A Q&A with Gary Mitchell, author of Doll Therapy in Dementia Care

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We caught up with Gary Mitchell on the publication of his important new resource for dementia care professionals – Doll Therapy in Dementia Care.

What motivated you to write the book – Doll Therapy in Dementia Care?

I qualified as a nurse in 2010 and my first post was in a dementia care unit in Northern Ireland.  When I began working on the unit I quickly saw the benefits of person-centred care and non-pharmacological interventions.  One particular intervention that was regularly taking place on the unit was ‘doll therapy’.  Initially it was an intervention that I wholeheartedly rejected because I felt it perpetuated stigma that can be associated with dementia.  I felt like playing with dolls would undermine the person-hood of the individuals living with dementia I was nursing.  After some time I began to see some very positive outcomes in some of our residents’ quality of life who engaged with doll therapy.  On reviewing the evidence in 2010, I found that there wasn’t really that much out there.  Over the past number of years I have closely studied doll therapy in dementia care through my practice and academia.  My opinions on doll therapy, informed by evidence and practice, are starkly different.  In short, doll therapy can enhance the quality of life for some people who live with dementia.  This was the sole reason for writing this book – to share the evidence and practice about doll therapy so as people living with dementia who will benefit from it can be enabled to do so. Continue reading

2016 Dementia Catalogue – New & Bestselling Titles

Take a look at our latest Dementia Catalogue. For more information on any of the titles, or to purchase a book, go to www.jkp.com.

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Mental health support made simple

Following the second edition release of Introducing Mental Health, authors Connor and Caroline Kinsella provide insight into taking a more global and simplified approach to mental health support in the fully revised and updated second edition.

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We wrote the original Introducing Mental Health: A Practical Guide to make the very complicated seem a little bit simpler and to help front-line workers do what often seems like the impossible. It’s not an easy role at the best of times, but much has happened in the nine years between editions to make the job of mental health care even more difficult than it was in 2006.

As thoroughly well behaved and professional writers (ahem) we chose not to fill the book with a long list of all that is wrong with UK mental health services. After all, most of our British readers need no reminders of the savage cuts, dwindling resources and disappearing in-patient beds that are now a feature of UK mental health.

But while it’s all very well to moan incessantly about our own back yard, we looked to the developing world for inspiration to update the simple, straightforward approach to mental health care embodied in the first edition. We’re lucky enough to have as a close friend one Vikram Patel, the Foreword writer of both editions, who is also the director of the Centre for Global Mental health, London. Vikram has spearheaded the global mental health movement which has helped make mental health a priority issue in those parts of the planet where malnutrition, malaria and HIV have traditionally demanded resources that truly put our own budget cuts and resource slashing into perspective. He is now on Time Magazine’s ‘World’s 100 Most Influential People’ list and we met up with him just as he had been interviewed for BBC Radio Four’s excellent The Life Scientific series.

It was a little strange sitting in a London pub with an old friend who is now the psychiatric equivalent of Kim Kardashian, albeit with a rather more worthwhile contribution to the world. While western psychiatry remains bound by an ever increasing list of obscure diagnoses, pharmacological treatments and reliance on highly trained professionals, the global mental health approach is a means of delivering care and support to communities without the need for complex resources, vast infrastructures or highly qualified personnel. Under this guise, mental health support is largely delivered by local people who, to put it quite simply, work with people not symptoms. In a word, it’s a very, very simple model of mental health care. And it works.

Psychiatry is, after all, a relatively straightforward science. It doesn’t take a master’s degree to recognise  when someone is severely depressed or saying bizarre things or taking an hour to leave their house because all the windows and doors need checking several dozen times. But supporting people through mental ill health can be anything but straightforward, and with qualified professionals and NHS facilities becoming ever more scarce, we now rely on police and prison officers, accident and emergency staff, housing support workers and (increasingly) friends and relatives to deal with our most needy and distressed people.

And while the poorest parts of the world begin to develop simple low-tech support systems that make optimal use of professional expertise combined with common-sense and the local knowledge of communities, the global mental health approach starts to look a lot like the sort of system that in many ways we in the UK are adopting by default.

We’ve written Introducing Mental Health twice, in both editions reflecting the many different scenarios and types of worker with whom we have worked in both clinical practice and training. We haven’t ignored the huge advances in the science of genetic and biological origins of mental illness, and have tried to make the science accessible to all. After all, there aren’t many people who would guess how much their Chinese takeaway has in common with the latest explanation of psychotic illness*. But above all we’ve strived to learn from Professor Patel and global mental health how this is above all a social issue, and how all of us have a part to play in helping our community’s most distressed and vulnerable people. It’s really surprisingly simple.

* Sorry. You’ll have to read the book to find the answer.

