Dignity in care workshop

Quick one off the top of my head - 'assisting a Mr Jones to eat' NOT ...... 'feeding Mr. Jones'.

Suzie Lloyd

Another one ..... Mr. Jones is addressed as Mr. Jones unless he states otherwise when during the initial meeting or first entering into the Care Provider's service. No pet names whatsoever unless the person specifically requests otherwise.

Suzie Lloyd

Hi Sally,

Not sure if this will be useful for you.

But Bob Langford wrote a piece on this forum in 2012, which he called 'DISABILITIES LIFES IN OTHER PEOPLE HANDS' and the link is:

http://www.dignityincare.org.uk/Discuss_and_debate/Discussion_forum/?obj=viewThread&threadID=671&forumID=45

It is a really thought-provoking piece, and you might find it useful in some way.

Bob's piece is lengthy, but I'll copy-in the start of it, so you can 'get the flavour':

One thing about being a disabled person is everyone who outside of our homes thinks they know what is best for you instead of asking the disabled person what they want.
When I had the optician came to see me, I was in the bathroom have a bath I had too get out of the bathroom fast and into lounge to see them, when I get in the lounge. Then optician started too talked about my eyes in front of me instead of asking me. I might as well have stopped in the bath or go to church and get married. Things are not like use to be.
When professional people come to the homes they come with files and a laptop then they put on table. Then they tell the staff how to do their job. There are only 4 people that do know about a disabled person is; disabled person themselves, disabled person's parents, staff at the centre where they is living, staff are doing our individual personal care for 24 hours every day and their support workers. Professional people they think they knew it all but they do not knew it all, when I was at nursing home I had a chest infection they put me on soft food for one day next day I was on normal food cut it up small and I was having thickener in my drinks. I leave there. Now I am showing them how do you eat without chocking or coughing by putting my head forwards. Also when I was there I had a bed sore all the professional people told me that I need a bed rests every day. When I came to Fisher Close I am having a bath every day, Then I had a idea to get new cushion for my chair after I had a advice from a staff at Fisher Close In a month after I had it my sore was getting better after all the exports told me I needed bed rests every day at Derby house. Now I having good laughs about this at Fisher I enjoy it this what life all about.

Hi Mike,

Bob Langford's thoughts are all too familiar. Many, not all, but many Professionals do have impersonal attitudes and tend to commodify the person; this is done in a manner which would suggest that soft skills, emotional intelligence, Dignity, Respect and Compassion do not come under their 'professional remit.

The further issue arises when HCAs, Support workers and other assistants bring such matters to their attention. Specifically, and again in my experience, the 'Professional' is 'provoked', 'unhappy', 'insulted', 'offended' and so forth, when questioned, which would suggest that they should never have to account for, or explain, their behaviour. Instead, when challenged they resort to the politics of superiority.

Suzie Lloyd

Hello Mike,

This piece is so ironic. Just the other day I had to represent my resident in a meeting with professionals. Out came the laptops, and they scrounged all around his room looking for "other professional notes". My word and that of the family didn't mean much.
My resident eventually fell asleep he was so bored, and no questions were directed at him, they were all over the top of his head.
Professionals, I know work hard to get to where they are, but that doesn't give them the right to forget the rest of us.
I too, am disabled. For many years my parents didn't include me in the meetings of the doctors, not realising I was the one taking the medication, and what side effects I was enduring.
Eventually I spoke up, refused to let my parents come with to the neurologists, and this man and I had a chat all alone. I had kept a diary of seizures, headcahes, etc and his rubbish tablets weren't working.
I told him if it didn't start working like nowish, I would go to the Medical Council and write to the tabloids. Amazingly enough I was put on other drugs and these worked..............

My point is, professionals think they might be right, but only the human/person knows their body/soul. Not that professional. He/she is only there for guidance and advice.

Thanks for the read..........

