to diagnose cataracts, check prescriptions are up to date and to assess for other conditions, treatable or otherwise.

Even if nothing can be done to improve a person’s sight, it is important to assess the quality of their vision so that carers can take it into account in their behaviour towards and around that person.

Yet, in a survey in 2014 the College of Optometrists asked their members how frequently they carried out domiciliary eye examinations in people’s homes or care homes.  Just 10% said they did so regularly in people’s homes and this dropped further to 6% for regular care home visits.

Such low numbers are not down to cost. If you are over 60, or over 40 with a close relative who has been given a diagnosis of glaucoma you are entitled to free eye examinations (in Scotland they are free for everyone). And for those unable to visit an optician unaccompanied due to physical or mental disability they are entitled to a free eye test at home.

So why are the numbers so low? First of all, there is undoubtedly a sense that ‘it’s just the dementia’. What’s the point in finding out about a person’s eyesight because it’ll make no difference? Those with that opinion should read the story of how the life of Suzy Webster’s Mum has been transformed (and how a potentially traumatic experience can be made so much more pleasant by involving the family) – see link below.

Research done by the College of Optometrists suggests that it is often the families who are not convinced of the benefits of an intervention, and there is plenty of anecdotal evidence to suggest that many professionals feel the same.

This is borne out by Thomas Pocklington Trust’s report (link below) quoting the RNIB who estimate that over half of older residents in care homes have some form of sight losss, yet care home residents’ co-morbidities mean that eye care interventions are overlooked or thought unnecessary.

What’s to be done?

As with so much in this world it comes back to communication. Bust those myths about it making no difference. Make it known that everyone in a care home is entitled to a free NHS eye test at least every two years. Build awareness about the importance of regular eye tests and the difference it can make to the individual’s quality of life where improvements to their sight can be made. As Suzy Webster says of her Mum after her cataract operation: “She’s a different person. She’s really got her spark back… she’s walking steadier, her mood is happier and she’s interacting with us all better.”

A look into the future

Simply slip a small device over the in-built camera on your smartphone. Turn on the Peek app, hold the phone close to someone’s eye, click and forward the picture to a trained eye care specialist.  This is the technology of the future to detect signs of glaucoma, macular degeneration, cataracts and other issues like high blood pressure. Social enterprise Peekvision claim that 80% of blindness is avoidable, and tools like theirs can replace an eye exam at a fraction of the cost. They should be shipping in early 2016 and expect it to be transforming lives in remote corners of the world… there’s a few lives waiting to be transformed right here on their doorstep. http://www.peekvision.org/

Photo by sk on Unsplash

Resources

Scie has a section on Dementia and sensory loss in their Dementia Gateway

The Age Page: Interview with Suzy Webster

Thomas Pocklington Trust: Undetected sight loss in care home

Vision2020 The Right to Sight UK (Dementia and Sight Loss Interest Group) working to increase the knowledge and information available for people living with dementia and sight loss has a useful  factsheet

Thomas Pocklington Trust: Design for Dementia and Sight Loss

The College of Optometrists’ Guidance for Professional Practice has a section ‘Examining patients with dementia or other acquired cognitive impairment’.

 

 

 

Making time to share stories

Read our exclusive interview with George Coxon – Director/Owner of Classic Care Homes Ltd and Chair of the Mental Health Nursing Association (MHNA).

Here at Care Charts UK, we are always interested in hearing about new initiatives that are helping people who are living with dementia and as such, we were delighted to find out more about a new initiative set up by George Coxon. As George explains;

“We are part of the social care world where, if we live long enough, we will be the beneficiaries of entertaining, stimulating, fun and safe 24/7 care. Our lives remain important no matter what our age or circumstances and our precious moments must be shared – it’s these moments that make us who we are.”

We recently interviewed George about this initiative; ‘10-in-10’ and how it’s already proving very successful in enhancing people’s lives.

10-in-10 is a new initiative. What exactly does it involve?

There are multiple jobs to be done by anyone working in a care home, so time is of the essence. It’s extremely important in such a busy environment to add value to the lives of our residents. Keeping them safe is obviously of the upmost importance, but it’s also vital to ensure that they have a meaningful life and to do that, it’s essential that we know well (and are known well by) those we look after. The project draws on work done by the Alzheimer’s Society in their ‘This is Me’ initiative and by you with your Remember-I’m-Me Care Charts but builds upon them further to create an ongoing series of conversations between staff and residents.

The concept is quite simple – both parties share 10 year periods of their respective lives in just 10 minutes. This makes it fun, focused and perfect for maximising time-limited situations, while capturing things we didn’t previously know about each other from the key periods of our lives, like the schools we went to, the dreams we had when we were very young, our early life friends and our favourite toys or holidays.

What was the key thinking behind the 10-in-10 initiative?

The 10-in-10 project enables us to get to know those staying with us in a focused way and in just a short period of time. It enables us to learn more about each other and ensure that we have some good-humoured, quality time. By breaking it into manageable modules we can quickly learn about  each other, capturing themes and past life moments that can then be used to assist in some of the many and varied events, occasions and celebrations  we have at Pottles Court. The initiative is highly focused on making the lives of those staying with us better, but it’s also a fun way for our staff to get to learn more about them too.

What makes this initiative different or unique?

