Working creatively with people with dementia

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Part of Enhancing the Healing Environment

Lorraine Turner shares how Derbyshire Community Health Services NHS Trust works creatively with patients.

Riverside is an 18 bedded Older People’s Mental Health Assessment Ward which is part of Derbyshire Community Health Services NHS Trust. The staff promote non-pharmacological approaches as the most appropriate response to agitated behaviours and have worked at creating an environment to engage and promote interactive behaviour even before they became involved with EHE

When we joined the EHE programme in 2009, we wanted the whole ward community; staff, patients and carers to experience ownership of the project. To this end, we undertook extensive consultation which resulted in the selection of our multi-purpose day room as the area we wanted to redevelop. This was a large and potentially intimidating space and our challenge was to develop comfortable and dignified social spaces enabling a degree of privacy while allowing staff to continue to observe the patients, offer appropriate stimulation, support family relationships and promote communication and interaction. The consensus was to create a ‘parlour’ with a TV, a quiet area and room for dining and other activities.

Limited funds had us look at generating our own artwork with patients and their families which has always been central to patient engagement on the ward. We decided to make mosaics to decorate the panels that were to divide the room.

This was new for us and after a period of experimentation with suitable materials and techniques we were surprised and delighted by the high level of interest and interaction evoked by this activity.

Patients were bringing their families and people working on the ward to look at what they had created. They used sweet papers, bottle top, coins, tin lids, drawing pins and leaves made from plaster of paris to produce flowers, fish, birds, topiary and foods. We had no idea how the mosaic making process would engage even those patients with the most severe impairments and what a rich and satisfying experience it would be for everyone.

Not only has this success informed and influenced our current work practices but also elevated the expectation among the whole team as to what our patients with dementia can achieve. The therapeutic benefits include increased self-esteem, identity, communication and inclusion. We saw moving connections between staff, patients and opportunities to recapture family relationships. Some of the images the patients created are so delightful that we have had them made in to gift cards that are now sold to raise money for other improvements.

Building on this we are moving into a new phase which we are calling 'Raising Eyebrows: Turning Heads: a creative arts project for people and their carers experiencing the dementia journey.' The intention of our project is to raise the expectations of the person, their carers and our staff about what the person with dementia can achieve. We are in the process of creating a website to promote the project. Our experience tells us that participation in art to raise expectations in this way can make an important contribution to delivering many of the outcomes hoped for in the National Dementia Strategy and is a cost-effective way of providing person-centred care.