Why activity is everyone's business

Go into most care homes and you will see a familiar array of staff, from carers to chefs, housekeepers to maintenance personnel. A role you will also often encounter is that of an 'activity coordinator'. All of my dad's three care homes had activity coordinators, all of whom were women and some clearly more suited to the role than others.

In essence an activity coordinator is charged with ensuring that everyone living in the care home gets to do activities that they want to do and enjoy doing. The scope for those activities is largely dictated to by budget, with some care homes having extensive 'activity' programmes that include trips out and even holidays, while others literally scrape around to find pens and paper for residents who want to draw.

Whilst I am the first person to advocate that people living in care homes should have opportunities to engage in 'activity', I am not a fan of the 'activity coordinator' role. Why? Because in my view activity is everyone's business.

By creating a role in a care home that is centred around activity, everyone else working in the care home automatically defaults to that individual for anything related to activity. This is seen with other roles, where everyone goes to the chef for matters relating to food, and everyone goes to the maintenance person if something needs fixing.

The other reason I'm not a fan of this role is that activity is about everything that happens in the day, from the moment you get up to the moment you go to bed. Given that people living in a care home spend most of their day with care staff, it is vital that care staff recognise that everything they do to support that person is, in itself, an activity.

By taking this approach, it is then much easier for care staff to appreciate the need to support the person to do as much as possible, thus retaining maximum independence, rather than just automatically doing everything for them and effectively de-skilling them and taking over their life.

Making a cup of tea, having a shower, getting dressed - these are all activities, just as much as bingo and singing groups. And they can all be expanded upon to go beyond the purely functional. So, for example, making a cup of tea could be about doing it 'the old fashioned way' with loose leaf tea and a tea pot, sparking a reminiscence session. Having a shower could become a full on pampering session, with some gentle exfoliation of hard skin, a massage with body lotion afterwards or a full-on salon-style blow dry. Getting dressed could be about coordinating colours and outfits, dressing up or dressing down, and might even lead onto a mending session if clothing needs some TLC.

Throughout any of these 'activities' songs could be sung, conversation could flow, laughter could be triggered and memories could be drawn upon and mulled over. The problem is, if your care home has an activity coordinator, he or she is unlikely to be involved in these 'care' related activities, and thus these daily occurrences just become bland tasks for the care workforce to 'get through'.

In my consultancy work with care providers, I look at the structure of the workforce in a care home, who is responsible for what, how those responsibilities are carried out, and whether there is, in fact, a better way of approaching how the care home operates. A huge focus for me is how holistic a care home can become, which in practice means frontline staff taking on a more fluid role that responds to the individual needs of the people living in the care home and treats every interaction as an opportunity to create a special moment with that person.

It is irrelevant if those moments will be remembered, and the fact that they might not is no reason not to create them. There is often a belief that group 'activity' sessions are more memorable, but actually as a person's dementia advances, it is often the one-to-one time spent doing something very simple and very familiar, like eating, drinking, folding laundry or making the bed that enhances wellbeing and quality of life more.

Persuading staff to be creative and expressive whilst providing this type of essential support is often very challenging; many would much rather just default to the activity coordinator when conversation and interaction is needed. But care staff who approach their work with an emphasis on both supporting the person and creating an activity out of everything they do generally have much more job satisfaction.

So what would I suggest care providers do with their activity coordinators? By all means turn them into event managers, charged with creating those important community experiences in the care home, and indeed helping people living in the care home to get out and about. If they are great communicators and creative types (which they certainly should be!), then utilise that to show other staff how to communicate more effectively and be creative in their support.

Encourage all of your staff to show off their talents - you may have some real gems who can play instruments or sing beautifully, people who are good at needlework, crafts, gardening, cooking or DIY. Support them to bring those talents into their job, whatever their 'official' role is meant to be. And likewise with your residents and relatives - find out what talents they have and how they might express those for individual benefit or the greater good.

