Nursing Practice Discussion Dementia care


Keywords: Dementia/Residents/ Kitwood/Personhood


●This article has been double-blind peer reviewed


A nursing home adapted and reinvented the Kitwood model for dementia care to make relationships and daily experiences key priorities


Dementia care: focusing on daily experiences


In this article... Why a model of care for dementia is needed The Kitwood Plus model and carers’ toolkit How the model works in practice


Authors Taleb Durgahee is director; Amir Durgahee is development manager; both at Palm Court Nursing Home, Eastbourne, East Sussex. Abstract Durgahee T, Durgahee A (2012) Dementia care: focusing on daily experiences. Nursing Times; 108: 36, 12-14. Dementia care is emerging as a national priority. It is affecting younger people and as many as one million could be living with the condition by 2015. This article describes the development


of the Kitwood Plus model, which was specifically designed to care for people with dementia. Based on Kitwood (1997), the model fosters high-quality interaction from high-quality carers to enhance relationships and daily living experiences. Smile, touch, eye contact and positive talk (STEP) are the basic tools needed to connect with people with the condition.


double in the next 30 years (Department of Health, 2012). The lack of skilled staff with training in dementia care in general nursing care homes, hospitals and domi- ciliary care is resulting in poor treatment (Brooker, 2003), which has been criticsed in the media. Dementia care must therefore be pow-


D


ered by a specific model (Dewing, 2004). There is an urgent need to educate carers (Ford and McCormack, 2000), and provide them with a toolkit that enables them to develop the key skills to support people living with dementia. At Palm Court Nursing Home, we see the Kitwood model, first published in 1997


ementia care is a silent crisis. Around 750,000 people have the condition in the UK and this figure is projected to


and updated in 2007, as forming the basis of dementia care in the UK (Kitwood, 2007). Kitwood has six strands: love; iden- tity; inclusion; comfort; occupation; and attachment (Fig 1). It enhances person- hood, which is conferred through actions and interactions between two people. We became its pioneers when we started


a full implementation in 2007. We now share our experiences; the successes we see and the improvements we aspire to in its new form are what we call Kitwood Plus. We believe this will help shape the future landscape of dementia care.


Dementia care redefined Reflecting on her own condition as a person living with dementia, Bryden (2005) said she found it difficult to make sense of yesterday and to project her thoughts on tomorrow because dementia affected her faculties. At Palm Court we use this to define


dementia care as “no yesterday, no tomorrow, but today”. This shapes our care practice, making it alive, relevant, real and not routine. Our vibrant approach ensures that our residents are stimulated to enjoy the moment of care and interaction. The nature of dementia can be likened


to driving on a foggy road, suddenly coming into a clear patch round the corner then re-entering the fog. The challenge for care practice is to make those clear moments brilliant and be helpful and be understanding during the mist.


Kitwood Plus: the carers’ toolkit Dementia care needs to be focused on experiences and relationships instead of activities of daily living (ADL). Kitwood Plus illuminates the two dominant themes


12 Nursing Times 04.09.12 / Vol 108 No 36 / www.nursingtimes.net


5 key points


with dementia is steadily rising


1 2 3


Dementia care should be


guided by a model such as Kitwood Plus, making personhood, relationships and daily experiences key priorities


This model redefines


dementia care as “no yesterday, no tomorrow, but today” to make care practice enjoyable and uplifting


4


modernise dementia care practice: stability; learning culture; practice reinforcement; and reflective carers


5


Carers need a toolkit to


connect with residents before they offer care and support to make care practice meaningful


Four key anchors


The number of people living


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