Connecting people through conversation and inquiry

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

1. Importance of family and relationships
2. Independence and a sense of freedom
3. 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.

Elaine Hunter
Allied Health Professional Consultant, Alzheimer Scotland
@elaineahpmh 

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.

“Realising Potential Together”

Last week saw the launch of an allied health professional policy document called “Driving Improvement: Implementing Realising Potential an Action plan for Allied Health Professionals in Mental Health” (Scottish Government 2014). The policy document reflects on the progress that has been made through the implementation of Realising Potential (Scottish Government 2010) and considers how future AHP practice should be shaped. However the policy document was always about harnessing allied health professionals creativity and energy and did not “ask AHP’s to do extra. It asks AHP’s to do differently”. (Scottish Government 2012). I am delighted to showcase the launch in this week’s blog and share a bit more about what and who the allied health professionals are.

“Making the invisible visible” through social media

Realising Potential encouraged multidisciplinary and multisectoral team-working and helped people to understand the added value AHPs bring to mental health and dementia services. A number of us tweet and on the day we used the hash tag #RealisingPotential2015 where we had some great conversations and interest in our work. Thanks to everyone who joined us.

“Tree of Celebration”

Like all great work, “none of us are smarter than all of us”. On the day we launched our “tree of achievement”. For the next year we will take the banner around Scotland inviting colleagues to add a leaf and share what they are proud of.

“Journey to Work”

During the launch we were reminded of the many ways AHPs are helping adults of working age to gain the confidence and skills to return to the work environment – or indeed to take up employment for the first time. We heard from Robert Reid how important that was when he read his poem.

thank you for all you did for me

i connected well enough to now be a support worker

i fought you all because i was terrified to be happy

when you have lived in darkness you do not recognise light

deep is the only up you know

with the help of some truly amazing people i am healing

i have had two of my poems published

i have had two exhibitions of my poems

i am going to publish an E-Book soon

i still doubt

i taught myself that when you sing it is impossible to be unhappy

i am growing I

am smiling

i am writing

i am happy I

am poet!!

thank you

Dementia Friendly Communities: ‘It’s just so AHP’

We heard and celebrated the partnership approach that has lead the way in dementia friendly communities in Scotland and heard from Sarah (@sarahahpmh) on the work in Highland to use technology to connect arts and health for therapeutic interventions in remote and rural communicated.  You can find out more by linking to this website. http://www.adementiafriendlycommunity.com/

Smile please

On the day we had over 40 AHP’s there from all over Scotland, sharing their posters, their awards and their work. This is just some of the great photos.

Where next & what now

“…..the Realising Potential story is far from over.

We have so much more to do and so much more to give”

We heard these words on the day and will continue to look forward and build on the momentum created to ensure the benefits gained of working together as a collective group of AHP’s does not diminish or disappear. We were encouraged to inform people of who the allied health professionals are and what we can do with the aim to develop a shared understanding of the positive impact allied health professionals can have on the challenges facing services today.

If you were to add a leaf on our tree of achievement what would you answer when asked:-

“What are you proud of? What has made a difference? What do you want to shout about?

You can review Robert’s poems on Amazon or Facebook.

References

Scottish Government 2010  Realising Potential http://www.scotland.gov.uk/resource/doc/314891/0100066.pdf

Scottish Government 2012 Realising Potential: our own and others. Report from the National Allied Health Professional Mental Health Clinical Leads Group on Implementation of the Action Plan, 2010-2011 http://www.gov.scot/Resource/0038/00389352.pdf

Scottish Government 2014 Driving Improvement: Implementing Realising Potential an Action plan for Allied Health Professionals in Mental Health http://www.gov.scot/resource/0045/00458245.pdf

 

Elaine Hunter
Allied Health Professional Consultant, Alzheimer Scotland
@elaineahpmh 

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.

 

A Week in the Life of an Alzheimer Scotland Nurse Consultant

“Tell It Like It Is”

When invited to write a blog on the role of Alzheimer Scotland Dementia Nurse Consultant, I initially felt honoured, then came feelings of bewilderment followed by panic as my deadline drew closer. My dilemma was how to fully capture the enormity of such a privileged role in so few words (supposed to be 500!). Looking to my ever supportive family for inspiration was met with “Just tell it like it is”  really helpful and inspirational!!, but  after much deliberation that’s exactly the angle that I have taken and “tell it like it is”.

Who are we?

Alzheimer Scotland Dementia Nurse Consultants are part of a national network, across the 14 Scottish Health Boards who work alongside our 4 allied health professional consultant to drive forward continuous practice development and aim to improve clinical outcomes and quality of life for people with dementia and their carers. Although a great deal of our work has a focus on acute care settings the scope is diverse and varied and in order to capture this, I would like to share a working  week with you.

Monday

Today saw me catching the early morning train to Edinburgh, shopping I hear you say?, no, something far more exciting, to meet up with my national peer group. We meet as a group of nurse and AHP consultants on a monthly basis to share practice and focus on developments , but today was slightly different. Today we had arranged to meet with Amanda Johnson  (@AJohnso10) Scottish Government  Dementia Improvement Lead, to develop specific actions and outcome measures  around the 10 dementia care actions in hospitals.

Tuesday

Some time for reflection on yesterday and catching up on emails before having the pleasure of meeting up with an extremely enthusiastic district nursing student who had chosen dementia care as a dissertation topic. We spent time discussing the positive journey in dementia care NHS Ayrshire and Arran have taken in recent years and future plans and objectives linking policy to practice.

