Getting the right support for you

An example of how Karen, who lives in her own home and receives 10 hours of support a week, uses her one-page profile to direct her support. Karen experiences periods of feeling low and having what is important to her and how best to support her as well as what people like and admire about her on a single sheet of paper helps to lift her mood and keep her on track at work and at college.

Karen's one-page profile

Karen’s one-page profile

Written by Tracey Gudgeon, Care UK

People describe Karen as a hardworking employee, great friend and someone who will always make time to sit and chat. Karen has her own home, which she is very proud of and loves the fact that she lives only two doors away from her best friend who she spends a lot of time with.

Karen receives 10 hours support each week to help her maintain her tenancy and to support her emotional wellbeing and health via support with menu planning and cooking.

This time last year when Karen’s service was being reviewed, the people working closely with her reported that her self esteem was very low. This meant that Karen was not going out and meeting her friends, keeping on top of her housework and not eating properly. It was also starting to have an effect on her job and college as she was struggling with timekeeping, was tired and finding it hard to concentrate.

The review highlighted that what wasn’t working was that when Karen was receiving the 10 hours support in the week she was asking staff to play jigsaws or just sit and chat. The team were not clear on their roles and responsibilities and Karen did not understand the purpose of her support and the outcomes which were expected, and what the support was funded for.

Karen and her team got together and created a one-page profile, highlighting Karen’s important to’s and important for’s. Karen really enjoyed doing this and was also happy to go further by creating a “Feeling Good” document with photos of how she looked and felt when she was looking great and had her hair done , nails painted , pretty clothes on. Karen also wanted photographs of her house in it when it was tidy. She asked if her staff would use it when she was beginning to get low as a gentle reminder of how much better she felt when things were going well.

Karen’s one-page profile has been paramount in informing the support she receives and therefore ensuring she not only keeps her job, continues to be a great student but also maintains her tenancy. Karen’s staff team now know what is important to her and how best to support her well and use the one-page profile to help Karen keep on track and keep achieving her goals.

Healthier, happier and in control – with a one-page profile

When Paul’s support team realised that he didn’t have a one-page profile they knew they needed to create one with him straight away. Paul owns his own home and is supported to live the life he chooses. His profile contains some very specific information about how to support him well, crucial to his ongoing health and wellbeing.

Paul's one-page profile

Paul’s one-page profile

Written by Tracey Gudgeon, Care UK

Paul is a gentleman who lives by the sea in North Wales. He owns his own home which he bought after his parents passed away. Paul is a fabulous artist and the other love of his life is his religion.

Previously Paul lived at home with his mum and dad and has been supported since buying his own home.

It was summer time and Paul was due to review his service again. He’s already had a Person-centred review so knew what it entailed and was looking forward to it. On the day of his review though, Paul decided it was far too nice a day to sit around  and he changed his mind about what he was going to do that day. He made up a picnic and went off on a long walk up the Orm, which is one of his favourite places and takes him past his old family home.

Paul told his team manager that he was happy for his team to spend time thinking from their perspective about what was working and not working and it was whilst doing this it was noticed that Paul did not have a one-page profile.

A one-page profile captures the important information about a person on one sheet of paper. It celebrates their gifts and talents as well as highlights what is important to them and how best to support them. It was considered essential that Paul should have one so his team set about working with him to create one at the earliest opportunity.

Paul’s one-page profile does have very detailed information around what is good support in relation to his cigarettes which play a big part in his daily routines. Paul’s world can revolve around when he is having his next cigarette and although he wants to cut down, he finds it hard to do so, just like so many other people.

The one-page profile supported Paul’s team to do their job better and have a clearer understanding of just exactly what was important in Paul’s life.

Having the one-page profile highlighted the need for better consistency with the staff rota , and helping Paul know just who was coming on to support him . This helped with Paul’s anxieties which in turn meant he didn’t feel the need to smoke as much.

The other benefits from completing a one-page profile has been that Paul has been able to feel healthier and lost some weight (which certainly helps when walking along the sea front or up the Orm). This has again been due to information highlighted around the need for good support with menu planning , budgets and shopping.

Capturing the past, present and future in a one-page profile

A powerful example of how a one-page profile has helped this man reconnect with his passions, improve his relationships and his communication. Ray’s family had become concerned about his health and wellbeing and after he was admitted to hospital, they asked for help to support him well.

