Practice Development

The My Home Life movement embraces the opportunity to support each other and to share resources and examples of good practice. The approach in Northern Ireland which incorporates active practice development is a critical component to the success of the programme. In the PD part of the programme participants must develop a resource, a change in practice which can then be shared nationwide.

Below are some resources produced by both managers who have participated in MHL leadership & practice development programmes in NI.   

Pre-Admission Process

A sub-group working on an initiative to facilitate a more positive transition to life in a care home introduced a new approach to the pre-admission assessment process.  This focused on the everyday rituals, routines, likes and dislikes of prospective residents and put systems in place to ensure that these were maintained and respected after the move to a care home. The revised assessment includes a section on ‘Thoughts and Feeling about the Move’ whereby the nurse undertaking the pre-admission assessment asks both the resident and the relative how they are feeling about the move to a care home. This has proven to be a very effective method of establishing relationships with prospective residents and their families, with one relative commenting “this is first time somebody asked me how I feel”.  

Outputs from this group include a revised assessment protocol and the production of a short film, both of which serve as educational tools for best practice.

This is Me Now

This is Me Now  a new approach to maintaining the dignity and identity of residents with end–stage dementia and severe communication difficulties. Questionnaires are completed by care staff and family members to collect a ream of information about the resident (click here for questionnaires). This is information about what matters to the resident how, the ‘little things’ that make a difference like being able to see out the window. This information is then transformed into a narrative account of the residents likes and dislikes and what helps them throughout the day often peppered with relevant information gained from their life story. (Click here to read Marys story – This is Me Now, Mary)

Decision Tree

As shared decision making is difficult to achieve within the care home setting, one of the groups introduced a ‘Decision Tree’ to facilitate the involvement of residents in decision about life in their care home.  Using this approach, a small tree, usually an artificial one, is placed in a focal point in the care home.  Alongside the tree a question is posted such as, Where would you like to go on an outing? or What do you think about the current menu? Leaves are located beside the tree, often represented by luggage tags and staff, residents and relatives are encouraged to answer the question by writing their views on a leaf and hanging it on the tree. The tree is usually left ‘open for answers’ for a week, thereby giving people time to think about their answers.  In addition to its impact on shared decision making, the decision tree has proven to be a topic of conversation between staff and residents and appears to be particularly appreciated by residents with dementia who previously struggled with questionnaires or ‘on the spot’ questioning by staff.

Community Engagement and Intergenerational Contact 

The final sub-group targeted the issue of community engagement and intergenerational contact within their homes.  This group introduced a number of changes to maintain residents’ link with their communities but also to promote the care homes as an integral part of the community.  This was achieved by collaborating with the Verbal Arts Centre which culminated in the introduction of the Reading Rooms programme to a number of homes involved in the project.   Links were also established with local schools to promote intergenerational contact and other measures were taken (e.g. open days) to encourage the general public to engage with care homes and their residents.  This sub-group worked collaboratively with Linking Generations NI, an organisation that promotes and supports the development of intergenerational practice across the region by providing structured opportunities to bring different generations together, improving understanding and increasing mutual support.  Community links were also established by including young people as volunteers and partners in the care homes.  These young people reported a greater understanding of dementia and memory difficulties.