For somebody living with Dementia, you may think that making a cup of tea is possibly a risky venture, but always putting safety first denies that person the right of choice and self-determination, which can lead to a loss of self-esteem, increased dependence, and does not support the principles of person-centred care.
At our Monmouth Nursing Home in Gibraltar, one of twelve care homes run by the Evolve Care Group, they specialize in both retirement homes and in offering person-centred care for people living with dementia. Part of this is using positive risk acceptance as part of that care.
Visitors could be forgiven for thinking the Home is more like a boutique hotel than a care organisation yet 10% of the home’s residents live with dementia. There is a restaurant, cinema, library, beauty salon, hydro-therapy pool and internet café, all set within the heart of breath-taking Welsh scenery.
They do things a little differently at Gibraltar, compared to more traditional care homes. For instance, they call their residents, family members, and have a no uniform policy which has a positive effect on the dynamics in each home.
When new family members arrive, they are allocated into small groups with other family members. These groups are as much like a home environment as possible. The kitchens look like many you would find in any comfortable, family home across the country.
Here, the team know that changes to a former breakfast routine for instance, can cause confusion and consternation. This is where positive risk acceptance comes in. Making a cup of tea, with a kettle of boiling water, has obvious risks associated with it. It is easy to see the negatives around people in care being given free range in a modern kitchen, but the benefits of ‘positive risk-taking’ often outweigh the harmful consequences of avoiding risk, altogether.
Nationally, kitchen accidents injure 250,000 each year. Most assume the kitchen is the most dangerous room in a house, but surprisingly, statistics show that more accidents occur on the stairs and in the lounge, than the kitchen. The most common kitchen accidents are knife cuts, followed by slipping on the floor, and thirdly, accidents involving kettles. But any risks undertaken in Gibraltar Nursing Home, are carefully assessed.
Wherever possible, if family members are considered able to make hot drinks themselves, that is encouraged. Care team members observe this from a respectful distance, to keep an eye on things. Using a kettle or spreading jam with a butter knife, are considered risks that enable older people to have more control and therefore, more choice in their lives. This maintains family members’ independence for as long as possible and for anyone living with dementia, this is important feel-good factor.
Michael Greene resides at Gibraltar Nursing Home and says that being able to make a cuppa whenever he wants, makes living in Gibraltar much more like living at home and that is the ethos of the Home’s care policy. They use what they call a “Household Model” of care, so named because they’re aiming to create a true continuation of life at home. They thoroughly research each life history, getting to know likes, interests and abilities – Only by knowing this, can they understand who each person is, and assess the positive risks that can be taken to help them. Gibraltar say care homes are an extension of life, not an end to it.