Ray's one-page profile

Ray’s one-page profile

Written by Gill Bailey

Eighty year old Ray is full of life and enjoys the company of others. He is a jovial character and loves telling stories about his life experiences. Ray has lived in his first floor flat in Burnley for about 41 years.

When Ray was younger, he had lots of jobs such as working on the railways as a signal man and a train driver. Ray went into the Army for a time with the Duke of Wellington’s Regiment and travelled all over the world. He went to Normandy and takes great pride in this.

Ray has always been a very active and sociable man. He has lots of hobbies like collecting books, reading, music of all types and going to the Miners Club where his friend Harry used to take him every third Wednesday to meet up with all the ex-soldiers. They would have a few drinks and then Harry used to bring him home.

Over the last few years however it has become apparent that Ray has not been managing as well as he used to do at home. People were not visiting him as regularly and his home was becoming difficult to move around because he had taken to collecting and storing boxes of papers, books and magazines.

He was beginning to become socially isolated and wasn’t going out as often as he used to. He was not taking care of himself and his health was deteriorating both physically and mentally.

Ray’s family and friends became concerned that he wasn’t coping well, and needed some help to “get him back on his feet.” It was when Ray was admitted to Hospital due to poor mobility, confusion and water retention that a home person-centred review was arranged.  Ray, his son and daughter-in-law, his best friend Harry and support staff were all involved in the review. The aim was to bring together those people who knew Ray best and who could help him get his life back on track.

By developing a one-page profile we were able to capture the things that are important to Ray and more of the things that matter to him and that he wants to be in his life. This has helped in creating activities for Ray and plans to make his life better and more enjoyable and worth while.

It has given his family, friends and those close to him some ideas and plans on how to best support Ray and to identify the things that worked well for him.

During the review lots of very rich nuggets of information about what people knew about Ray and what mattered to him came to light. His past, present and his future were also discussed

Big changes have resulted from the review and the one-page profile. We recognised the need to do more work using communications charts and relationships maps to help Ray in these areas. We also identified the problems he was having in his home, keeping on top of cooking and cleaning and how his difficulty getting out had left him feeling lonely.

Ray has since moved into a sheltered housing scheme in Burnley. There are activities daily in the complex that Ray can get involved in and they have a book club in which they are looking at appointing a new member for the committee. They also have a local cookery class that is being run by the Volunteer Services who collect the group twice weekly and they go to the local community centre and regain confidence, motivation and skills in and around the kitchen so Ray can go back to his own flat in the complex and prepare meals for himself.

The complex provides lunch and evening meals daily, so Ray gets to go and mix with others and tell them his stories. Ray has a key worker who has been matched to him using his one-page profile and they have started visiting the Miners Club again every third Thursday and Harry meets them there for a drink.

Ray is much more relaxed, less frustrated and his life now has more meaning and purpose. He feels valued and he now offers others support. Ray is much more settled and appears happier in himself, smiling. laughing and joking with his new and old friends.

 

 

 

What they can achieve still amazes me!

Cath’s journey to being a fitter and healthier person demonstrates how one-page profiles can still bring surprising results, even for those who work with them daily and know their worth.

Cath's one-page profile

Cath’s one-page profile

Written by Cath Barton

In my early forties I became more concerned about my weight, fitness (or rather lack of) and overall health and wellbeing.  I was in the habit of crash dieting before a holiday or big event, only to put the weight back on, ending up feeling deflated and unsuccessful.  I knew I wasn’t alone in this and some people spent their life feeling this way. The difference for me was that I am a Person Centred Planning Coordinator. My day job is to use person-centred approaches. I had the resources and knowledge to identify the things that are important to me, think about the support that works best and make positive changes.  I had even used one-page profiles for myself and family in my personal life but for some reason I hadn’t thought to apply it to my health and wellbeing before now.

I promote person-centred approaches passionately and needed to practice what I preach and use the tools at my disposal to create and support change within my own life.

I decided to develop a one-page profile specifically for keeping healthy. Not to focus on dieting, as I knew that in the past this had been a short term solution, rather to think about what was important to me about keeping healthy and the support I needed to achieve this.

I took some time thinking about what worked well for me, what did good healthy days look like, when did I feel I had achieved, how could I have more days like this? I recorded the information, shared it with my family and put it on our achievement wall in the kitchen where it was easy to see.