The best care homes do this seamlessly, because they appreciate that activity is everyone's business and they facilitate that way of working. It may mean staff allocations need to change or rotas need to be adjusted. It may mean that someone in one role is actually much more suited to something else. It will almost certainly need training, mentoring and monitoring, but ultimately you will have created a care home far closer to what a home truly is, and what living a life in a care home and working in one should represent.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

Doll therapy - Disrespectful or comforting?

One of the most controversial non-drug therapies for people with dementia is doll therapy.

Before the work I do now, I knew this not as a 'therapy' but as the lady in my dad's care home who occupied the room opposite him having dolls she would cradle, talk to, dress, put to bed and at times cuddle as if her life depended upon it. To a lesser extent my dad also found comfort within the principles of this therapy - not with dolls but with life-like soft toy farmyard animals that he would stroke and cuddle.

Back then I thought nothing of the ethical arguments around introducing items most closely associated with childhood into the world of people at the other end of life's spectrum. All I knew was that my dad had extremely restless hands that needed something to hold onto, and he seemed to draw a lot of comfort from stroking these animals and looking at them.

Likewise the lady in the room opposite had her dolls brought in by her daughter who would talk to her about them, and leave her to hold them and 'care' for them when it was time for the daughter to go home. From what I observed, the lady found a great deal of pleasure in these dolls, and seemed to have a far more creative interaction with them than she did with the daytime TV programmes that would often blare out from the corner of her room.

Looking at the use of these dolls and toys now with my more objective hat on poses an interesting dilemma for me. In my work I am a staunch advocate of ensuring that we never infantilise people with dementia. A dementia diagnosis doesn't mean you stop being an adult. Everything about dementia care should be dignified and respectful, and never treat people in any way whatsoever that belittles or demeans them.

On the flip side, do I really have any right to deprive someone who is living with dementia from finding comfort, enjoyment or familiarity from participating, of their own volition, in doll therapy? I saw first-hand how my dad's soft toys benefited him - they were our idea as a family, we bought them, we gave them to him, and we facilitated his use of them (at the time dad had these soft toys he was immobile, so he couldn't walk across the room to pick them up himself). He didn't ask for them, but he actively participated in handling them.

I didn't see his affiliation with these items as something that made him less of an adult, but arguably someone walking into his room seeing a grown man in a chair with a soft toy lamb on his lap might have thought very differently, and then treated dad as less of an adult as a result. Whilst I wouldn't have wanted to be responsible for anything that stripped away dad's status as an adult, I would have done anything that gave him comfort and pleasure.

In essence, this sums ups the complexities of the arguments around doll therapy. Such arguments polarise opinions and leave people like me - who pride themselves on offering balanced views, thoughtful commentary and helpful advice - with a real dilemma. I've never openly advocated for the use of dolls in dementia care in the way that fans of this therapy have, but equally I could never go into a care home, see dolls being used and honestly object, provided it was clearly in the best interests of the person with the dolls and something they were participating in willingly.

That last point gets to the heart of the arguments around doll therapy. The willingness of the person with the dolls is, for me, the deciding factor. If the person with dementia really takes to a doll in the way that someone else might find comfort in any other object, then that is their choice. We may present items other than a doll in the hope that they might prove more appealing, but if the doll remains the item of choice then that must be respected.

The argument about infantilisation in relation to dolls has much merit, but I think infantilisation can be avoided if the attitudes of those around the person remain respectful and adult. For most people with dementia who find comfort in having a doll, the doll is merely the physical manifestation of the person's need to care for something, and for that something to be familiar.

We know that as dementia advances a person often retreats to memories of their early life, which may involve childhood or early adulthood, marriage and starting a family. In the present day, a doll could easily be a reminder of childhood or of starting a family. Dogs and cats could also remind a person of those landmark childhood and early adulthood years, but many care homes (not all) won’t allow animals to live within their homes unless they are of the soft toy variety.

