Care homes have been offering daycare for as long as I can remember. It is essential for many families needing time out from continuous care commitments. It also acts as a bridge, smoothing the transition between life at home and life within a care environment. But could we do it better?
At Court House, we looked at it again. We saw the term ‘daycare’ as potentially demeaning, almost ‘play-school’ for the elderly. The thought of suggesting to my formidable, but forgetful, mum that she needed to go to a care home for the day sounded like a hard sell. So we wondered if there was a better way to do this.
The idea was simple. What is the most normal activity outside the home that we all do with friends? The answer… meet up for a coffee.
So we built ‘Parrots’, our coffee shop. The aim is to offer care slots of about two hours, including morning coffee (and cake), lunch club and afternoon tea or any mix of the above.
Saying to mum that I am off to do the weekly shopping or a trip to the dentist, whilst she goes for a coffee with friends makes the care home visit sound more positive. The bite-sized visits should be less stressful, with the staff member supporting the club in helping to facilitate new friendships. Any transition that might be needed happens in a natural way.
As for our residents, the wonderful benefit is not only being able to head off for a coffee with their new coffee club friends, but also taking family and friends who visit for a treat like the old days.
So today (Thursday 26th of Jan) I’m up at 7am reviewing the emails while I munch on my Wheetos. There’s lots of focus currently on replacing beds/chairs/furniture and flooring across our homes and seeing where we are at with this and the next steps......
.....Then I’m looking remotely at morning handovers and clinical reviews across the homes, looking for things that need follow up. One home has had a family member return from hospital and they had prepared an altered menu and snack list for her diabetes, so I check in with the chef that they know this and its importance.
We’ve had a couple of very poor pathway zero readmissions yesterday so I draft up my email of complaint based on what I know and save this to add the specific list of medications not supplied later.
Then it’s making sure the kids are dressed, hair tied back (theirs not mine) making sure everything is in the bag for the day (mine not theirs) getting a strong coffee down before heading out the door.
I’m heading out to one of our homes so I take the eldest and drop her to school on my way out and then after she’s at the gates, I have a 30 minute drive to enjoy my current audiobook (the Poppy War Trilogy)
And then getting into the home - it's 'hello' to everyone - and then into the adventure of combining; considering the compatibility of admission assessments with existing family members and homes, have we arranged quotes for a new carpet on a flight of stairs before installing a chair stair lift, a light hearted conversation with one of our nurses about which one of us is more of a pain in the bum than the other, and the fact a step ladder would be needed if the joking threats of purely comical violence ever came to pass.
I’m then onto chasing PETROC college for whether they have any street art students that wish to decorate a temporary building on the grounds of one of our homes.
After that it’s measuring up corridors for floor refurbishment and climbing onto one of the flat roofs at the home with maintenance to look at water accumulation on the and felt needing to be replaced.
Then we inspect external guttering and look at whether the different quotes are going to cover the full spec of works and looking at whether fascias need to be replaced or not.
Next it’s a check in on another home expecting a new admission and how their day is going, making plans for another one tomorrow and speaking to a couple of new starters in the home who I completed inductions for a couple of weeks ago to see how they are doing.
As the afternoon moves on, I’m catching up on emails, talking to some of the team about how they complete day one inductions, being used as a Guinea Pig in their “can you spot what is wrong with this wheelchair practical exam” (and yes the lap belt clip comes apart when you tug on it).
It's nearly time to leave, so it’s now time to catch up with the leadership team, and share any major updates. I go through where we are at with the major estates issues/purchases, we talk about the new starters and those waiting to start. I take away a list of questions to chase up for the team and then it’s back home (more of the Poppy War Trilogy, you really have to read it) and just in time to join the weekly DCHC directors meeting.
We spend 90 minutes going over issues like the fair cost of care, this week's locality meetings, current hospital discharge quality and sharing our updates. Then it’s 6pm, and time for tea!! We all sit down and talk about our day, and then my favourite moment…. Getting changed into slacks and fluffy socks, a final look on emails and approving a funding submission and it’s 7pm, there’s a couple of messages in the evening from some of the team to reply to, and then the Apprentice to get angry at!! Alarm set for the morning ready for a run, and another day.
