Transcript www.chc.brookes.ac.uk

Life Story Work– Rachel Niblock 2012
YOUR STORY MATTERS BECAUSE YOU ARE
YOU
WELCOME
Life Story work is our history, the present and
the future – the ‘golden nuggets’ -today we
aim:
• To have an understanding of the background
of ‘Your Story Matters’ and The Life Story
Network.
• To appreciate the value and importance of
Life Story work supporting the care and
support we provide for people affected by
dementia .
WORDS INFORM OUR LIVES
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Excerpt from ‘Keeper’ by Andrea Gillies
P191/192 2009 Short Books –
‘everything we are is the sum of our history’
• ‘She stains the time past, lights the time to come’
John Webster ‘The Duchess of Malfi’1613/14
• Lemn Sissay – Inspirational journey of discovery
& vision
• Kahlil Gibran ‘Yesterday is but today’s memory,
tomorrow is today’s dream’
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MEMORIES
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Words and stories help us to make sense of
things and our interpretation will change at
various stages in our life. ‘I need to return briefly
to a few incidents that have grown into
anecdotes, to some approximate memories,
which time has deformed into certainty. If I can’t
be sure of the actual events any more, I can at
least be true to the impressions those facts left.
That’s the best I can manage.’ Julian Barnes
‘The Sense of an Ending’P4 2011 Vintage
Books.
WE WILL CONSIDER:
What is a Life Story Book?
• Underpinning principles of Life Story work
It will help you to consider your story/narrative:
• Think about who you are and how this experience
makes you feel?
• How we communicate, our thoughts and feelings,
how we behave.
• How do you know if you have rapport and what is
the link with quality relationships?
• How this can be applied to the people you work
with?
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THE FIRST PART OF OUR STORY WHAT IS IN A NAME?
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Our name is important
and a crucial part of our
identity.
Our name is often
decided before we are
even born.
Our name can be the
first part of our life story
Your name makes you
uniquely you.
TALK ABOUT YOUR NAME……
• Tell someone about your
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name
Who named you? Are you
named after someone? If
so what significance does
that have?
Does your name reflect
any religious, racial or
cultural origins?
What effect, if any, has
your name had on your
life?
Are you known by a
THE BACKGROUND
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www.lifestorynetwork.org.uk
www.knowmewell.com
National ‘Your Story Matters’
programme funded by DoH
dementia workforce strategy to
deliver Life Story Books to 500
people with dementia.
Life Story work is not new- it has
been used with children in
adoption services, people with
learning difficulties and as part of
person centred planning over
many years.
KEN’S VISION
• The Life Story Network
became a Community
Interest Group in 2011 and
all began in 2003 in
Oldham when Ken Holt’s
wife went into a care
home.
• Ken wrote his wife’s life
story so that the staff could
understand and know how
to care for her.
• Ken brought carers and
professionals together to
enable a local and national
THE NATIONAL DEMENTIA STRATEGY & COMMON CORE SKILLS
• The funding for YSM came through Objective 13 of The
National Dementia Strategy: To develop an informed
and effective workforce. (NDS 2010)
• Common Core Principles for Supporting people with
dementia (Skills for Care and Skills for Health 2011)
• Principle 3:Communicate sensitively to support
meaningful interaction
• Principle 4: Promote independence and encourage
activity
• Principle 5: Recognise the signs of distress resulting from
confusion and respond by diffusing a person’s anxiety
WHAT IS LIFE STORY WORK?
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A process, not a finished story,
Not necessarily a chronological approach
Not task orientated/not a care plan
Looking back on the past and forward to future
hopes
Done on a one to one basis
Can be a great engagement tool for the
individual, family members and staff
A legacy
WHAT IS A LIFE STORY BOOK?
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Know me Well (Caring
Memories example)
Dementia UK example
A Scrapbook, a sheet of
A4, a box, a DVD, a
recording.
A book capturing the
golden nuggets of your
life in words and pictures
so that those memories
resonate and remain vivid
to an individual.
WHY IS LIFE STORY WORK SO IMPORTANT?
• Enables the provision of high quality care.
• Life story work in practice will embed a human rights based approach to the
provision of care and commissioning of care and support.
• Person centered.
• It is a legal requirement to respect basic human rights and dignity in care.
• People’s stories/narrative are not pathological – people have many layers, and
have very rich stories to tell.
• It is not just reminiscence, it is not therapy, although it can be therapeutic.
• Someone who received a dementia diagnosis and older people may be viewed as
the person they have been, the life they have lived – Life Story work supports the
life being lived.
• Life Story work may provide an opportunity to explore what is important..
• Life Story books are not a care plan – they are owned by the individual – and can
be an ongoing process.
• A valuable tool for supporting individuals who have numerous carers – as Life
Story books will contain the ‘golden nugget’ information about their lives. .
