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Rachel Thompson describes how staff can be supported to implement and sustain biographical approaches with clients
Abstract
Life story work has been promoted as a tool to enhance the care provided to older people, particularly those with dementia. The benefits for individuals, families and/or friends and for staff include improving understanding of the individual, promoting relationships and assisting in the delivery of person-centred care. However, professionals often experience difficulties using life story work.
This article considers a range of life story tools and advice on gathering information about a person. It highlights the importance of leadership and developing positive cultures to ensure that life story work can be effectively sustained.
Keywords
Dementia, life story, person-centred care
the care received by older people and those with dementia needs to improve, an issue that has been raised repeatedly over the past few years (National Audit Office (NAO ) 2007, Alzheimer's Society 2009). Despite national strategies, minimum standards and patient outcomes for dementia, findings suggest that care is still of poor quality (NAO 2010, National Confidential Enquiry into Patient Outcome and Death 2010, Older People's Commissioner for Wales 2011).
The National Audit of Dementia (Royal College of Psychiatrists and Healthcare Quality Improvement Partnership 2010) has found that people with dementia in acute hospitals are not offered appropriate assessments and care. The Alzheimer's Society (2011a) states that many people with dementia being cared for at home, and their carers, are not receiving the help they need.
The National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence (2006) guideline on dementia provides an overview of treatments for people with dementia and their carers. It includes recommendations for proper assessment of a person's life history and the use of life review as a psychological intervention. Life story work is increasingly recommended to improve care.
Recent initiatives such as the national life story network (www.lifestorynetwork.org.uk) provide valuable resources. However, there are often difficulties in making and sustaining improvements (Thompson 2009, Gibson and Carson 2010, McKeown et al 2010). These include poor understanding of the rationale for life story work as well as lack of leadership and support for implementation.
What is life story work?
'Life story' or 'life history' is an approach which involves reviewing and...