 

Caroline Kinsella has been a registered nurse since 1980 and has specialised in working with offenders and individuals with severe mental health problems. She has a Master’s degree in Forensic Mental Health from St Georges Hospital Medical School and is currently working with the Dorset Inreach Team as a mental health nurse assessing and care co-ordinating the needs of offenders in several Dorset prisons. Both Connor and Caroline live in Dorset, UK.
Connor Kinsella trained as a mental health nurse and has considerable experience of working with mentally ill people in both in-patient and community environments. Since 1998 he has designed and facilitated training for a wide range of services in health and social care. He writes a well-regarded blog called The Stuff of Social Care and has contributed to The Guardian’s Social Care Network.

To learn more about Introducing Mental Health click here.

 

Introduction to the Psychology of Ageing for Non-Specialists – a free extract.

Stuart-Hamilton_Introduction-to_978-1-84905-363-1_colourjpg-printIn this extract from the Introduction to the Psychology of Ageing for Non-Specialists author Professor Ian Stuart-Hamilton explains a little about the idea behind this edition and the audience he wrote it for.

For a free sneak peek, just click the link below to read the preface from the book.

An Introduction to the Psychology of Ageing – preface

You can find out more about the book, read reviews and order your copy here.

Karen Watchman on Intellectual Disability and Dementia

Karen Watchman, Lecturer in Dementia at the Alzheimer Scotland Centre for Policy and Practice, and editor of the new book Intellectual Disability and Dementia, joined us for a short interview. She talks about how she became involved in the field, and gives her advice for those working with and supporting people with intellectual disabilities and dementia.

How did you get involved with this area of study?
I spent many years as Director of Down’s Syndrome Scotland where I worked alongside families and people with Down syndrome of all ages. There was even less research conducted about dementia in people with intellectual disabilities at that time which spurred me on to complete a Masters degree in Dementia followed by a PhD researching the experiences of people with Down syndrome and dementia. So, whilst I have an academic interest in this area I am very much grounded in practice and in ensuring that information is made available in an accessible format.
My Great Aunt had Down syndrome and, unusually for the period in which she grew up, lived at home with family into her adult years. So it came as no surprise when research started showing the link between quality of life and increased life expectancy.

 

People with disabilities are living for longer and as a result we are seeing more people with intellectual disabilities than ever develop dementia as they age. What training is available for carers and professionals to help deal with this increase?Watchman Intellectual Disability and Dementia 9781849054225
Typically in the UK, staff, volunteers and carers supporting people with an intellectual disability do not have training in dementia. Similarly, staff supporting older people with dementia do not have training in intellectual disabilities, despite many younger people (especially with Down syndrome) being diagnosed, and some moved inappropriately to care homes for older people.
This is slowly starting to change but there is still not enough interdisciplinary exchange of learning. Training and courses that I deliver where staff attend from across sectors are very valuable, as participants learn from each other. However, it is not just intellectual disability or dementia services – equally important, especially as dementia progresses, is the input of all allied health and palliative professions and that there is partnership working with all services talking to each other and to carers, and all being consistent in their approach.

 

 

Are they any particular methods or activities which are helpful in explaining a dementia diagnosis to someone with an intellectual disability?
This is an area addressed in the book and is something that doesn’t receive enough attention currently. As a result there is inconsistency in practice. Information about a diagnosis or suspected diagnosis of dementia is not routinely shared with the person who has an intellectual disability, despite UK dementia strategies maintaining that everyone has a right to know of their diagnosis. We need to think more about how this can be done with people who have an intellectual disability and embrace non-verbal communication methods too.

 

 

What should staff or carers be aware of in order to be able to support people with an intellectual disability and dementia?
Someone who already works alongside people with an intellectual disability is likely to have been trained to support people to maximise their independence, to work towards independent living or community involvement to the best of their ability. Their work will be person centred and will be focused on the needs of each individual. There is an element or re-learning required by staff when the person with an intellectual disability has a diagnosis of dementia. The work should still be person centred and based around the individual but as capacity and cognitive ability change there is an associated need to change the way that staff, volunteers, family and friends provide support.
Carers also need information about interventions – this may or may not include medication. Social interventions such as meaningful activities and life story work are also essential. Awareness of contraindications with medication is important especially as many people with intellectual disabilities are over-prescribed anti-psychotic medication.
Specific knowledge of dementia that needs to be shared with staff, volunteers, family and friends include: what dementia is, different types of dementia and how each affects the person, early signs (this can differ from early signs in older people without an intellectual disability), environmental adaptation to ensure that accommodation is appropriate to the persons changing needs, communication changes and physical changes that will occur as the condition progresses. I am often asked for help with what is perceived as a behavioural issue, but with appropriate information or training there is a realisation that if we get the environment, communicating and our approach right – this is what has caused the changes in behaviour.  We need to work out the triggers and acknowledge our role in this – often a change in behaviour is caused by us not understanding the person and not providing appropriate support.

Intellectual Disability and Dementia is due to be published May 2014. 
Karen Watchman is the editor of the book as well as an experienced expert in working with intellectual disabilities. 

 

The magic of puppetry in dementia care

copyrightKM2012Writing1BWIn this post Karrie Marshall, author of Puppetry in Dementia Care, describes using the power of puppetry to engage with emotions that go beyond words and memory, and how she was met with a tentative response on first suggesting the idea in adult care work.