If dolls, and indeed soft toys, are seen as props to facilitate reminiscence then they take on a different significance. The ability to reminisce is considered the mark of a life lived with all the memories and events along the way that come with adulthood. Reminiscence also draws on the wisdom and experience that is the landmark of ageing. Therefore in that context dolls could be the spark to unlock knowledge, for example about parenting, for some people.

Ultimately, whatever your views on doll therapy - and incidentally I remain largely on the fence -  I suspect that being judgmental does more harm than the therapy itself. Yes, it has the potential to be disrespectful. It also has the potential to be comforting. The key to unlocking both the value of this therapy and combatting the negatives associated with it seems to be more about how those supporting the person with dementia facilitate it and react to it.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

When concentration becomes difficult

I suspect that from time to time most of us lose our focus on a task, object, TV programme, person or other aspect of our life that momentarily requires us to put aside all other thoughts and images to ensure our full attention. This lack of concentration is sometimes associated with a lack of interest in something or someone who we are meant to be focusing on, or a need to ‘get something done’ that we perhaps really don’t want to do at that time.

In the context of living with dementia, however, a lack of concentration can be more than an occasional annoyance and become very pervasive into daily life, both for the person themselves and those around them. A problem concentrating is something that many people with dementia report as an early symptom and it can come in many guises, from difficulty in concentrating when reading and writing, to problems focusing in conversations, when driving, watching TV, or completing routine tasks of daily living that previously held the person’s attention.

I can only imagine how frustrating these issues must be for a person with dementia, and whilst they may act as an early warning sign to seek help, a diagnosis can at best explain the problem rather than making it go away. As a person’s dementia advances, problems around concentration can become much more acute and affect an individual's ability to focus on eating a meal, drinking a drink, getting dressed, washing themselves or participating in hobbies and activities.

For those around the person with dementia, be they family, friends or professionals, this lack of concentration from the person with dementia may also pose problems. It can lead to frustration that the person isn’t focusing on something that they need to focus on (like eating), and massive concerns about their wellbeing. These worries often set off a pattern of trying to persuade the person with dementia to concentrate on whatever it is they aren't concentrating on, and if that doesn't work the family member, friend or professional exercising their power and bossing around the person with dementia.

First and foremost, I am not a fan of trying to make people with dementia do things that they either don’t want to do, or in the context of a lack of concentration, are struggling to do. What I am a fan of is trying to find alternative ways to support the person so that life can remain as familiar and comfortable for them as possible.

So for example, not everyone can concentrate for long enough to sit at a table and eat or drink. That’s fine. They might prefer to sit in a comfortable chair with a meal on their lap, or eat finger food on the go while they walk (my dad went through a phase of doing this). We can often become very fixated on people doing things in an ordered way, or in the ‘usual’ way, or in the way they’ve always done them, and if the person with dementia responds well to those options then great, but if they don’t it is important to be flexible and modify the way we support them rather than expecting them to conform to what we want or believe is necessary.

These modifications often happen more readily when we think about the essential aspects of life – like eating and drinking – but often happen less automatically with the elements of daily living that might be seen as ‘optional’. Here I am thinking about supporting a person’s hobbies or interests, or even just helping them to do things that keep them physically active or mentally alert.

Lack of concentration shouldn’t mean a person with dementia has to abandon things they previously enjoyed, or indeed give up discovering new things. What is needed is an understanding that the person may not approach a hobby, interest or task in the same way that they used to – IE: sitting and reading a book, watching a favourite film from start to finish, participating in a board game, doing needlework, cooking, housework, gardening, painting/drawing etc – but that they may still be able to do these things in a different way (change location/time of day etc), in shorter bursts of activity, and/or with more intensive assistance (helping the person, not doing it for them).

When concentration wains some prompts may be helpful, like talking to the person about what comes next, or inspiring them by reminiscing about aspects of their early life that might relate to what they are trying to do. For example, if the person is doing something creative like painting or drawing, but struggling to start or continue with it, thinking about something they loved in early life might just spark a thought that they can commit to paper.