The initiative itself is an adaptation of other ideas that I’m sure have been trialled, but by branding it with a quirky headline it achieves more focus. 10-in-10 requires a two-way exchange based on shared lives, which we believe is more beneficial than the tendency to only have a one-way dialogue. The outcomes will be part of the work we are doing with our local research colleagues and the embedding of what we describe as ‘discovery conversations’ in our care plan compilation creates an active and ‘live’ part of the life stories and life history work often seen in care homes

What has been the greatest revelation from the 10-in-10 sessions you have held?

It’s still quite early days for the initiative but we have already seen some really useful learning taking place. It’s been really powerful to hear the detail of recollections from the first 10 years of residents’ lives and this has enabled staff to get a greater sense of who they are as a person and who they were when they were in their prime. Sadly these realities are often not acknowledged in later life when we become more dependent and less able to convey the confidence and spontaneity we enjoyed in our youth. Another really useful benefit has been witnessing the levels of ability people have to articulate their stories revealing verbal skills and recall capacity that might not have appeared as apparently previously. We have been very sensitive of course in not pressuring people to remember distant memories and as expected, some do very well while others struggle a little – this is a useful part of the ongoing assessment of not just those with cognitive impairment and dementia, but also those with normal memory decline associated with growing older.

Has the initiative been easy to implement?

It’s been very easy – as with all things in life, making time is the biggest challenge so having an in-house initiative that is popular with and talked about by staff, and that forms part of supervisions has given it real status in the home.  It’s about hearts and minds, enthusiasm and embedding ideas as part of a home culture – leadership and followership as we like to see it. Ideas are for success and trying things like the ‘shared lives 10-in-10’ project is but one of many of our projects and initiatives.

To find out more about the 10-in-10 initiative, or to read about the other projects undertaken by Pottles Court, please visit http://www.pottles.co.uk or check out their blog.

 

Spread the cost of your care charts

There are hundreds of care homes who have been using their Care Charts for over three years now, and we frequently get feedback as to what good value for money they offer.

Nevertheless, we understand the constraints cashflow can impose, and we’d like to do what we can to help you incorporate Care Charts into the daily life of your organisation.

So we are delighted to offer you the opportunity to spread your payment over up to 6 months*. Your payment schedule can be set up in a matter of minutes; just email us to say what you’d like to order and over how many months, or call us on 01403 210485 to chat it through if you prefer. It won’t cost you a penny more and you can delight your staff, inspectors, residents and their families with this care-enhancing device, whilst minimising the impact on your cashflow.

*Min: £100 Max: £1,000 Max timescale: 6 months

Chatterbox Reminiscence Cards

ManyHappyReturnsMany Happy Returns Chatterbox cards help older people to share their stories and happy memories. Recommended by The Sunday Times, Saga, leading care homes and families as the perfect Christmas gift, the cards reconnect the generations through easy, fun conversations. They are a wonderful spontaneous activity for older people, even those with some cognitive impairment.

There are two sets:

  • 1940s, suitable for people 80+ years old
  • 1950s, for people 65 – 79 years old

For more information, please go to www.manyhappyreturns.org

chatterbox imageWith familiar images of everyday life, background information and prompts, the cards trigger easy connection between young and old so that they can share and enjoy fun conversations about people’s life experiences from the times that hold their most vibrant and enduring memories.

Does colour make a difference?

There has been a lot of evidence collected about the benefits of using coloured crockery for people with dementia. What is less clear is whether it is merely a question of improving the contrast between a plate and its background so that it is easier to see, or whether particular colours actually provide stimulation to eat. Nottingham University Hospitals (NUH), for example, are now using coloured crockery on all their wards, to ‘help improve the nutrition of patients with dementia’.

NUH and Salisbury District Hospital have chosen to use blue, and Cumbria recommend using either a border or entirely blue crockery. The reasoning behind blue is that there is no blue food so you are always guaranteed a contrast. Whilst the King’s Fund Environment Assessment Tool  emphasises the relevance of contrast in general, others have had particular success with red. Read about Amber Lodge’s introduction of red crockery in 2011, courtesy of Care Industry News, and here is news of another  person’s spectacular results with red crockery, courtesy of Torbay Dementia Action Alliance.

Further information:

How contrasting colour can help people with dementia, courtesy of Alzheimer’s Society

The importance of colour and contrast, courtesy of The Dementia Centre, Stirling

Suppliers of virtually unbreakable coloured tableware: Harfield


Care Charts UK Founder named as one of HSJ’s Innovators 2014

Care Charts UK’s Founder Zoe Harris is delighted to have been included in HSJ’s list of Top Innovators 2014, celebrating ‘those working in the NHS and the wider healthcare sector who have taken innovative approaches that make a tangible difference to patients, their colleagues or wider society’.

The judges worked around some broad criteria: significance, or how big the problem solved has been; impact, or what difference the innovation has made and to what extent it has worked to change things; and support, or how the innovation has fostered and led to other innovation and how it has given inspiration to others.

What the judges said: “In response to her and husband’s experiences, Zoe has invented a great product which is now used by lots of hospitals and care homes.”

Alastair McLellan, Editor of HSJ, said “Our list, we’re pleased to say, is diverse, encompassing everything from top-flight clinicians at the leading edge of their research fields through to frontline staff, patients, managers and simply free-thinking spirits, from within and outside the NHS, who have brought their imagination and creativity to bear. It shows how, for all the NHS can be at times big, unwieldy and bureaucratic, it should be applauded for still allowing space for innovation and “blue sky” thinking…”

Click here for the full list of HSJ Innovators 2014.