When I first started talking about joyfulness in relation to dementia, people found that a difficult concept to consider. At conferences I noticed the majority of terms used to describe dementia conveyed a sense of hopelessness and despair. These difficult feelings are of course very real for many family carers and individuals facing a diagnosis of dementia. However, it is also important to acknowledge the real capacity for humour, positive relations, creativity and enjoyment.

My talks give examples from the book of uplifting experiences shared by people with dementia and their carers (family or paid staff). I love hearing members of the audience talk about their own experiences. People generally want better services or want to know how to improve dementia care. The talks help people see this is possible.

Throughout my career in nursing and lecturing I found people learned more and communicated better in a creative environment. My specialty is puppetry, but all art forms can reduce stress, increase confidence and improve interactions with or without words. I am interested in how we (professional care staff, family carers, relatives, artists and the general public) can use this knowledge to improve quality of lives.

Recently my talk for the Scottish Women’s Rural Institute focused on positive communication. Talks for local libraries give practical tips and creative ideas from the book. My university talks focus on person-centred care and compassion, which are major themes underpinning the book. The talks also offer opportunities to share best practice with carers and artists.

When I first introduced puppetry into adult care work, there was a hesitant response! But puppetry has a long history with adults (making social and political comment). There is also a magical quality to puppets. They engage with emotions that go beyond words or memory. I love the stories in the book that show how people with dementia focus on the puppet and completely ignore the puppeteers, the staff and the relatives!

One of the biggest challenges carers face is around relationship changes. Sometimes the nature of the dementia may mean reduced recognition of a loved one. For others the relatives are dealing with mood swings or behaviour changes. Learning how to let go of the relationship they used to have whilst maintaining a loving and meaningful connection is complex. In the book I show how this process is possible through creativity. First I explore a theory about relationships between care-givers and care-receivers that describes a progression towards alienation.  During talks, audience members give examples of feeling they are losing someone, or of drifting apart.

However, over the past ten years of working creatively with families and care staff and people with dementia, I know people can go beyond alienation. They can re-emerge into a different way of connecting that has moments of pure joy and wonderment. People have different ways of reaching this, but generally we find people with dementia get there faster!

Each experience of dementia is individual, and that is a key message in the book. Not everyone wants to be actively engaged, so we discuss the therapeutic use of silence and breathing in unison. Often I find this leads to participation. It works because people tune into where the person is. The book explores theories about human motivation and the importance of matching individual needs.

One of my favourite stories is about a man who people thought might not be interested in anything to do with creativity and certainly not puppetry.  He turned out to be one of our most enthusiastic participant puppeteers. He helped make a puppet of himself (instructions are given in the book).  This had great presence and character, as so many of the ‘soul puppets’ tend to have.  I often get a sense that the work helps us see people more clearly. Creativity has no boundaries.

It takes a long time – perhaps a lifetime – and a lot of practice to really understand what it means to be person-centred, to genuinely consider and positively respond to individual preferences. Yet this is at the heart of good dementia care. Writing the book helped me explore how we can better do this, and highlights the importance of support for carers to connect confidently and creatively.

 

 

The comfort of music at the end of life – an extract from Musical Encounters with Dying

Runningdeer_Musical-Encount_978-1-84905-936-7_colourjpg-webWhile teaching piano to an adult student, an unexpected diagnosis led Islene Runningdeer to explore how music could provide a deep sense of comfort and support at the end of life.

Read more about the story here

This extract is taken from Musical Encounters with Dying, in which Islene Runningdeer shares many moving and inspirational tales about her work with patients facing death. This supportive guide considers the key ingredients for bringing music into palliative care settings such as creating a therapeutic relationship, helping patients to reach final goals, showing sensitivity to cultural contexts, and dealing with difficult emotions.

 

 

Books for Professionals Working with Older People.

If you work with older people or have an interest in elder care and dementia care, we’ve put together this booklet of new and bestselling titles which might be of interest to you. Feel free to browse, share and email the booklet to anyone you think might be interested. Double click on the booklet to view full-screen.

 

 

Please also note: although the prices shown here are in UK £, most books are available internationally. If you’d like any further information on any of the books in the leaflet, simply click on the title you’re interested in and it will take you straight to the book information page.

If you’d like to download and print a copy of the leaflet, simply click here.

Try out these free activities from ‘Activities for Older People in Care Homes’

Next month sees the release of JKP’s Activities for Older People in Care Homes from Sarah Crockett, the 2010 winner of  the National Association of Providers of Activities for Older People (NAPA) Activity Award.

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Activities for Older People in Care Homes

Here you can get a sneak preview of the book by clicking the link below to download some free activity ideas, which can easily be adapted to suit individual or group purposes, and can also be adjusted to suit differing levels of movement and interaction.

Sarah Crockett – An Activities Handbook – Extract

Visit our website to get additional information or to order your copy of Activities for Older People in Care Homes.