An example of how Dementia Mapping led to the introduction of a one-page profile for Jenny, changing her world for the better. Jenny used to spend her time agitated or withdrawn. Now that her carers know her well and use what they know to support her, she is engaged and content.
Written by Gill Bailey
Jenny has lived in a residential home for the past six years, she has dementia and staff were finding it difficult to cope with some of her behaviour. Jenny had started walking around hitting out at staff members, other people living in the home and the walls. This was very distressing for everyone involved. Three staff were required to support Jenny when she needed assistance with personal care tasks and this was a time of great frustration for her causing her to constantly hit out at them. When Jenny was not walking about the home she would remain in her bed all day. Jenny was also refusing her medication. Communication had deteriorated so much that Jenny was refusing all physical contact with the people trying to support her and at this time she didn’t talk at all.
The situation saddened the staff and they felt that they were letting Jenny down, they were barely meeting her basic human needs and she had no quality of life.
In November 2008 the home asked two Dementia Care Mappers to map Jenny; they wanted to seek ways to understand her. The mappers spent two days observing Jenny as she walked around the home. The results were then shared with the care staff of the home. During the two days observing Jenny, recordings showed there was very little interaction with her, but when care staff did speak to Jenny her mood rose and she would smile. She also appeared to enjoy rubbing the wall paper and her clothing which were very textured. It was noticed that Jenny interacted with music that was playing, by clapping and singing along to it and that she picked up a bundle of towels and carried these around with her.
Discussions took place with the staff to explore how Jenny’s quality of life could be enhanced. Staff explained that because of the home’s routines they had not noticed what Jenny was actually doing other than walking around and were constantly asking her to sit down to keep her safe. Once staff were able to understand Jenny’s behaviour they were able to suggest potential activities around the home that Jenny may like to be involved in. Ideas included a tactile/rummage box to meet Jenny’s sensory need, and to find out what type of music Jenny enjoyed. Staff were asked to explore Jenny’s life history as this may explain some of her behaviours and also to find out what her interests and hobbies were in the past.
Key to this new approach was to involve Jenny, her family and support workers that knew her well in creating a one-page profile. The one-page profile pulled together the rich information from the observations and the people closest to Jenny. It recorded what was important to her and how to support her well. It also celebrated her personal talents and gifts so that people using the profile got a snapshot of her as a ‘thoughtful, caring, loving and affectionate’ person.
The one-page profile was used together with other person-centred thinking tools such as ‘working/not working’ to personalise jenny’s support. A year later the Dementia Mappers returned to map jenny again. The results showed a real improvement not only in the home environment, but also in Jenny’s wellbeing. In the map that took place initially Jenny’s wellbeing score was that of a +1. This time it had risen to +1.9. Jenny spent all of her time in a positive mood/engagement level and 46% of her time was in a +3 level.
There has been a real change in Jenny and both her family and other agencies involved with her support have commented that she is a new woman; Jenny appears content and is involved in meaningful activities around the home such as folding the laundry. The manager explained that when the initial map took place Jenny would not even go outside but now she loves to walk around the garden with staff.
Jenny’s one-page profile has grown and evolved into a richer document (a person-centred description) over the past year and staff are more aware and ensure that Jenny is getting those little things that are important. They explained that recently they found out that she loves Mars bars and when she lived in her own home she would buy them in bulk. This new learning is continually added to her profile ensuring it is always up-to-date and serving Jenny well.
Learn more about using person-centred thinking tools in Dementia Care Mapping here.