UNDERPINNING PRINCIPLES
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Stories are a partial description of our lives
Stories have a real effect on shaping our futures
Our lives are multi storied
We are different people in different settings and
roles.
Stories of competency, knowledge, skills and
ability are enabling
Challenge the ‘Labels’, which can alter the way
we are viewed.
ONE OF MY GOLDEN NUGGETS
WHY IT IS IMPORTANT FOR STAFF
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Staff can get to know the person better to
develop an holistic care plan and tailor care
to the person’s needs.
Increase the understanding of what people
say and how they behave.
To understand people’s biography and social
history.
Increases job satisfaction with more
meaningful relationships.
WHY IT IS IMPORTANT FOR FAMILY & CARERS
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Peace of mind
Others will have a sense of
knowing the person
Enjoyable
Reflective
Loved one can be seen and
remembered as a personchallenges assumptions made
about a person in their current
state.
Legacy for children and
grandchildren
Helps to bond families together
Can enhance relationships
WHY IT IS IMPORTANT FOR THE INDIVIDUAL
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Help with the
’maintenance of self’
(Surr 2006) and help to
retain and regain a sense
of individuality and
identity
Improve self-esteem
Maintaining/developing
relationships with carers
A means of interaction
Feel valued
A way of expressing
VIDEO CLIP
Wifey and daughter
http://vimeo.com/32086112
REFLECTION ON WIFEY & DAUGHTER
Let’s talk about the Happy
Bits ............and the sadder
bits
THE DRAWS AND THE CAN OF WORMS
•The
Chest of drawers
Analogy
•Top of chest of drawers –
stories that people don’t mind
other people knowing about
• The middle drawer may be
things that you just want your
family and friends to know
about
•The bottom drawer may
contain things that you don’t
want anybody to know about.
•(Dawn Brooker adapted from
Egan)
The Can of Worms:
Talking about difficult things is
not more upsetting – they
were upset anyway, it may be
liberating being given
permission to talk about a
difficult subject.
HOW TO START
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Explain why you are
suggesting Life Story Work
Gain permission/consent
Agree how the information will
be gathered and formatted
Will you involve other people?
Agree where the book should
be kept.
Cannot be done in one sitting
– over a period of time,
organic rather than task
focused.
A creative piece of work.
YOUR DAY
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Think about what is
important for you in
every day.
Consider all aspects of
your life.........Self-care,
productivity, leisure,
spirituality
What do you want and
what is important to
you?
MASLOW’S HIERARCHY OF NEEDS
COMMUNICATION
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Consider how we
communicate with
people
93% of our
communication is nonverbal.
55% is body language
And 38% is tone of
voice
RAPPORT
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Think about somebody
you really like and what
makes them likeable.
Now bring to mind
somebody you cannot
connect with or who irks
you – what is it about
them?
HOW DOES IT FEEL?
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Think about how you
feel when someone
takes a genuine
interest in you?
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Think about how you
feel when someone is
not interested in you at
all...how does that
make you feel?
RAPPORT IS ABOUT
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Building a bridge
between you and me
The ability to see the
world from another
person’s perspective
To be on the same
wavelength
A way to understand
and be understood
THOUGHTS FEELINGS & BEHAVIOUR
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A greater
understanding of
people’s lives may help
us to understand why
people behave the way
they do – for example
‘challenging behaviour’
– every behaviour has
an intention– we need
to try and understand
the reason.
THINKING, FEELING & BEHAVING
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What we think about
affects our feelings
Our feelings affect the
way we behave
So if you want to get
better relationships
Change the pattern of
your thinking
You need more
information about the
person/who they really
are – life stories.
STORIES
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A greater understanding of people’s lives
may help us to understand why people
behave the way they do – for example
‘challenging behaviour’ – every behaviour
has an intention– we need to try and
understand the reason.
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Embodied self-hood’ a greater
understanding of how people’s values
can be discerned via their body and what
they do (Pia Kontos)
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Man and hats
2 ladies at 2.45
Green clothes
Lip stick
Under the table
Getting undressed at night time
Hammer in the television
Pain
THE USE OF ANTIPSYCHOTICS
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There is an aim to reduce the use of antipsychotics in order to manage challenging
behaviours by two thirds.
We need to try and understand behaviours
rather then sedate people. Ask why?!
‘The ability to express themselves verbally
their self expression often becomes equated
with erratic demented behaviour’ (Pia Kontos
Toronto Rehab Institute)
HUMAN RIGHTS CORE VALUES
Fairness
• Respect
• Equality
• Dignity
• Autonomy
Otherwise known as ‘FREDA’
These core values should underpin the care
and support we all provide.
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16 BASIC RIGHTS – KEY ONES TO CONSIDER
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Prohibition of inhuman or degrading
treatment
Right to Life
Right to respect for private and family life.
Freedom of thought, conscience and religion
Freedom from discrimination
Right to peaceful enjoyment of possessions
STORIES UNITE US