Choosing how to spend your time

Winifred’s one-page profile

How a one-page profile can help people with dementia reconnect with their past, recall happy memories and make decisions about who they want to spend time with and what would make them happy.

Written by: Gill Bailey

Ninety-two year old Winifred Baguely can be heard singing and laughing as she helps the housekeeper out with her daily routines at Bruce Lodge where she lives. Winifred, who has dementia has always been warm, loving and generous but she hasn’t always been this satisfied and relaxed in her new home; until she produced a one-page profile with dramatic effects.

One-page profiles for both staff and people living at Bruce Lodge were introduced to achieve two things. For staff, it enabled a greater understanding of each other and meant that each week team members spent time away from their day to day activities to do something that they personally felt was an important part of their role. For the people living there with dementia, the one-page profiles acted as a job description, allowing them to direct their own support and ensuring that the people providing the support understood what was important to them.

All staff at Bruce Lodge, including housekeepers and maintenance staff, produced their own profiles. This exercise allowed the people living with dementia to be matched well with the staff team and choose who they wanted to spend extra time with based on their interests and what was important to them. Winifred chose to spend her time with Beryl the housekeeper because she said she enjoyed helping out with the daily chores such as polishing, sweeping and mopping. Winifred’s two daughters and staff at Bruce Lodge helped uncover this by sitting down with her and chatting over tea and biscuits to inform the one-page profile. They asked about good days and bad days, past and present. What was going well and what needed to change. What Winifred had enjoyed in her life in the past, and what she would do, if she could, in the future.

Winifred’s new relationship with Beryl and extra responsibility has had an extraordinary effect on her happiness and wellbeing. At home she would routinely clean the house, so before this was identified in the one-page profile as being important to her, a big part of her life and identity had been missing.

Maureen and Bernie, Winifred’s daughters, have noticed the change that the one-page profile has made to Winifred. She is happier, chatting more, using fuller sentences, sleeping better and is generally ‘’more alive’’. Maureen goes on to say; “The difference is astounding; mum was a housewife, a practical person who spent her life caring for her five children and our father, who died 20 years ago. Her desire to care for people was never blunted but the ability to do so was robbed from her and that left her very frustrated. These chores are helping her connect with other things from her past and are opening up new pathways in her mind. The first thing that we noticed had come back was her language – within a week of working with Beryl she was recalling words much better and introducing me to other people by name, whereas before she didn’t know who I was.”

Winifred now has enhanced choice and control over how she lives her life and how she is supported on a day to day basis.  Winifred can often be found well into the evening, long after the housekeeper has gone home, sitting and folding the laundry. This has simply become the way she chooses to spend her time and the impact this has had on her happiness is evident for all to see. Not only is her smile lighting up her own room but she can be seen beaming all over the home as she reconnects with what she loves most; helping to look after others and bringing joy to the people she lives with.

Helping Kenny reconnect with his past

A powerful example of how one-page profiles can help people living with dementia share what is important to them and how best to support them. Kenny wasn’t using speech to communicate anymore and his mobility had suffered after a fall. His family and support team needed to share what they knew about Kenny and his history with each other to help him communicate better and have more choice and control.

Written by Gill Bailey

The company of his wife and mother, chocolate, magazines, newspapers, tea with two sugars and long bubble baths; these are the things that are important to Kenny. The people who support Kenny know this straight away even if it’s the first time they have met him. How? Because it is written on his one-page profile.

Kenny is 64-years-old and is one of the warmest people you could wish to meet. He has lived in a home which supports people with dementia for five years.

As a young man, Kenny was a professional football player. Aged 25, he went into the textile trade as a salesman until retiring due to early onset dementia at 54–years-old. Kenny loved sport and played every sport going.  His mum Ethel said: “if sport had been his exams, he would have been top of the tree in them all!”

He loved golfing holidays with his mates and he also spent many happy weekends away with his wife Jean in their caravan, which was his pride and joy. Kenny and Jean didn’t have any children but, as Jean said;”we were always content to just have each other and our group of friends.”

Kenny was a very confident man who could go and chat with a roomful of strangers easily. He enjoyed socialising with friends, and a drink in his local most days on his way home from work.

As Kenny’s illness progressed it became clear to those close to Kenny that he was bored and restless.  Kenny no longer used any words to speak and was unable to move around unless supported by two staff members or in a wheelchair due to a fall which led to a broken hip a year previously. A person-centred review meeting was arranged with Kenny, his wife Jean, his mum Ethel. I was the facilitator and we brought in the support staff who knew him best, including Adrian the nurse who had specialised in dementia care.  Prior to the review, they carried out a functional assessment to establish a broad brush view of the stage of dementia Kenny was at, which at best could be helpful in creating activity which would increase Kenny’s well-being and ensure he had the things that mattered to him present in his life.  At least it would give those close to him ideas to try in order to learn what worked well for Kenny.

At Kenny’s review meeting, everyone gathered their collective learning about what was important to him, what best support looked like from his perspective, any questions to answer or issues to resolve; and what was Working and Not Working from the perspective of Kenny, his family and the staff team. This was a process which helped everyone think about Kenny’ life with him.  Its purpose was to inform action that made life better for Kenny and his allies. Those who knew Kenny well recognised what he was saying with his behaviours and so they began to record that rich information onto communication charts. This would be added to by everyone who spent time with Kenny as they learnt new information. They also explored how they could provide opportunities for Kenny to try new things to help them learn more about what would make life better for him.

The most significant outcome from the meeting was the development of Kenny’s one-page profile which would prove invaluable to staff as they used it as their job description (how best to support Kenny) on a day to day basis. It meant that even new staff could get to know Kenny quickly and support him in ways that made sense to him. Having the things that were important to Kenny written down on one sheet of paper made a massive difference. Knowing the important people in his life, how he takes his tea, what treats he likes, what calms him down and what works him up enabled the team to support Kenny well.

As well as capturing this vital information, the great in-depth conversations that occurred between Kenny’s family and support workers when creating the one-page profile meant that they were able to share history and personal knowledge that could be used by each other to help Kenny feel more in touch with his past and reconnect with familiar times.

Life is much more interesting for Kenny these days – evidenced by the spark in his eyes and frequent smile on his face – a rarity before staff explored these approaches with him. His support worker Jane described it as a “transformation…’’ and it isn’t just Kenny’s life that changed so positively. The people who care about Kenny now have the confidence that people understand him well and appreciate him for his personal talents and gifts.

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You can use conversation cards to ask good questions that draw out rich information, when supporting someone with dementia and their family to create a one-page profile.