I’m constantly amazed by the changes that can be achieved from information recorded on a single sheet of paper.  I feel much more in control of my health and fitness. Simply having the information at my fingertips has helped me to focus.  It’s made me much more positive about exercise too, not seeing it as a chore but remembering how good it feels afterwards.  I’ve even started Pilates and swimming and met some interesting people through this.

I wanted to be able to make long term changes, not quick fixes and my one-page profile supports me to do this, incorporating healthy eating and exercise as part of my daily routine with support and encouragement from those around me.  It will always be a work in progress, to review regularly and keep up to date. But this time I won’t be obsessing over the scales. I’ll be asking myself how I feel.

New learning for me was also how powerful the appreciation section in the one-page profile can be.  It’s not about fishing for compliments or simply having positive words recorded. For me it was recognising what others admired about me, qualities I might not have recognised myself but which boosted my confidence and desire to achieve.  I want to uphold people’s views of me; be determined and strive for success. Having others recognise that I can succeed is a powerful motivator.

So did my one-page profile help to support positive change?  Most definitely!  I’m fitter than I have been for a long time, I’ve found an exercise I love to do and have a good balance in my life.  One of my proudest moments was swimming my first mile.  I’m still amazed by the difference it has made and grateful for the success my one-page profile has supported me to achieve.

Choosing how to spend your time

Winifred's one-page profile

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.

Supporting patients with learning disabilities in hospital

How using a one-page profile in hospital can help medical staff support patients with learning disabilities, reducing anxiety for the person needing treatment and ensuring they get the medical attention they need.

Len's one-page profile

Len’s one-page profile

Written by Tracie Gudgeon

Ninety year old Len lives with his three best friends who he has known for 60 years. Len has a mild learning disability and after spending much of his life in an institution he moved into a supported house.

With a fun sense of humour and a warm, affectionate disposition, Len is a well-loved member of his household.  The limited contact Len has with family members makes his relationships with housemates and support workers all the more important.

Despite being in good health generally, Len recently became ill and was admitted to hospital for tests. After a couple of days on a ward Len’s wellbeing began to deteriorate. He’s stopped eating and drinking as he usually would and it was believed that his change in behaviour was because of the unfamiliar environment and people. The decision was made to send him home in the hope that he would feel more settled, but within a few hours of returning he was recalled to hospital after falling ill again.

It was then that a conversation took place with the Patient Liaison Co-Ordinator around the care Len was receiving whilst in hospital. It was obvious that although the Hospital Passport was being used, it didn’t contain the right information for the ward staff, doctors and specialists to know and understand who Len was and what individual support he needed. In response, Len’s team met and within a matter of hours produced a hospital one-page profile to ensure that Len would have the very best support during his stay.

Over the next few days Len remained in hospital but with the one-page profile at the end of his bed and sent electronically so that it could follow him around each department, medical staff understood Len and how to support him. Even the Consultant said ‘it was lovely to have a photo of Len when he was looking happy and well to see the difference in his appearance and understand how he should look.’

As someone that works to support Len, myself and the team firmly believe that the one-page profile helped in his recovery, meaning he was well enough to return back home to the people he loved much sooner. Len’s experience led to his housemates deciding that they too wanted a one-page profile, ensuring that if they went to hospital, staff there would know how to support them. We have been helping them to put these together. Using person-centred thinking tools, we have also completed a “Working/Not Working’ review with the people we support and shared this with the Patient Liaison Co-Ordinator at the hospital, who wanted to understand how she could further improve the hospital experience for people like Len.

Len is currently in good health, full of beans, and back making us all laugh. He is happy, in his own house, with his friends around him.

At the heart of support

A powerful reminder of how what might seem like a small gesture can significantly improve a person’s happiness and wellbeing. Mary was brought to tears when her support team introduced her to the home pet, after stating how important animals were to her in her one-page profile.

Mary's one-page profile

Mary’s one-page profile

Written by Lancashire County Commercial Group Care Services

Mary is 75 years old and has dementia.  She was living in a care home and we were asked to see if Mary could move to Beaconview. When we assessed Mary she was laying on her bed with the bed rails up. Mary is registered blind and has had some paranoid experiences. The staff from the home where we saw her said that ‘she liked to spend time in her bedroom’. Mary was very quiet and appeared to be quite isolated.

