Contrast two scenes. The first is a restaurant – where the food is carefully prepared and warmly served in an atmosphere which seeks to delight its customers. The second is a hospital. Parking the car is nearly impossible – the long impersonal corridors where people avoid eye contact. The noisy ward – the short temered administrator; the disinterested receptionist; the doctor talking over the patient who feels ignored. There is no space or time or sensitivity. If we were treated like in a restaurant we would complain and ensure that we warned friends against any contact with that place.
We are proud of the NHS and its values. It is deeply rooted in a philosophy of care for all – it aspires to mend and heal; to prevent and support. It inspires great public service from energetic practitioners who want the best for those they serve. We have all benefited from the developments and investments in health.
However, there is a crisis deep within our culture. It is a crisis of care – the way we treat people; how we engage and listen to our service users. If we believed that patients paid our salaries then we simply would not go on failing them. Managers have a responsibility to oversee the shape of the culture within which health targets are delivered. We are shapers of both systems and structures. Are they fit for ‘care’ purpose? How radical is our commitment to the patient and their experience in all its complexity? How responsive and people-centred are our transport access, reception areas, our wards or consulting rooms? Would an ordinary older woman be empowered to respond to her doctor with gratitude for his time and compassion? Are hospitals places of understanding? Is the Board meeting a place where feedback from the patients is as important as the financial results or the latest set of targets? If we want to develop and grow, then managers should take a lead in asking: ‘Don’t tell me what is going well here – let’s look at what is wrong!’ I do not doubt the intentions of those who work in the service – but there are preciously few people who are angry at not getting it right enough for people. We exploit their fear and dependence at very vulnerable moments of life by failing to enlarge humanity through the sharing of power and control.
Dismiss this plea at your peril. There can be no improvement of quality without attention to creating communities of compassion where the person is the beating heart of our work. We must make the jump from seeing things from others’ perspectives. Here are some actions that might help you explore the added value of putting care firmly on your organisational agenda.
1. Find time and places where you can observe your organisation at work. Take note of those things that would be unacceptable to anyone about whom you care.
2. Invest in listening to the patient experience. Respond to complaints as opportunities to deepen care.
3. Ask others how they would describe your place of work with one adjective. Be energised by the gaps between how we describe our aspirations and what the actual practice is! Let us do away with the minimalist functionality of much of the space where we deliver care. What about the imaginative use of colour, light and texture?
4. How much power and control do we give to the patient? Are they partners in decision making? Let them decide what is appropriate – we do not always know what is best! In Birmingham, our Palliative Care Network has launched a compaign to ensure that choice is given back to people at the end of their life. What shape would your campaign take?
5. Discover what makes your staff tired and de-motivated. Invest in programmes of staff support so that we can be energised by service. Too often our staff makes the experience of going into hospital like going to a foreign country – an alien land where no-one tries to understand your language let alone engage with your vulnerability. Our staff need to be supported to deliver care differently.
Visiting the Memory Café and other Dementia Care Activities
Evidence-based Interventions for Care Homes
Edited by Caroline Baker and Jason Corrigan-Charlesworth.
Jessica Kingsley Publishers 2017, ISBN: 9781785922527
They can be few families who are not affected by an individual who is engaging with some degree of significant memory loss. For some the prospect of old age is rather haunted by the possibility of having to embrace dementia. Understandably we fear the loss of our memory and its instrumental part of our well-being and personhood.
Jessica Kingsley continues to seek to resource our understanding of dementia, and a compassionate and practical approach to person centred care. This book works on the widespread assumption that activity and engagement are vital to our well-being throughout our lives and this is carried on and through with people living with dementia. Maintaining and developing this activity and engagement is necessary at every stage of our independence and dependence.
The editors draw together a rich and skilled collection of writers and practioners who explore aspects of how particular interventions with people living with dementia can improve and develop quality of life. This volume consistently challenges us to think about what we have to learn from people living with dementia. Underlying this approach is a commitment to the fundamental importance of getting to know the individual well.