The afternoon was spent in Crosshouse Hospital catching up with clinicians and 2 of our dementia champions, the focus of the afternoon was supporting theory into practice, particularly the use of non-pharmacological interventions, this also allows me the privilege of  maintaining  direct clinical contact with patients and families.

Wednesday

As an Alzheimer Scotland Dementia Nurse consultant, a key component  of my role is to lead and influence change in dementia care practice through continuous improvement methods.  To facilitate this, I deliver 2-3 training days per month based on the Promoting Excellence Framework.  The training aim  to drive forward service improvement for people with dementia that is person centred and strengths based, with a focus on enablement, involvement, choice and rights.

Today’s session was delivered at “skilled level” and as always, I am overwhelmed by the thirst for knowledge and enthusiasm shown by staff and their eagerness to introduce an array of proactive management strategies as an alternative to reactionary care management.

We also had the pleasure of being joined today by Linda Boyd,  Health Care Manager for Mental Health(1^st on the right)

Thursday

Thursday morning was time to catch up on phone calls and emails before heading to medical photography to collect our framed pledge trees and meet Tommy  (Whitelaw) in time to deliver session 8/10 #youcanmakeadifference.

Tommy has kindly given his time, to work collaboratively with NHS Ayrshire and Arran in highlighting dementia from a carers perspective with a key message that everyone can make a difference. Today had the additional element of being part of our “make a difference” film. Hollywood??? Or more likely cutting room floor.

 

Friday

This morning saw me head off to Erskine Hospital for a “Food for Thought” team meeting. As part of my role, 1 day per week I work with University of West of Scotland attached to the Alzheimer Scotland Centre for Policy and Practice.   “Food for Thought” is a collaborative  research programme with Erskine Hospital and UWS which focuses on nutritional intake in end stage dementia care. The programme has now been completed and the purpose of today’s meeting was to begin the evaluation process.

This afternoon I find myself sitting in front of my computer with the dilemma of commencing a presentation on the role of Scotland’s dementia nurse consultants for the 24^th Alzheimer Europe Conference “Dignity and autonomy in dementia” and writing this blog, what a great way to end my week.

Thank you for allowing me to share a snap shot of the diverse, stimulating and inspiring role of an Alzheimer Scotland Dementia Nurse Consultant and I would welcome any comments, views or feedback on my blog. Just “tell it like it is”.

 

Author

Janice McAlister
Dementia Nurse Consultant
@janicemcalister

Alzheimer Scotland Dementia nurse Consultant working within NHSaaa. I provide professional strategic nursing leadership, research/academic leadership and expert consultancy on all aspects of clinical nursing practice and care of people with dementia across the patient pathway. With a specific remit to support the development of practice and services in the general hospitals. This involves working across professional boundaries, in partnership and in collaboration with others including service users, carers, health professionals, social work, voluntary sector staff and local education providers. I also have a defined research and teaching remit within the University of the West of Scotland.

Connecting People, Connecting Support

After World Alzheimer Day on the 22^nd September, we hosted a one day conversation celebrating the best in Supported Self-Management for people with dementia and co-creating the future direction. In this week’s blog we will share with you what we did that day, including a launch of a publication, live stream presentations, posters, structuring the day around appreciative inquiry and interviewed delegates. During the day we kept talking about dementia and we hope you enjoy some of the resources we have developed as a result of the day.

Launching a publication

Our first speaker for the day was Jacqui Lunday Johnston launched our second publication “Allied Health Professionals Delivering Post-Diagnostic Support: Living Well with Dementia”. Click here to access a copy of the publication.

Four Presentations

The day included presentations from

• Jacqui Lunday Johnston , Scottish Government @JacquiCHPO
• Dr Claire Craig, Sheffield Hallam University
• Peter, David & Carol, Scottish Dementia Working Group @S_D_W_G
• Amy Dalrymple, Alzheimer Scotland @alzscot

 

You can view all the presentations here.

Co-Create the Future Direction

To enable us to celebrate whilst “co-create the future direction” of post diagnostic support, we structured the day on the principles of appreciative inquiry, inviting all participants to capture their thoughts and consider these questions:

• When supported self -management really works, what kinds of things happen for you and the person with dementia?
• Walk 12 months down the line and imagine that supported self-management exceed the expectations of everyone, draw that picture, describe that vision, communicate those emotions, define those outcomes
• What one thing can you do tomorrow to start this journey
• What would you put in place around supported self-management if you Knew success was guaranteed?

 

Delegate Interviews

Here is what our delegates thought of the day

https://vimeo.com/107136018

https://vimeo.com/107018827

Here is who they are:

• Jacqui Lunday Johnston, CHPO, Scottish Government
• Dorothy Hathaway, podiatrist, NHS Fife
• Fiona Roberts, link worker, Alzheimer Scotland,
• Rebecca Kellet, speech and language therapist, NHS Dumfries and Galloway
• Ylva Champion, occupational therapist, NHS Highland
• Joanna Payne, occupational therapist, NHS Ayreshire and Arran
• Lynne Douglas, AHP Director, NHS Lothian
• Alison Groat, AHP Post Diagnostic Project Lead, Alzheimer Scotland
• Prof Maggie Nicol, Chair of the Alzheimer Scotland AHP Expert Group
• Dr Norma Clark, AHP Mental Health lead, NHS Fife

The names in purple also at contributors to the AHP Publication

 

Your Reflection

Peter on the day shared with us, “crucial thing is early support because it helps you to adapt, helps you to make choices, to make decisions………

 

From reviewing all the resources we have shared in this blog, what has been the most relevant for you? We would love to hear your views.

 

 

 

 

 

 

 

 

Photo Gallery from the day and still more to be added

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