Identity and purpose
People living in care homes can risk losing connection with the people and the places and the activities that make them who they are and give them a sense of purpose in life. Making sure that people are able to maintain or regain these connections can have a significant impact on their sense of wellbeing.
Simon Stockton - Strategic Consultant in Health and Social Care
Carol Taylor - Manager, Garth House care home
Vicky Clarke - Contracts Manager, Surrey Continuing Healthcare
Simon Stockton: We hear lots of stories of how connecting people with a sense of purpose that can be really transformational for them.
Coming into a care home people may not assume that they will be able to do things that connect with their own values and who they are and what's important to them but finding ways to be able to support people to do that is a really important part of what care homes should be doing. Because everyone has something to contribute.
Identity and purpose are things that don't necessarily register as top priorities for providing good care but they are actually fundamental to people having a really good experience when they come to live in a care home.
We know that people can experience a great sense of loss when they when they move. A lot of that experience of loss is associated with not feeling that they're able to be the people who they were before they went in. And homes can do an awful lot to redress that imbalance by working over time to understand people and what makes a difference in their lives and helping them to to do the kind of things to mix with the people who they want to mix with to have the connections that they want to have and to follow the interests that they want to follow.
Carole Taylor: Our approach starts at assessment so when we do our assessment we ask questions about who people are what they did in their previous employments, about family members, then what we also do is ask families to provide us with some sort of family history - where somebody was born, who their siblings were, about a family tree, about important places in somebody's life so we build up a picture, we're going back to that you know da Vinci painting, starts as bit of a sketch so that all forms part of that sketch.
And that becomes quite important when somebody has dementia for example because when somebody has dementia they may go back to a person that they were 20, 30 years ago and if they start talking about a place or a person that they had a relationship with, a friendship with 20, 30 years ago, if we've got an idea about who that might be through some information that we've gathered through our information gathering, then we will be able to help that person.
In a previous care home, I had a gentleman who was a painter and decorator and we had an old shed that needed painting so he went out with my handyman and he and the handyman painted the shed. Shed got painted on numerous occasions but it gave him a sense of purpose, a sense of achievement when he saw the shed had been painted he was exceptionally happy and that was lovely.
We had a lady once who - her dementia progressed and she failed to recognize herself so she used to have arguments with herself in front of a mirror and we had pictures of each resident on their door so they recognized where their room was and she ceased to remember which was her room and it used to make her very frustrated but she did recognize herself in her wedding photograph when she was at 23 years old and she recognized that as being her so what we did was we took a photo shot of the photograph of her, blew it up, put that on her door and she was happy.
Vicky Clarke: One really good example of identity and purpose that I am aware of is a lady who used to work as a manager of a cafe and when she moved into the care home she was used to working and she's kind of worked beyond retirement so she wasn't really interested in just doing activities and sitting around watching telly and things so she spoke to the manager and said "What can I do that doesn't just involve joining in with the other activities?" so he suggested that perhaps she'd become the dining room manager so now she meets and greets all the other residents for breakfast, lunch and dinner, makes sure that they're all seated before she tucks in. And then at the end of each meal she goes round and says "Oh did you enjoy your meal? Is everything okay?" And then she actually - I think she takes feedback back to the chef as well, if anyone said we didn't enjoy that and now she feels like she's really part of the family down there.
Simon Stockton: So it's also important to not make too many assumptions about what's important to people based on what they might have done in the past. People's sense of identity changes over time and coming into a care home may shift that quite significantly so it's important for staff to be able to have nuanced conversations with people.
Another aspect of identity which is obviously really important is people's sexual identity and people coming from LGBTQ communities may have particular anxieties about moving into a care home and may be concerned about what other people's views and prejudices might be so having an open and honest discussion about that early on and helping people to explore what the culture of a local home feels like is really important.
Identity and Purpose: Points to Consider
- Help people explore their gifts and skills and what makes them who they are
- Encourage people to think about what contribution they might enjoy making
- Talk to people about what things they want to continue doing and and any new things they may want to try
Use the care home action plan – it’s free!
A MySCIE account is required to gain access to your care home action plan and answer the question on Identity and purpose.
Designed for managers and owners of care homes for older people, use this care home action plan to:
- Build a shared understanding of what personalisation (or person-centred care) means in a care home setting
- Identify and plan practical improvements that will make your home more personalised
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