Sal

Hello Sally,

About 5 Years ago, We felt that the staff needed training. So we provided training ( if you look up www.meaningfuleducation.org.uk we provide Preserving Dignity Training and Peron Centred Apporaches) but i am a great believer in "putting your self in their shoes" so we asked staff to become a " Resident for the day" they all had instuctions on their roles, they were given different names, ages, medical conditions, we blindfolded someone for the day, we bandaged legs,used the hoist to support them to move, one member of staff had to stay in bed for the day, etc ( we made it quite hard on them for the experience to be an impact on them) it completely changed the approach, attitude, increased empathy and they leant alot from the experience, this was later published in the NAPA magazine.

Hi everyone
I'm overwhelmed with the help and advise
Susie,Mike ,Clare
Velocity resourceful
Best wishes

Hi Everyone,

Sally-Ann's 'My word and that of the family didn't mean much' is a theme which really angers me, and which I keep banging on about in my end-of-life debate.

If any of you are involved with people who lack the mental capacity to make their own decisions, and if you are as unhappy as I am with 'professional bias' within behaviour, can I appeal to you to join the National Mental Capacity Forum by going to this webpage and clicking on the 'click here to join' link. Once you have been accepted, you can get to a website which is part of the work being lead by Baroness Finlay with the stated objective of improving implementation of the Mental Capacity Act. The website has bits of news, MCA-related blogs, and also - crucially - a discussion section where people can send in their own pieces, in the hope that others will comment on them. So far, there isn't very much discussion going on - there needs to be, because of:

''My word and that of the family didn't mean much'

There are some influential people on the list of members (the DH's MCA lead, the CQC MCA lead, the SCIE MCA lead, etc) but we need to be getting the views of people on the 'front line' and of family carers and relatives into these discussions, or else we will never achieve better behaviour from the professionals.

Quick note to Sally - I hope there is something useful you will be able to take from the replies to your question. This Dignity in Care discussion forum, does often produce useful answers. You might also try the Dignity in Action Facebook page.

Being assisted to get out of bed while not being able to see and hear the person assisting.... how would you want to be approached and what would you find an intrusion on your personal space? Touching someone's hand is usually acceptable but if you touch their shoulder or leg this could be percieved as threatening. As a carer or supporter, how would you communicate in a dignified way for that person, and what as individuals make us different from each other in terms of personal space, good manners and compassion?

Hi Jen,

When I read your question a few minutes ago:

'Being assisted to get out of bed while not being able to see and hear the person assisting.... how would you want to be approached and what would you find an intrusion on your personal space?'

my first instinct was 'I've no idea how to answer that - much too tricky for me !'.

But I've spent about 15 minutes doing something else online, and my mind must have been pondering your question. My pondering popped this into my head: it rather depends on the person, surely. If the person who cannot see and hear is otherwise mentally 'in good shape', probably the person will be able to rationalise why they are being touched: for example, if they feel their calves being grasped, they could work out 'that must be to swing my legs over the side of the bed, I'd guess'.

But if the person is, for example, suffering from something like severe dementia, perhaps wherever you touch, the person isn't going to understand.

So for the 'understanding person', perhaps you always start with something like 'tapping the shoulder' - but for the 'not understanding person' it is very tricky indeed.

Just my initial thoughts - and another thought, is do you see this as a common problem ? And do you have experience of it, or is it a thought experiment to illustrate a point ?

Hi Mike
Thank you

Hi Jen,
Have just seen your post, firstly one should not assume that a deaf blind person cannot communicate in other ways for example signing and braille they may be perfectly able to make decisions and answer questions on how they prefer to be supported.
I honestly think that we can go round in circles and tie ourselves up re the dignity agenda it is only as complicated as one makes it, we should all know and have knowledge of the basic principles and what underpins them, staff training is important but i feel that within the care sector most knowledge should be gained from positive mentoring on site, unfortunately many private sector care providers have senior care workers in place that are either under experienced / trained which leads to non existent mentoring in the workplace.
I personally worked with and mentored a young man with aspergers whilst working in the care sector yes it was difficult at times but he turned out to be one of the best care workers within the team, as we all know any team is only as good as its leader.

This does help, Mike.
Thank-you for listening.

I would suggest a role play exercise
Have one staff blind folded and ask the other staff to take turns in assisting them to wake up and have breakfast. Then have another staff pretend to be deaf and mute. The staff who support them should not speak but use actions or signs to communicate. Let them support the staff to do the same thing as the blind patient. Then have a reflection on the process. First ask the staff that was supported to explain how they felt and if there needs were met. Its an exercise that will help staff to evaluate how there actions actually make patients feel.