A line that many will recognise – “Do it with us, not to us” – had to be repeated in meeting after meeting pre-COVID.
Before February 2020, I hardly went to any sector meetings. My first and last memory of a pre-COVID meeting was the one with the new contract and none of my questions could be answered by the people at the front. Either they didn’t know or their answer was wrong.
It is therefore extremely satisfying to be able to say that in the context of the above, the world has changed. Care Home Forum was pulled together very quickly in preparation for the full COVID alert. Nicola Tribble set the tone on behalf of the state. We need to work together. George Coxon, unknowingly, highlighted how useful providers talking to each other could be. At the first meeting he announced that all of his payments were wrong and had been so for the last two years. As Evolve were experiencing the exact same problem, it was clear that we had common ground!
Whilst there are lots of imperfections in Devon, and we will continue to find them and change them, we must also recognise what we are achieving. Those of us that work in other counties will have a comparative and will therefore be able to acknowledge that in an imperfect system, we are listened to and we can effect change. There is still a long way to go, but the foundations are laid thanks to our friend COVID-19.
Our job now is to continue the spirit of the relationships that were formed or cemented in COVID culture and continue to work together with the system as we hit challenging times of a different nature – mostly of the economic nature.
With that end in mind, we have spent a lot of time laying the ground for engagement with Social Care and specifically with residential settings to be more organised, efficient and goal driven.
The introduction of the Integrated Care System, which covers Devon, Plymouth and Torbay, should give us the perfect platform to work together to develop our sector and ensure Providers are financially secure, Registered Managers are well supported and the wider workforce have access to everything they need. It is also important that service users benefit from a constantly improving Health and Social Care system that delivers real improvements to their daily life in their lifetime.
So we are co-designing engagement, we are being extremely clear that Social Care must be at the table and we are leaving no stone unturned.
We are working our way right through the system asking the same question – how is social care represented and by whom?
To engage with the system is a complex task. We are all different, our companies are all different and the sector we work covers such a broad spectrum that it is difficult for one person to truly understand each and every niche in order to properly represent them.
In the Integrated Care System, we enter a world dominated by the NHS with their red tape, fancy data collection systems and years of experience in the way they do business. Objectively, we start off on the back foot and need to play catch up.
One of our aims this year is to formalise our data collection system so we truly represent the Care Home Voice – i.e. we represent you and your needs. At the moment we are guessing (hopefully correctly 80% of the time).
We need to ensure that our data collection from our members is detailed and timely in order that we can challenge appropriately where system decisions do not support our needs.
For example, in a workforce meeting the NHS can state immediately the number of Registered Nurses or Carer vacancies. When it gets to Social Care, we have to guess and then, rightly, money is not allocated to us because we cannot necessarily rely on the data. We are the only ones that can fix that and fix it we must. Our ask of you is to participate as soon as a survey comes to you. We will only be asking if we need the data for a reason. Please help us to help you!
The textbook answer here should be to represent your views. My tongue in cheek answer is get yourself to one of the meetings and state your own view. It is much more powerful!
My personal goal and the main reason that I spend so much time on sector work is to improve the system for people living on a cognitive journey. I had the pleasure of living under section under the NHS roof for three years. The way they treated people in Fromeside hospital, during my time there, was shameful. I truly believe that we have foundations in Devon to change the way the system works and deliver measurable, tangible improvements that will mean people living in Health and Social Care can access a better life. Life gave me a second chance. The geriatrics living on a cognitive journey in our system will probably not be so lucky, so this maybe their last chance. We need to get it right!
So for this year we have set some Strategic Objectives to work towards through engagement.
We recently spoke to Jane Hanrahan, Workforce Development Manager at Norfolk County Council about how they use social work apprenticeships to recruit and retain staff. We asked Jane to give us some background information on the council's use of apprenticeships – this is what she had to say.