Chapter 1 explores and discusses to life story activity that helps an individual document key memories as part of embracing a deeper knowledge of the person and their living. Chapter 2 introduces an intervention designed and developed to encompass a digital approach to reminiscence therapy. Chapter 3 discusses the use of Namaste and how this has helped one particular care home improve well-being and nutrition. We learn about the implementation of empathy dolls in chapter 4 and chapter 5 informs the reader about the introduction of memory Cafés within a home care setting. Chapter 6 explores the introduction programmes of physical activity and in chapter 7 we discover something of the use of guided imagery accompanied by smells and sounds. There is an impressive commitment in all of these case study based chapters to focus on the individual and provide them with an environment within which they can thrive. Chapter 8 discusses the maintenance of daily living skills; chapter 9 reminds us of the importance of environment and chapter 10 evaluates some of this practice-based research.
The editors are clear that this is work in progress emerging out of the Barchester Charitable Foundation. It is distinctive, well written and grounded in practice. It not only offers many practical suggestions about programs and therapies but challenges us to think differently about how best to embrace memory change and memory loss within ourselves and others.
This book should become essential reading for all those who are tasked to provide care for people living with dementia. However I think it also would help families to think through how best to support loved ones.
As ever with Jessica Kingsley Publishing this book is well designed and printed and is easy to read and follow. There is a good index and a comprehensive bibliography.
Professor James Woodward
The Spiritual Dimension of Ageing
Elizabeth MacKinlay Jessica Kingsley Publishers 2017 £19.99
With a background in nursing and specialisation in gerontological nursing much of McKinley’s focus over the past years has been on age and spirituality. Her preparation for Ministry nurtured priest and nurse in a commitment to deepening our understanding of the ageing process, its physical and psychosocial needs, and the common disease conditions of older adults. Her body of research work and books have been a fundamental and important part of the growing literature in our developing understanding of spiritual care.
MacKinley has brought into this commitment her own belief system and managed to hold both Christian conviction within the context of a secular environment in such a way as to demonstrate the core significance of the spiritual as part of enriching human flourishing for all older adults.
The book has 19 chapters with a number of helpful figures and tables illuminating a range of discussions which include the relationship of spirituality to health and well-being; meaning in life; images of God; the spiritual journey in ageing; humour and laughter and spirituality in ageing; isolation; cognitive decline and the nature of professional engagement in this area of support and care.
The second edition of this book is a welcome resource for all of us who are teaching, learning and research. MacKinley puts her learning to use in a meaningful, coherent and insightful way. Those of us who know her work will bear testimony to its capacity to change thinking and practice.
Relationship-Based Research in Social Work : Understanding Practice Research
Edited by Gillian Ruch and Ilse Julkunen
Jessica Kingsley Publishers, 2016,
I write this short notice after a brief look over the Sunday newspapers. Misunderstanding, disconnection, prejudice and sometimes sheer blindness seem to characterise our human relationships. The information technology revolution does not seem to have enabled us to deepen our understanding of making human relationships work. Although this book, technical in its scope, will be used mainly by social work students and practitioners the implications of its methodology are far-reaching.
The book draws on psychodynamic, relational, discourse analytical and systemic understandings of research and practice. The thesis grounded in a range of accessible and stimulating case studies suggests that as we dig deeper into our understanding of roles and relationships we move into the heart of a co-creation of knowledge in practice research. As a teacher and facilitator this collection of 12 essays has enabled me to look at learning and the way in which we are both enabled and disabled into new areas of knowledge by our own limited views and perspectives.
The essays examine a number of case studies of research projects carried out in England and Finland. In an age when we do not examine with enough wisdom and intelligent critique the dependability of sources of knowledge this useful and insightful collection of essays will deepen and integrate knowledge in the teaching of research and practice.