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All About Me
the benefits of life story documents

Mark Howard, Angie Williams, Andrea Bentley and Dawn Elmore overview the development of The Orders of St John Care Trust’s updated All About Me life story document, its benefits and case studies about how it has been put to use to assist care teams across the organisation.

According to the Office for National Statistics, over 290,000 older people in the UK live in care homes – a figure expected to rise as the proportion of the population over 65 continues to grow. Recent studies also show that the number of people living with dementia in the UK will increase from 800,000 to 1.7 million in the next 40 years.

With that in mind, The Orders of St John Care Trust (OSJCT) undertook a project to develop an updated All About Me life story document that would allow care teams across its 68 care homes to deliver a higher level of person-centred care, whilst also contributing to the Trust’s compliance with Regulation 9 of the Health and Social Care Act 2008.

What is a life story document?

According to Dementia UK, a life story document is a comprehensive biography about a person, created following conversations with the individual, their family members and friends. These are used to better understand each person. This, in turn, can enhance communication and the ability for carers to meet individual needs more effectively, as well as help those with dementia reduce stress and anxiety, and maintain a sense of self.

Life story documents come in all shapes and sizes. For instance, OSJCT’s updated All About Me life story document is a detailed scrapbook outlining each resident’s past, including family details, former occupations and hobbies, likes and dislikes, photographs and other personal information. This document acts as the cornerstone of the OSJCT’s resident assessment process and relationship-centred care approach.

Developing a more person-centred Document

In 2013, OSJCT’s St John Admiral Nurses were asked to lead a project to review OSJCT’s current use of its life story document, which had been in place for nearly 10 years. Because there was very little commitment or awareness about its benefits, the team was also tasked with developing an updated, user-friendly document, in addition to training carers and management on how it could be used to improve the care of residents.

To gain insight, a series of workshops was held with nearly 80 dementia leads from OSJCT’s care homes. Feedback included condensing the number of sections focused on the past and past events, and utilising a scrapbook layout for the new version, in place of a design that required a signature and date of entry on each page and had no pictures or colour.

Several new sections, focusing on ‘the now’ for residents, were also added to the document. These included pages focusing on how individuals like to spend their time, what makes them happy, how they communicate and the people and things that are important to them, in addition to a page relating to end of life care wishes.

Once completed, OSJCT’s home managers were introduced to the new document through a series of interactive sessions. The finished product was then rolled out across all OSJCT care homes at the end of 2013 and throughout 2014.

Benefits of an updated life story template

The primary benefit of more person-centred life story documents is that they encourage and enable a higher level of person-centred care to be used. For example, OSJCT has found that assisting residents with completing their All About Me scrapbook is a very valuable and meaningful activity for employees, residents and also family members.

The information from life story biographies can also be used to support interventions when the Best Interest Summary document is used. By doing this, care workers can demonstrate that care being provided during times when a person struggles to make simple day-to-day decisions has been based on recorded knowledge of their previous likes and dislikes.

Care providers should use life story documents to shape care plans. In the case of OSJCT, St John Admiral Nurses felt it was important that care colleagues completing the life story document were able to make links to care plans, so included a set of prompts to achieve this. For example, reminders were added to the ‘How I like to spend my time’, ‘Are there things that you particularly enjoy in life that you would hate to lose?’ and ‘What makes me happy’ pages, referencing the relevant care plans that should reflect the information on that particular page.

Success stories

Below are two examples of how this type of document can be updated and utilised to enhance the level of care residents receive, as provided by one of the OSJCT’s St John Admiral Nurses.

A gentleman living in one of OSJCT’s Wiltshire care homes was finding it very difficult to understand and would resist care staff when they tried to assist him with his personal care. The care team soon learned from his sister that the gentleman’s wife used to lay his clothing out on the bed for him, run the shower and prompt him to get undressed and into the shower each day. The care staff tried this approach and found that the gentleman was able to shower and change independently and without distress – he only needed the correct prompts. As a result, this information was added to his life story document, so all care staff working with him could read, understand and adapt to his behaviour.

A lady living at one of the Trust’s Gloucestershire care facilities would regularly become very unsettled after teatime, walking around, asking for her coat and trying to open outside doors to ‘go to work’. The home’s care team eventually found out that, when she was younger, the woman had worked evenings in a pub for a number of years. Bearing this in mind, the care team began inviting her to help gather the plates and glasses and wash up after tea, a routine that fitted in with what she had done for many years in her previous role. As a result, she became more settled in the evenings, knowing she had completed her job. Her life story document was updated accordingly to reflect this information about her past and her behaviours, to help other members of the home’s care team better understand and work with the resident.

Embedding the documents

Despite finding that the completion of all-new life story documents was not a major day-to-day priority, over 70% of the Trust’s residents now have their own All About Me scrapbook.

Various strategies have been used to better integrate the new document into each home’s culture and everyday routine, including home manager workshops and an Introduction to the All About Me Life Story leaflet created to raise awareness about the document and inform families and employees about its many benefits.

Further All About Me life story workshops are still being facilitated by the St John Admiral Nurses across OSJCT homes, in addition to many homes holding life story-themed coffee mornings or afternoon tea sessions, where residents can bring their life story with them and add photographs from the recent activities or events that have taken place.

Many benefits

OSJCT’s development and success with the new All About Me life story document demonstrates that engaging with residents and their families to record memories and past experiences can not only improve the quality of person-centred care that employees provide by offering valuable insight into residents’ behaviours, but can also build and enhance relationships.

With individualised care at the forefront of the industry, life story work provides a valuable template which, when used with other tactics, can truly assist care homes with providing uniquely tailored care and support to each client.

Mark Howard, Angie Williams and Andrea Bentley are St John Admiral Nurses at The Orders of St John Care Trust. Dawn Elmore is a Care Performance Analyst at The Orders of St John Care Trust.

Emails: m.howard@osjct.co.uk, a.bentley@osjct.co.uk, d.elmore@osjct.co.uk, a.williams@osjct.co.uk Twitter: @OSJCT

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