As a social work employer, we’re able to provide a career path for our employees who are in social care support roles, and who have the ability and enthusiasm to progress their careers into the social work profession. Social work is a shortage occupation, so apprenticeships are a great way of ‘growing our own’ social workers. This is particularly important as universities are getting fewer applicants to their undergraduate courses, and we need to maintain and grow the supply of newly-qualified social workers. As an employer it’s a good way to use the apprenticeship levy and demonstrate our commitment to careers development through this route.
Apprentices attract people from all backgrounds and provide a route to achieve a degree whilst earning a living and not having to finance course fees. Traditional qualifying routes can be seen as mainly aimed at those who are early in their careers and have successfully progressed through our education system. Apprenticeships have a broader appeal, for example to those who need to earn while they learn, to support a family, or are changing careers.
Apprentices are a positive influence in teams. They’re keen to learn, bring new ideas, and can share their learning with colleagues. This is the first year we’ve recruited externally as well as internally, and we’ve attracted a more diverse cohort than we would normally from internal recruitment alone.
In the longer term we anticipate apprenticeships will improve the stability of the workforce, as many of our apprentices are local and are likely to remain in the county.
To employers I’d say that in a difficult recruitment market, apprenticeships are an invaluable recruitment and retention tool. New employees are attracted to the opportunity to gain a qualification and current employees are more likely to stay with you if you invest in them and their careers.
To individuals I would say that if you have experience working in social care and are keen to progress into the social work profession it’s the ideal way of qualifying. You’ll really enjoy the opportunity to upskill and contribute more to your community. The caveat is that you do need to be ready for a challenge in terms of managing the demands of work and study. An apprenticeship will test and develop your time management and organisational skills.
We’ve had a great number of successes within the programme since starting the apprenticeship route. One of the key elements that we feel is really important is that we’ve been able to provide a route into social work for those with a lived experience of the care system.
With a variety of apprenticeships available in adult social care, including in non-care roles, it’s a great time to consider if apprenticeships can support both your recruitment and development needs within your organisation.
Funding is available for organisations wishing to recruit apprentices. However, the level of contribution will depend on whether your organisation is a levy, or non-levy payer. You can find more information about funding on the Skills for Care website.
If you’re interested in finding out more about welcoming apprentices into your organisation, you'll find everything you need on the apprenticeship section of the Skills for Care website.
DCHC ran a survey early in July in response to a request from DHSC about how the care sector are finding recruiting and retaining staff.
The participants were asked if they were happy for the below to be passed to DHSC, all stated that they were. Here are the votes responses to the questions with examples of their thoughts.
As you can see, the answer was unanimous with all the participants stating ‘Yes’ that they are having problems recruiting staff. A few examples that were given as to why they feel this are:
“We have 4 Care Homes. 2 Cooks short. Several care staff short. Staff leaving for better pay in variety of roles. Care Homes now in wages war for staff. To be competitive, wages need to increase by 12.5%. Significantly impacting viability. Most staff recruited from other sectors find it too hard and leave. Many find increasing intensity of training extremely difficult. It has not been as bad in last 20 years.”
“The quality of applicants is poor, and quantity of applicants is tiny!”
“We either get no candidates for the job advertisement or not suitable. Many don’t send back their application form!”
“We have consistent vacancies for both care staff and nurses. It is also very hard to recruit catering staff. We have had several vacancies open for many months now.”
“Staff apply, don't turn up, don't want hours offered, low pay not interested.”
“In recent weeks have advertised 3 slightly different care roles in an attempt to attract a wider variety of people. No successful appointments made.”
“Advertised on indeed, Facebook, Local paper, Banners, staff referral scheme for support workers. Competitive pay rates (£10.84 phour) but just not getting applicants.”
“Get applications, then no return of application form or no show at point of interview”
“Poor response to adverts, no general enquiries re vacancies”
The issue with the staff retention seems that the participants where an equal divide with the answers being split 50/50. A few examples of the answers left by the participants that stated ‘Yes’ are:
“Last 12 left for better pay into poorly performing homes. More money. Much easier. It seems perverse that poor services incentivised to cut corners. Homes managing complexity the opposite. System is a complete failure.”