Hi Sally,

So thought provoking.

Suzie Lloyd

Hi,

Excellent exercise.

Suzie Lloyd

You are most welcome,

Suzie

Dignity

Activity -

You are involved in writing your own care plan, what 'dignity' issues will be important for you to include?

Explain why these issues would be important to you.

Profuse apologies - in my earlier post at 25/02/17 - 09:58 I did not insert the necessary link. Which made the post extremely confusing to say the least !

Anyway, with the missing link:

If any of you are involved with people who lack the mental capacity to make their own decisions, and if you are as unhappy as I am with 'professional bias' within behaviour, can I appeal to you to join the National Mental Capacity Forum by going to this webpage and clicking on the 'click here to join' link.

http://nmcforum.ning.com/

Once you have been accepted, you can get to a website which is part of the work being lead by Baroness Finlay with the stated objective of improving implementation of the Mental Capacity Act. The website has bits of news, MCA-related blogs, and also - crucially - a discussion section where people can send in their own pieces, in the hope that others will comment on them. So far, there isn't very much discussion going on - there needs to be, because of:

''My word and that of the family didn't mean much'

There are some influential people on the list of members (the DH's MCA lead, the CQC MCA lead, the SCIE MCA lead, etc) but we need to be getting the views of people on the 'front line' and of family carers and relatives into these discussions, or else we will never achieve better behaviour from the professionals.

Did I start something here.............?

Really good idea

How about starting by everyone involved writing a one page profile? (and when I say everyone - I mean everyone! - the residents, all staff, regular professional visitors, regular family members) - this would be a way of learning and sharing what is important to each person - its includes considering the mundane everyday things to the absolute fundamental heartfelt things that are important to us - it is what makes us unique.

There are lots of decent models of one page profiles out there to consider.

I always found Dignity in dining really interesting and found that staff really,found it beneficial

now that's a much better idea!

Hi, we use one page profiles in my services and they have really opened up people's eyes to the individuals they support. Another suggestion is doing the following exercise. It is something I did about 15 years ago but still has a massive impact.
In groups get people to record anything and everything that really annoys them, it could be swearing, leaving the toilet seat up, rude drivers, it does not have to relate to work. Then get the group to choose their top ten from the groups list.
Next tell them that they have imagine they are someone with support needs whose family have gone on holiday so they have come into the home for a fornights respite and all the top ten things were happening all around them. Get them to record how they would feel and how would they react.
Then tell them that their family have decided they can no longer support them so they have to stay in the home for life. Again ask the group to discuss and record how they would feel, how they would react and what do they think the typical service response would be. You can add that they have lived there will all that happening for a year, would it be any different.
The final bit is then saying there is a new worker appointed who says they can change things, how would this worker convince you they will do anything, what would they have to say or do. In this way it makes staff think about their own pratice.
You do need at least an hour for this to work properly. I have done this with many groups and you can feel the atmoshere in the room change.
In this way people have to think about what communal living is like and the impact on individuals.
If anyone uses this exercise I would be really interested in feedback to how it went.
Hope it helps.

How interesting. I suggested the very idea to a steering group set up to support diversity at our local council. I said it would be good to do a personal profile so that as leaders and leim

Hi Sally,

Looks like you've been given some fabulous ideas here. I thought it might also be worth mentioning the ideas I developed as a result of my husband's experience of living with dementia, and seeing the care home staff struggling to develop a relationship with him because he could not communicate in the conventional way.
First, I developed the Remember-I'm-Me Care Charts, to ensure that a person's needs and preferences could be available to everyone interacting with them. And then I developed a set of posters reminding staff of some very simple behaviours that they are likely to have learned in training.
Here are the links:
http://www.carechartsuk.co.uk/product-category/carecharts/
http://www.carechartsuk.co.uk/store/posters-and-prints/because-i-care-daily-prompt-posters-a4/
I hope that helps.
Best wishes,
Zoe

What a good question!
not only does it give a carer or a member of a staff something to think about, but you also get to know their thoughts too regarding Dignity in care.