If the person struggles with conversation, some picture and word cards might help. Make sure any glasses or hearing aids that are usually in place are being used, and that distractions are minimal or non-existent (a blaring TV in the background is rarely a good idea). Think too about balance - respect independence but don't leave a person with dementia struggling or disappointed because they can't complete something. For example, if concentration is difficult when reading a book, see if the person would like you to continue reading it to them when they have gone as far as they feel able to that day.

Above all, offer gentle encouragement, and try to back up the person’s fleeting thought processes by helping to think for them in a completely person-centred way, sensitively anticipating, guiding and reassuring. This should always be supportive, rather than in any way controlling, and it will inevitably involve a lot of patience, time, calmness and perseverance.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

GP's and care homes - A relationship under pressure

When I first read that GP's were proposing to alter their current arrangements for visiting care homes, I wasn't surprised. Back when my dad was living in care homes, GP's were already under considerable pressure. I know that one of my dad's care providers had to pay for GP visits, and even then some of the younger GP's in the practice were reluctant to visit the home when residents were quite poorly.

By contrast, the senior GP in the practice visited regularly, had a lovely bedside manner (he was a tall man and would kneel on the floor so that he was at dad's eye level to chat to him), and even attended one of our relatives meetings to discuss providing healthcare for the residents and long-term planning.

I recall arguing with one particular young female GP about whether dad had any 'quality of life' and whether or not he should be given antibiotics for a chest infection (in my view he had quality of life, and he got the antibiotics in the end, which cleared his infection). I also remember possibly the worst experience I'd ever had with a doctor, when an out-of-hours GP visited late one Saturday evening and refused to even touch dad to examine him.

That experience with the out-of-hours GP is perhaps a glimpse into the future whereby the services of the local GP practice could, potentially, be replaced with privately contracted GP's who may not provide the same level of continuity or personalisation. It is not a scenario I welcome or look forward to in any shape or form.

It is my view that a regularly visiting, local GP is absolutely vital to the provision of high quality care in care homes. A good local GP will get to know their patients, pick up on illnesses and conditions quickly, keep medication under review, and provide a useful external oversight role in relation to how well the care home are caring for their residents.

I appreciate that general practice is under severe, unprecedented pressure and needs additional funding, but there is no suggestion that care for other sectors of society needs a separate contractual arrangement with the government and for that reason this feels like victimisation. The argument from GP representatives is that care homes are becoming extensions of hospital wards, and the needs of the people living in them are increasingly unmanageable for local GP's within the current structure and funding of general practice.

It is undoubtedly true that care homes have changed from what they were. Traditionally a residential home accommodated people of relative ability who just needed a bit of assistance with personal care, low level health needs and some companionship, while nursing homes offered the same but with a registered nurse on duty to support people with more extensive health needs, medications etc.

However as people live longer, have more complex long-term conditions, and the NHS is under pressure to discharge people back into the community, it's fair to say that a lot of residential homes have become more like the traditional nursing home model, and the nursing homes of today have morphed into mock hospital wards. But that isn't the fault of the people living there. They aren't in hospital, so don't have access to hospital doctors - the only way they can have care from a doctor is from a GP practice.

By all means GP's need to raise their concerns with the government and seek additional support to continue to provide the care that people in care homes need, but if the government don't agree to a separate contractual agreement to cover GP care in care homes, it would be wholly wrong for care for this sector of society to be withdrawn. People in care homes rarely ask to be living there, and they are as entitled to care from their local family doctor as anyone else. For these individuals, their care home is their home - they shouldn't be penalised for living in a care home by losing their local GP service.