During our assessment, we asked Mary what her hobbies were and what her preferences were for a variety of things. We also asked her if she really did like to spend all her time in her bedroom, her answer to this was that she liked to spend some time alone. Mary also told us that she loved animals.  From this conversation we were able to create a one-page profile for Mary before she came to Beaconview.

Once Mary’s one-page profile was completed the care staff were able to read it and had an understanding of what her needs and preferences were, whilst also having a clear understanding of what was important to her.  Mary’s experience in moving to her new home was enhanced by the fact that staff were able to have conversations that were more pleasant and personal to her as a result.  Because of this all the staff at Beaconview were able to begin to build a trusting and meaningful relationship with Mary from the very moment she moved in.

We had recently bought a bunny for Beaconview and because the care staff knew from her one-page profile that Mary liked animals they decided to take the bunny to Mary so that she could enjoy its comforts.

Mary’s face lit up when she was informed that the bunny was here to see her, we asked her to put her hands out so that she could feel it. Mary was so pleased that we had ‘thought about her’ and the things she liked that she began to cry. Mary then cuddled the bunny and kept talking to him. Mary never did spend all day in her bedroom after that as she had something to focus her attention on. She felt a great sense of wellbeing each day.

Mary kept thanking the staff for what they did and although it seemed a small gesture on their part it really made a difference to her life.  The care staff were also extremely pleased that they were able to bring her so much happiness.

Having a one-page profile makes a massive difference to a person’s wellbeing, as it helps to build and form good relationships and it makes staff realise from a snap shot what is most important to a person.

The one-page profile is easy to read and easy to understand. This skill is very useful to all other professionals also.

Before we had one-page profiles it was difficult for all the staff to understand what was important to that particular person. The profiles ensure that not only is the person supported in a way that makes sense to them but that what matters to them is also included in their support.  The important bit is to act upon the individual preferences outlined in a one-page profile; truly keeping the person at the heart of all support.

Triggering happy memories

A powerful example of how a one-page profile can draw out the important information needed to support someone with dementia to re-connect with their past and feel happy and safe in their surroundings.

TobyWritten by Tracey & Rose from Merry Hill House

Eighty-seven year old Toby was born and bred in Wolverhampton. Described as a real gentleman, Toby’s wife sadly passed away five years ago. His son Sean is his main carer as Toby is now in the advanced stages of dementia. Sean says Toby was a hands-on husband and father and his family was always his priority. Toby has an infectious smile and personality to match, he has always had strong work ethics and Sean can’t remember his dad ever having a day off. He recalls fondly that Toby would often say; “the harder you work and save for something, the more you’ll appreciate it.”  Throughout his life Toby has liked things to be ‘in place’ and would always look immaculate.

Toby came every six weeks for a three night respite stay here at Merry Hill House. During his stays he would go around the unit collecting other people’s shoes and lining them up in his room. He’d also be fascinated with the electrical sockets and get quite agitated when staff tried to move him away for his safety.

A staff member sat with Toby and his son to discuss one-page profiles and how through discussions we could find a solution to help Toby feel happier, safer and more independent in his environment. Toby was present but unable to contribute a great deal verbally due to his dementia which meant that his son Sean was the one that provided the rich insight into Toby’s life.  It became clear very quickly that Toby led a full and active life, working and spending quality time with family. For many years he was an electrician and in his spare time he would take his son to a unit he owned where they built a barge together.

As a group, staff were asked to think about how we could use the information gleaned from his one-page profile to reduce the risk and to increase Toby’s wellbeing, giving him back the feeling of control in his day to day life.  We wanted to help Toby re-connect with his past and for him to feel busy as this is what he was used to. Together the team and Sean made a list of some of the items that would help Toby. Sean was to pack extra pairs of shoes when Toby came to stay and we were to provide shoe polish and a blacking brush so that he could polish shoes just like he did for his family as a child on a Sunday afternoon. We also filled a box with electrical items like plugs, light switches and a flex. Whenever Toby started touching the sockets or gathering shoes we were able to lead him to his boxes and he was happy again.

We have noticed a great difference in Toby’s wellbeing as has Sean who now uses the boxes at home too. Toby will spend many an hour polishing shoes until they are pristine, he will also sit with a small screw driver taking the plugs apart and connecting flex to them. We learnt this important information from Toby’s one-page profile and we are now able to support him to do the things that trigger his happiest memories; a wonderful outcome from having a good conversation and recording the important information on just one page.

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

Kenny picThe 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.

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.