Seeing the person behind the disease: introducing the reflection tool

Abstract

Context, aims and objectives of the workshop : Health and social care professionals working in both residential and home care are often confronted with complex behaviour and complicated demands for care, especially in relation to persons with dementia and their relatives. Solutions for this behaviour and these demands are not easily found. Therefore, several partners in dementia care in Flanders, Belgium (a partnership called ‘Limburgs Network on Dementia’ between UC Leuven-Limburg, Centre of Expertise Dementia, the province of Limburg and Nursing homes Grauwzusters vzw with collaboration of the Centre for informative games) developed the reflection tool to guide the dynamic reflective process preceding the solutions for these complicated situations. The tool puts the person (and not the disease) in the centre of care and allows team members to search for answers and solutions to complex behaviour and complicated demands. Together with the other partners involved, an understandable and easy to use tool was developed to facilitate the reflective process in finding solutions to complex behaviour and complicated demands of persons with dementia and their relatives. The tool is based on the principles of person-centred care as described by Tom Kitwood, and on the principles of Appreciative Inquiry, with a focus on possibilities rather than problems. The whole reflective process, guided by the tool, can be completed in a limited amount of time. The reflection tool can be used in different settings, both in health and social care, and can also be used with students, while reflecting on their first clinical experiences during internships. The reflection consists of a board game with clear explanations and instructions for the different steps to take. After developing the reflection tool, the tool was tested by two health care teams of two residential care settings. After testing the tool for 2 months, participants were questioned by means of a written questionnaire on usability, clarity and immediate effects of the tool. The head nurse of each team was interviewed about her/his personal experiences and the experiences of the team using the tool. Based on their feedback and remarks, the reflection tool was further developed and adjusted before introducing the tool to our network. Key characteristics of the reflection tool: - A group of 5 to 6 people was considered ideal for using the tool - The reflective process takes about 20 minutes - A trained facilitator who guides the reflective process is a necessity - The first focus in the process should be installing a ‘safe environment’ where concerns can be shared Up till now, the tool has been used 14 times in a multidisciplinary group of 3 to 8 persons. The majority of participants found the tool useful. According to the participants, instructions and questions were clearly formulated for all stages of the reflective process. All participants agreed that the tool helped paying attention to the perception of the person with dementia and stimulated reflection on the caregivers’ actions within the framework of person-centred care. After this feedback from caregivers in Flanders and the Netherlands, it is now time to introduce the reflection tool to professionals working in other, non-Dutch speaking countries. We are happy with the opportunity to do so during a workshop during the International Conference on Integrated Care. Proposed structure and timing : The workshop will start off with a brief explanation of the theoretical background of the reflection tool mentioned above. The principles of Tom Kitwood’s person-centered care and of Appreciative Inquiry will be explained. The best way to learn and understand the reflection tool, is by using it. Therefore, in the second part of the workshop, the participants get the opportunity to try out the reflection tool with cases from their own clinical practice. The last part of the workshop will be used to receive feedback from the participants, and to investigate what the possibilities are for further cooperation to improve and further develop the reflection tool. Ideally, total duration of the workshop will be two hours, but this can be adjusted to better fit in with the conference’s schedule. Target participants : This workshop aims at health care professionals, policy makers, students and others interested or involved in the care for people with dementia. Due to the intensive character of this workshop and the fact that we might only have one hour to give the workshop, we have to limit the number of participants for this workshop to 18. If there is a possibility to give the workshop during two hours with two trainers, we can increase the number of participants to 30.