Retro-decorating can help people with dementia to stay at home for longer by placing familiar items from their past in their home to reduce anxiety and to trigger memories. Jeremy Dunning reports
With about 750,000 dementia sufferers in the UK, costing the UK £20bn a year and numbers set to grow to 1.7 million over the next 40 years, commissioners and providers are looking for cost-effective models of providing dementia care.
Adult social care manager Joelle Bevington, from Surrey Council, has seen good results from retro-decorating since the council began implementing the model as a facet of personalisation. “We are seeing that people do feel less anxious and more able to do things and getting things for themselves from their kitchen because they know where things are,” she says. “People are more self-sufficient.”
The council has been using the technique in people’s homes, day centres and care homes for adults with dementia.
The intention is to allow people to stay at home for longer and out of hospital by providing low-level support, such as old-style fixtures and fittings or pictures of favourite movie stars, that people with dementia will remember from their childhood. This is because long-term memories, unlike short-term memories, are normally retained and can be stimulated. This will be mixed with surroundings that are airy and light.
People can also be helped by finding ways for them to re-engage in activities they enjoyed in the past. For example, by providing someone who likes cooking with basic utensils to do a bit of baking with the support care workers may lead to a reduction in anxiety levels with the consequent effect of reducing cost to the health and social care system by ensuring they do not require hospital treatment.
According to the Centre for Housing Policy and York Health Economics Consortium, at the University of York, postponing entry into residential care by a year saves on average £28,000 a person, based on the average cost of providing residential care (Kent University personal social services research unit sets this figure at £26,000).
“For people with dementia, quite often they have recognition and you can stimulate memory from the past and usually you have to go back quite far. The short-term memory is lost first so it’s about taking people back to a place where they feel familiar. Where people recognise their surroundings a bit more it lessens anxiety and it means people feel more able and capable so in a kitchen people can recognise if you use an old-style kitchen,” says Bevington.
The Riverside Home Improvement Agency, of Liverpool, is also piloting this “dementia-proofing” approach.
Paul Booth, regeneration manager at The Riverside Group said: “We believe that the holistic nature of a home intervention can help to reduce usage of other public services. We can provide interventions that allow an individual with dementia to live an independent life which can help reduce dependence upon anti-psychotic drug therapies. These benefits continue year-on-year after implementation, without significant further investment.”
Riverside team leader Brian McGorry estimates that 100 clients could benefit although he acknowledges that the pilot is in its infancy. However, work with one woman, who is in the early stages of dementia, has indicated the possibilities. Here the team put in an old sewing machine and a 1960-style Bush transistor radio which brought back many memories of preparing family meals accompanied by the BBC’s Light Programme as well as old-style rugs and mats. All of this costs the agency £65.
The technique is time-intensive for staff because it requires conversations with family members and the sufferer in order to put together a life-story of the person and then to work out how to implement that in terms of therapy.
“There’s a lot of involvement from us because we’ve got to see the client a lot and see if they’ve kept the item or whether they’ve taken it down,” says McGorry.
Anne-Marie Hunter, a caseworker for Riverside HIA Liverpool explains how this involvement can work: “We know that the symptoms of dementia can worsen over time, to a point where people can become withdrawn and uncommunicative with loved ones. We can source simple items of furnishing or decor, which can trigger a memory in the person with dementia, which can penetrate this uncommunicative state. The only way we can do this is by spending time talking with the client and their family and encouraging a reminiscence dialogue.”
Bevington says the technique means a different way of working for people, but it allows social workers to get back to their roots by working with and supporting people using “remembrance therapy”.
However she points out the intensiveness of the time taken to understand people and then working with people at home means financial savings are not necessarily offset.
While this technique still requires piloting, early results seem promising. As a result councils are increasingly exploring this as a humane and cost-effective measure.
What is retro-decorating?
Retro-decorating is a relatively inexpensive answer to reassure people with dementia.
Schemes see modern technologies replaced by older versions, surrounding dementia sufferers with objects from the past, such as old-style-looking radios to trigger their memory, and using colour and light to make daily tasks simpler.
Surrounding someone with furniture from their past can also help them to remember their daily routine – such as sitting down for a meal or washing themselves.
Ultimately it can play a part in reducing the need for anti-psychotic medicine and residential care. The intervention means that most sufferers are able to live at home for longer.
Client goes back to the 1950s
Cynthia* is 75 and lives with her husband in north Liverpool in a two-bedroom house managed by social housing provider Riverside.
Ten months ago she was diagnosed with dementia, though it is still in the early stages. Recently Riverside helped dementia-proof their house.
Among changes, chests of drawers with see-through panels were brought in so Cynthia can see which drawers contained clothes.
Her husband also told the Riverside’s home improvement caseworker that he had put up a few old family photographs in their bedroom and had found some old records that the couple used to enjoy when they first started courting.
He showed the records to Cynthia who began talking animatedly about those days. The problem was that they no longer had anything to play the vinyl on since their old gramophone had broken.
The caseworker found a record player, similar to their old one so they could play their old records to trigger positive memories for Cynthia.
Cynthia also told the caseworker that she loved the old transistor radio she had as a young woman. She would prepare family meals while listening to the BBC’s Light Programme on the radio. The caseworker bought a Bush transistor radio and it was put in the kitchen, which she switches on whenever she goes in there helping her remember what to do.
It also turned out that Cynthia was a huge fan of 1950s singer Dickie Valentine, so the caseworker offered to print out some old posters advertising Dickie’s music to put around the house.
Cynthia had worked for a number of years as a secretary and the caseworker managed to find a typewriter similar to the model Cynthia had used. She could then write letters using the machine and remember those days when she was highly active.
Riverside says that, although it is still early days, Cynthia is talking a lot more about the past and happier times, while her husband is feeling more able to cope.
* Not her real name
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