“Those new to sector realise it’s not for them, many staff now exhausted & can’t take pressure anymore. Lastly staff leaving Due to direction government going re vaccination”
“Nobody wants to work in the health and social care industry anymore. Overworked and underpaid, no recognition”
“Other local care homes poaching staff”
“Staff are getting fed up with working with full PPE on and going to other areas of work where this isn’t required.”
“No one appears to like being asked to comply with certain aspects of the job or role. Poor reliability. Lots of mental health issues and sickness.”
“Due to limited response from applicant, having to appoint staff who have no experience in the complex needs of those we support. Of 19 staff recruited in last year we've lost 9 of them. Turnover is higher than ever before”
“Higher wages elsewhere - e.g., retail/warehouse/driving roles”
“3 staff left in a week, all to work in Torbay Hospital for NHS”
When asked why they think that has happened the participants quite a range of answers, a few examples of these are:
“Because (i) central government has no vision, plan or strategy for social are (ii) instead it continues to ignore sector leaders. (iii) it is underfunded even without any kind of vision. (iv) social care / elderly care is constantly demeaned (v) government only prioritises health for young and displays ageist thinking in its priorities. (vi) inconsistency / duplicity in guidance or lack of it has presented additional / avoidable / foreseeable risk (which continues). Could go on.”
“Mix of exhaustion from working throughout pandemic and loss of EU recruits and nobody wanting to work in social care for poor pay, few benefits and no recognition”
“Not enough praise & too much pressure from outside agencies”
“Poor press about care homes. Jobs in care stressful hard work and not ‘attractive’”
“Recruiting staff that are deemed safe, but not at the bar we would've previously set; Burnout - tougher conditions through the pandemic; care yet again receiving bad press, so rules out by some applicants”
“Poor wages for job, covid has made it harder”
“Combination of factors; Brexit, people leaving the sector as difficult time through Covid and pay low, workers that came in returning to previous career paths”
“It's very hard for us to match salaries. There is a huge shortage of nurses with PIN numbers. There is also a skills shortage and whilst there's lots of funding for training, it's still hard to get anyone to commit to this whilst working for a very low wage. The status of care work has NOT CHANGED DESPITE THE PANDEMIC AND THE ENDLESS CLAP FOR CARERS. If the government doesn't lead by example in respecting the care sector, how on earth can everyone else follow suit.”
“So many other options of work around, why would you want to work with so many regulations and requirements like masks and testing when u could earn the same without the hassle, even long-term carers are looking to leave”
Again, a full unanimous response to this question about if a social care crisis is looming, a few examples of their views are:
“It has been looming for decades. It is here now. Brexit and staffing chaos. Underfunding, neglect, and persistent delay in strategic planning. Ageism. Top 3.”
“Two reasons, lack of staff and low occupancy. If occupancy increases and the staffing crisis isn't fixed, homes will close due to unsafe staffing or will have to make the decision not to admit. Either way it is disastrous. Exhausted staff will leave the industry to work in industries that recognise their worth in a monetary way and in recognition. We need parity with the NHS in every way”
“Under paid, NHS taking staff, disrespect from everyone, no incentive for some people to come off benefits to work, better pay in other industries”
“Staff tired of covid19 restrictions and worry, PPE, low pay, long hours, and also willing to try other similar paid jobs now which are less stressful. Finally, the more short staffed a home is the harder it is, and so other staff face burn out, and may seek alternative employment”
“Staff morale and stresses with existing staff. Uncertainty about Covid impact moving forward managers and staff exhausted disillusioned totally fatigued”
“Overstretched workforce, can't recruit from Europe anymore, can bring people over from red list countries, no staff left”
“Without staff there is no social care. There is no incentive for people to move into this area of work. The pay has never been good, however the job used to be fun and rewarding which to some extent balanced the poor pay. Covid and the necessary restrictions this has involved such as the use of PPE, not being able to eat and drink with the residents, limiting of community access, overall, more of a clinical emphasis to life in the home rather than a social one has totally changed this”
“Lack of proper funding for care which then keeps wages low and therefore difficulties with staff recruitment - this will lead to care home closures”
“Perfect storm of Lack of public funding creating low pay conditions for challenging job, viability of homes being challenged”
thankyou everyone for your interest in a DCHC Chef Club and Nutrition and Hydration Champion Course.
