Theme: Maintaining Identity

Cohort 1

Project Title

Maintaining the dignity and identity of residents with end-stage dementia and severe communication difficulties.

Aim

To enhance  person-centred care for people living with advanced dementia.

Description of the Intervention

The focus of this project was maintaining identity and promoting person-centred, relationship-centred care within the care home setting.

Participants  recognised that while person-centred care is frequently discussed, there was a need to translate this into meaningful daily practice for residents, particularly those with complex needs and limited communication abilities.

Central to this approach was engaging residents and their families in meaningful conversations to identify individual preferences, routines, interests, and values. By understanding these personal aspects, staff could better support residents as unique individuals rather than focusing solely on their care needs.

Drawing inspiration from the Alzheimer's Society's This Is Me document, the team developed a new resource entitled "This Is Me Now." While This Is Me focuses on a person's life history, the new approach sought to capture what matters most to the resident in the present moment. The initiative emphasised that every resident continues to have individual preferences, choices, interests and emotional needs, regardless of age, frailty, cognitive impairment or level of dependency.

The project particularly recognised the importance of maintaining identity among highly dependent residents, including those with limited or no verbal communication. Families and relatives were actively involved to ensure that personal preferences and individual characteristics remained central to care delivery.

Who was Involved?

Staff and Families.

Changes Implemented

To implement the "This Is Me Now" initiative, staff were encouraged to develop a deeper understanding of residents through observation, relationship building and everyday interactions. This required staff to spend time getting to know residents as individuals and to identify the small but significant factors that contributed to their comfort, wellbeing and sense of self.

A key aspect of the project involved promoting a cultural shift within the care home. Staff were encouraged to move away from task-focused language and practices that can unintentionally reduce individuals to their dependency or clinical needs. Instead, the focus was placed on recognising and describing residents as unique people with their own preferences, histories and identities.

The "This Is Me Now" document was piloted with highly dependent residents. Staff worked alongside relatives to gather information about personal preferences, routines and meaningful activities. This information was recorded in a format that could be easily accessed and used by all members of the care team.

The initiative demonstrated how small, personalised interventions can have a significant impact on a resident's wellbeing. For example, one resident preferred to be seated facing the window when her husband visited so that she could see his car arriving. By recognising and consistently supporting this preference, staff were able to enhance the resident's comfort, sense of connection and overall experience.

The completed "This Is Me Now" document became an integral part of the resident's care plan. It was made available to all staff and incorporated into daily care delivery, ensuring that individual preferences and personal identity remained central to decision-making and care practices.

Evidence of Impact/Outcomes

Participants developed relationship-centred approach within their care homes which increased person-centred care.

Staff, residents and relatives reported improvements in communication and inclusivity.  Participants reported increased quality of care standards.

Sustainability and Spread

Selected for oral presentation at the UK Dementia Congress 2015 .

  • Presentation Title: Light Bulb Moments for Care Homes.
  • Presenters: Sarah Penney & Danuta Lapinska

Questionnaires

Two questionnaire forms have also been devised which are available for download, the first relates to relatives and the second to carers.

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