Telling their stories

Researching and recording the life stories of people living with dementia is already recognised as an effective therapeutic tool. Now aged care provider Amana Living is incorporating the task into care planning.

Amana Living has called on Curtin University occupational therapy students to help move towards this goal. During seven-week placements, the final year students are working in pairs at five  Amana Living service locations. Each pair is developing life story tools for up to eight residents, with a total of 120 to be completed by the end of the year.

Assisting those living with dementia to tell their life stories can reportedly enhance wellbeing through:

• a structured process of reminiscence, the storyteller may be able to place themselves in time, albeit temporarily, while enjoying happy memories;

• recording the stories in an accessible way means the storyteller is able to revisit the memories, using them for quiet contemplation, or to regain their equilibrium during a period of agitation; and

• the stories can also invite a greater understanding and respect when shared with others, helping to ease the frustration of those with dementia when they are struggling to find a way to communicate.

“We envisage the project could run for up to five years with student involvement, including additional students allocated by Alzheimer’s Australia WA,” Amana Living’s general manager of health care, Zenith Zeeman, said.

“By then we expect to have established the most effective process for developing and utilising life stories, both as individual tools and as an integral part of care planning for people with dementia.”

As well as books containing images and captions, students are using videos and slide shows to tell stories and putting together memory boxes of tactile objects. Sometimes additional information is included to help staff make better use of the stories when communicating with residents.

“One resident who is often agitated will sit for 45 minutes watching a video of herself boot scooting as a younger woman,” Amana Living dementia specialist, Louise Jones, said.

“Another lady, who used to be a seamstress, has a box of the oldfashioned paper patterns that the students have cut and laminated for her and some fabric. She derives pleasure from placing the patterns onto the fabric.”

Ms Jones said the reaction to a jogged memory could be just a smile, or sitting for a longer period of time without agitation. Other important benefits lie in the understanding gained by those caring for the person.

While the concept is simple, there is skill in drawing out the stories sensitively, recording them in a meaningful and accessible format, and recognising what is a positive response for each individual resident.

“The outcomes of this project will feed into our three-day dementia care training package for all staff,” Ms Jones said.

Families are also important to the success of the initiative. The life stories focus on positive experiences, but not all memories are good. This means consulting with families if trauma comes to light, and raising awareness with staff.

While accuracy is not always the most important aspect of a life story, families are often able to fill in the missing parts, supply photos or verify stories. Some families are keen to take on the whole task themselves.

Amana Living is planning to run workshops to involve families to explain the benefits of life stories within the overall care plan, and how to create a story that can be accessed by their loved one easily.

Plans going forward include formal evaluation of the project’s effectiveness, involvement of volunteers, additional staff training, and a life story kit to enable activity staff to run story-making groups.

“The first six months of the project have been very rewarding, laying the foundations for developing an integrated approach to the use and development of life stories.

“This initiative will play a significant role in offering truly individualised care to people living their second half of life in the presence of dementia,” Ms Jones said.