We are planning to start the NH Champion course in September (date to be finalised).
It would be helpful at this planning stage to have input from you and your chefs to make this as accessible and relevant as possible. So please look at the info below and send your feedback/comments/ideas to me - firstname.lastname@example.org. Course will run on zoom so sorry, you will need to provide your own cake!!
Proposed content includes: the role of the champion; legislation and guidance; Nutritional screening/actions/fortification; Care planning/preferences/risk; IDDSI; Menu planning & special diets; Mealtime experience/food presentation & service; Hydration; Training; Involvement of residents, professionals & others; Achieving excellence in Nutrition & Hydration care (KLOE E3); Evidencing what you do; Catering procedures/food safety/risk analysis/allergens/audits. Will be using a DCHC Nutritional Strategy as basis for content.
Anticipating course will be 1-2 hours @ 10 sessions. Could be weekly/fortnightly/monthly. Propose @ 2pm on a Wednesday. This will then move to an on-going chef club, frequency to be agreed.
Will be seeking input from external professionals/experts and other relevant sources, and also would like to involve your chefs, so please get in touch if you have a particularly keen dietician, SALT, chef or other contact who would like to get involved. And finally, if you have a special interest in this ( apart from eating!!) and would like to support the preparation/presentation please let me know - email@example.com
p.s. watch out on Whats app for further updates.
When my father arrived at Castle Grove just two weeks before lockdown in March last year, he did not have a mobile phone, had never had cause to use a PC, laptop, tablet or any other form of digital device. Yet he is an incredibly social 95 year old who loves to chat with people of all ages, had a very close relationship with members of his family and a large circle of neighbours and friends with whom he was in very regular contact. In 15 years of living alone he would make the short walk into the town centre most days or drive his mobility scooter to engage with staff in the bank, post office, GP surgery or supermarket. He loves to be fully up to date with what is going on within his family, locally and around the world.
With the onset of lockdown 1 the change to his lifestyle was much more dramatic than those already in a care home as he had not had time to properly adjust and this was a particularly difficult time for us all. We had got him a mobile phone when he arrived and he needed help from the nurses in the early days to use this and as he is pretty deaf often the conversations were very difficult.
The advent of the booked skype calls at the Castle Grove office did help as we found he engaged much better on screen and certainly had a greater understanding of the conversation. We were also able to show him photos etc.. on the screen to keep him in touch with what was going on in our lives. We then moved back to controlled visits in the garden for a short time which when the weather was good worked well but on a couple of occasions it was too cold for him but any contact was better than none. During lockdown 2 we were back to skype again for a period before controlled visits inside behind the plastic screen. This was by far the worst experience as it literally felt like a prison visit! I was lucky enough to get two in room visits and was actually able to give him a hug and hold his hand after nearly 10 months before we went into lockdown 3.
During this period Castle Grove had made a number of improvements including upgrading their broadband to enable each room to have access. This then gave me the opportunity to look at options to keep in touch on a more consistent basis and the Facebook portal seemed to be the answer, although getting a 95 year old to understand voice recognition has caused some very funny moments!
Dad is now able to see and speak to any member of his family at any time he wants by just asking the machine to call and he is really engaged in the conversation, noticing everything around us on the screen. We have bought portals too and the calls also pick up on our phones if not at home. Portal to portal the picture is really clear and the sound is excellent, so he can fully engage in the conversation, see his new great grandson, the various dogs and cats he loves so much and is certainly much more chatty then when on his mobile phone. He does seem to be really enjoying this and has helped hugely until we can finally get the green light to commence visits again.
My inbox starts alerting me to an influx of emails. Anxiously I click on each one searching for the word negative. After ticking them off against my resident and staff list, I can finally breathe, all results in, all negative, we are finally out of outbreak.
Unless you’ve experienced an outbreak in a care home you really can’t imagine the rollercoaster of emotions - pain, trauma, loss but also a sense of pride and camaraderie between the team.
