Alzheimer Scotland was commissioned by Scottish Government to develop a model of practice for allied health professionals, also known as commitment 4, Scotland’s Dementia Strategy (2013). It was important the model was informed by the experiences, hopes and aspirations of as many people as possible who are living with dementia and family members. To help us do this, during 2015, we invited people living with dementia and their families to meet with us as we were interested to understand what is important to people now and in the future and we wanted to listen to their stories from their perspective.
We were interested in whatever people wished to bring to us and therefore the approach to the conversation was based on appreciative inquiry to explore what was important to people when living with dementia and their families. The conversations used appreciative language, allowing us to hear the rich detail on peoples experience and we did this using photos and powerful questions. This offered us a flexible resource that could be used in groups or with individuals where people pick a card and say why they like it and then chose to respond to one of the questions on the other side.
We invited people to consider:
- What things are important to you, or do you value in your life?
- What do you value most in your life?
- Can you tell me about the things in your life that you look forward to the most?
- When you reflect on a good day, what is it that has made you feel happy/satisfied/confident/ pleased/proud?
- When thinking about positive health and well-being what things do you value?
- Can you tell us a story about what and who enables you to live your life the way you want to?
- What’s your best story of engaging with services in your local community?
- Can you tell us a story about the times/activities that you enjoy sharing with your friends or family?
- Can you tell us a story about a pastime that meant or means a lot to you?
- Can you tell me about a time when the dementia cafe/dementia support services have helped you live well with your dementia?
- Can you tell us a story about what enables you to live your life the way you want to?
- What matters to you in your life right now and in the future?
Appreciative Conversations: “what is important to YOU?”
To help us carry the conversation forward the allied health professionals summarised the themes that came from the conversation, the themes noted were agreed prior to the conversation ending and the reflections we gathered are from the therapists only and no-one was personally quoted. Outlined below is a brief overview of the therapists’ reflections.
Themes from themes
Conversations always surface themes; there are universal themes that connect us as humans however in our conversations the three main themes were
- Importance of family and relationships
- Independence and a sense of freedom
- Engaging in activities valued as important
The positive elements of the conversations that emerged as significant were:
- People have hope for the future and are determined to live as full a life as possible.
- The real story wasn’t about dementia; it was about people trying to feel good about life, themselves and their contribution.
- Peer support makes a difference; reduces isolation and loneliness and creates a space for reminiscence, learning, activity and fun. People want to feel useful and valued. This was important for both the family and the person living with dementia
The attached document summarises the conversations in more detail, surfacing significant themes and learning reflections for us to consider when developing the allied health professions evidence based policy document and the ambitions to be included in commitment 4. You can read the full report here: http://www.alzscot.org/assets/0002/1187/Connecting_People_Through_Conversation.pdf
Thank you for taking the time to read this blog and we would love to hear any comments. However if you picked up a postcard with the question “What matters to you in your life right now and in the future?” what conversation would we be having?
Thank you to the people who shared their stories with honesty and humour, enabling us to learn and think with you. To Fiona MacNeill who guided us to reflect on the power of inquiry and also to my allied health professional colleagues who hosted the conversations and tried something new:
Angela Pointon, Danny Shanks, Iona Parkinson, Jannetta McQuat, Pasna Sallis, Ruth Gardner, Wendy Chambers, Sandra Johnston, Karen Thom and Angela Howard.
Allied Health Professional Consultant, Alzheimer Scotland
My remit in Alzheimer Scotland is to bring the skills of AHPs to the forefront of dementia practice and to share with them the principles and practice of working in a major charity that is dedicated to “making sure nobody faces dementia alone”. I am leading the delivery of commitment 4 of Scotland’s Dementia Strategy. In short, a great job working with great people.