I update the capacity tracker; the tracker I’ve come to hate as the pandemic unfolds and the list of questions increases. Our home is now open. The now vacant beds reflect the loss of life, grieving families and a missing part of our care home family.
You want to rejoice the end of an outbreak, you feel like your team deserves a medal or at least a shared pizza and cake but no, infection prevention still means no sharing of food or encouraging gathering around food without a mask.
There’s still so much work to do. Those who have survived Covid have increased needs. Many have spent considerable time in their bedrooms, they need to move, stretch and socialise. We have to find ways to boast mental and physical health.
Our home has empty beds. Our maintenance person has never had so many empty rooms to prepare at once. Each room has been deep cleaned, refreshed and awaits our next admission. Outside of this pandemic we invite individuals to look around the home, choose their wall paint colour, their front door colour, join us for afternoon tea. Now we have to send pictures, welcome someone into a home neither they nor their relative have ever entered before. When they arrive rather than introduce them to everyone, we need to ask them to live in their room for a fortnight.
The home smells of cleaning products, paint, mixed with the baking from the kitchen. I sit at my desk, I should’ve been at home ages ago. I’ve lost count of the extra hours I’ve worked days and nights they all merge. I stare at my screen, then outside and then back to my never-ending to do list.
I cannot help but reflect how did this virus enter into the home? Did we miss disinfecting some items coming in? Did someone not part of the testing regime bring it in? Did another professional unknowingly bring it in? Was it the contractor that did some emergency work? Was it our resident who’d been in hospital for an appointment? We know we will actually never know but you can’t help but wonder if it was a failure on your part. It doesn’t help that you heard someone else say ‘oh the care home my friend’s mum in hasn’t had it - they’ve been so careful’. Do they not realise how hurtful that comment is - we’ve been careful, we’ve studied countless guidance, followed people on Twitter, Facebook, LinkedIn, trying to learn best practices that we could use within our own home….but it still got in.
We’ve been asked if we want to take part in a debrief on what was good, what lessons could be learnt. The good was all the amazing staff that continue to care, picking up extra shifts, dropping off supplies to their colleagues isolating. The good was the families sending emails recognising, thanking and praising the staff efforts. The good was finding a drink or food that a resident finally started to have, having complained that chef’s previous dish tasted like dishwater! Clearly it didn’t but Covid certainly destroys people’s taste buds.
The lessons - so many but include; pause and take care of yourself, know you will get through the outbreak even if at times it feels impossible. You will not please everyone, there are not have enough hours to update paperwork to the standards regulators expect, you’ll never have a rota that stays unchanged for more than an hour, some families will not be satisfied with your efforts. You’ll come to find all your imperfections - it might be that your staff contact numbers aren’t actually as up to date as you thought; that the manager, team leader and administrator all have to isolate, and you realise how much information you haven’t shared. It might be that the individual & family that have never been comfortable talking about end-of-life wishes, is the person who passes away in the middle of the night - and you still don’t know what their wishes are next.
One lesson is that an outbreak acts as a reminder on how amazing all staff working in care homes are.
The other lesson is that post outbreak, your home can feel like its soul has been ripped out but laughter returns, in time we will heal emotionally, physically and financially.
The most beautiful people I’ve known are those who have known trials, have known struggles, have known loss, and have found their way out of the depths.”– Elizabeth Kübler-Ross
Always ask ‘could it be sepsis?’, that’s what we have learnt over recent years when noticing any of the insidious signs so easy to miss yet so life threatening for those living in care homes.
I have said throughout this year dominated by coronavirus that the virus hasn’t cured sepsis and in fact even as I type this sepsis remains the world’s biggest killer above Covid and cancer too with 11 million global deaths in 2017. In the UK we see 56,000 deaths and 144,000 cases each year (box1).
Over the 9 years of the Devon Care Kite Mark, the predecessor to the Devon Care Home Collaborative, of the many things we have done together as a Devon residential care provider led initiative, introducing the reciprocal peer review programme has perhaps been one of the most impactful elements. During all this time we have visited and been visited by many colleagues who understand the challenges and the importance of ‘sharing our treasure’. Every peer review I have done has included asking appreciative inquiry based questions of the senior team being visited about sepsis (box 2).
DCKM Sepsis Peer Review questions:
I know there is greater expertise in our NHS system and working together in how we skill ourselves us is vital – we are so grateful to Pippa Richards for example – the Sepsis lead nurse at Musgrove Park Hospital, Taunton, who as a friend of the Kite Mark gave time to support us with key facts and do’s and don’ts on sepsis recognition, response and care including a talk at last year’s annual DCKM December ‘Jamboree’ also joined by Kate Terroni, Chief Inspector at the Care Quality Commission. Whilst we have had our first year without our annual celebration of work, welcoming friends and guests as well as the marvellous festive cakes we always share, we do intend to make sure 2021 has lots of opportunities to come together and share work including our own best practice top tips on how we address Sepsis in our work.
All of our staff have been very receptive to the key message in this piece – if concerned about signs of decline or deterioration in any of our residents we must raise an alert and when speaking to colleagues or seeking external help and say “we are not sure but it could be sepsis”. Reporting this as a risk could save a life mindful of another of the things I will always say when talking about sepsis; “every missed hour that passes where we don’t get help for a person with sepsis, the chance of fatality increases by 7%”. So just to say again- always ask ‘could it be sepsis?’.
- George Coxon
The Power of Music in Dementia Care
There is power in music. Revolutionaries have used music as a platform to convey messages of change, during periods of civil and societal unrest. Protest songs have illustrated realities of war, injustice, civil rights, while artists have used music to record their pain and personal experiences of these times of uncertainty. Music, in all its forms has given hope, invigorated, and touched millions across the world. While we may think of social change firstly in terms of the ‘power of music’ I would like to propose a bigger musical power to you; the magic of music for those living with a dementia.
We Associate Feelings and Memories with Music
Many of my happiest memories are often recalled when I hear a song and it takes me back to lying in festival fields, beer in hand and squinting through sunshine watching a band I love. Equally, some songs can remind me of times I have lost relatives and have found comfort in the melodies and verses that eased my pain. For many of us, music provokes emotions and feelings from times passed us by.
It’s good to look at living with a dementia as a journey; each person has their own personal experience of that journey and how it affects them can be very different. The further a person living with dementia travels on their journey the more difficult it becomes to communicate and recall memories. While conversation may fade and words forgotten, the magic of music remains.
Many studies have been carried out on the relationship between music and language and while more recent studies have found that they do depend on some of the same brain systems, they originate in different parts of the brain. Which is why someone living with a dementia may have lost the words to say, but a song from their past can resonate and reanimate within them.
At Frome Nursing Home
Long at Frome Nursing Home have we found that musical occupation or what some medical professionals may call ‘music therapy’, has enabled our family members to reconnect and reminisce with moments of their past. This is not incidental, when we welcome a new member into the Evolve family we learn as much as possible about their life journey.
This learning allows the home to shape the home and find the sounds that fill the air between all the walls. This knowledge determines the radio in the background during mealtimes and which life performers are invited into the home.
Music allows members of our family with dementia to express themselves, whether that be through dancing and singing for those who are starting their journey with dementia to movements, humming and tapping for those who are coming towards the end of their journey. Recognising music validates feelings of self-worth, and this validation can help relieve a person from any feelings of anxiety around any confusion they may have. This connection can remind a person who they are and where they have been.
This can be emotionally powerful to witness, particularly in later stage dementia. Seeing the change in someone’s demeanour and behaviour at the sound of a note or beat. The brightness in their eyes, the tapping in time and the humming through smiled lips is a heart melting moment like no other.
While the likes of John Lennon and Bob Marley gave a voice to millions, I guarantee you there is nothing like the overwhelming warmth of seeing a loved one living with dementia invigorated by the sound of their favourite song.
- Josh De Witt
Ogwell Grange, Rectory Road, East Ogwell, Newton Abbot, Devon, TQ12 6AH