I appreciate that GP practices work best when patients visit them rather than when GP's have to conduct home visits, but if the patient can't get to the surgery then the GP needs to go to them, regardless of where they live. Yes, care homes may have the option of buying in private GP care (if indeed they could afford it, which is highly questionable for many), but from the perspective of residents that isn't the same as having your own local GP who gets to know you and your needs.

If new contractual arrangements with GP's aren't forthcoming, I fear that individuals with dementia may be hit the hardest. For this group of people continuity of care is vital. A good local GP who understands the person - and understands dementia - can make a huge difference to the life of an individual with dementia, as we saw first hand with that senior GP whose interactions with dad were a real joy to see.

Families also rely on good local GP's to help and advise them on the different conditions their loved one has, the various medications they are (or could) be taking, and when discussions need to be had in relation to long-term planning and end-of-life care. Keeping people in their care home for end-of-life care is infinitely preferable to being in hospital, but good local GP support is vital to facilitate that.

I hope that GP's and the government will manage to find a mutually agreeable compromise, and that this issue doesn't escalate in the way the junior doctors contract has. Without such a compromise the people who suffer most will, yet again, be some of the most vulnerable in society, a fact that shames us all.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook

Please note: This blog was modified on 12 February 2016 due to information received.

Fixing dementia care in hospitals

Standards of hospital care for people with dementia made the news last week, with an investigation by the Alzheimer's Society showing shocking variations in the quality of care being given, prompting the charity to launch their 'Fix Dementia Care' campaign.

Given that this time four years ago my father was still alive, and had been the recipient of some extremely variable hospital care in the years prior to 2012, it is a source of huge concern and sadness for me that many of the problems we experienced continue today.

The Freedom of Information requests that provided the substance for the Alzheimer's Society investigation highlighted that people with dementia were:

•    Falling while in hospital

•    Being discharged at night

•    Being marooned in hospital despite their medical treatment having finished 

Whilst my dad thankfully never had a fall whilst in hospital, being discharged at night was something he experienced on almost every inpatient stay. The reason given in his latter years with dementia when he was completely immobile was that he needed transportation via ambulance, and this was most easily accomplished at night when paramedics were less busy. Never mind what dad might have wanted of course.

 

I suspect the fact that he was being discharged to a nursing home, with staffing 24 hours a day, was also a somewhat convenient excuse. It was, however, a horrible experience for dad - these events often came in winter, and being moved out into the cold night air when he should have been tucked up in a warm bed was, in my view, a particularly sadistic form of 'care' that would leave him upset, disorientated and confused.

 

Being marooned in hospital was also a harsh reality for dad - at one point he spent three months in hospital (despite being medically fit for discharge) whilst funding was arranged for the care home placement that his doctors said he needed. During this time dad lost half of his body weight and the NHS picked up a huge bill for his care - a no-win situation for all concerned.

 

Alongside collecting data from Freedom of Information requests, the investigation by the Alzheimer's Society surveyed people affected by dementia. They found that 92% of those individuals felt that hospital environments were frightening and only 2% felt that all hospital staff understood their needs. 

 

Reading this led me to reflect on how my dad might have responded to his hospital experiences. I'm certain he found the hospital environment pretty unpleasant, from the noise, smells and routines of hospital life, to difficulties in finding facilities like the toilet and having opportunities for stimulation, occupation or activity during the long days as an inpatient. Only on one particularly 'fortunate' stay in hospital could I honestly say that dad had a better experience - he had his own room and staff found him a CD player. We brought in CD's for dad and his mood changed completely. Simple stuff, but so effective.

 

Sadly, however, meeting staff who understood dad's needs wasn't the norm. During the latter years of dad's dementia when he had dysphagia (swallowing problems), hospital staff refused to allow him to have food or to help him eat it, mistaking his hunger cries for pain and writing him up for morphine. This was a 'mistake' that could be interpreted as covertly putting him onto an end-of-life pathway by administering a drug that he didn't need and could have shortened his life with an inappropriate dosage.

 

Furthermore, this 'mistake' was only rectified because dad had a family visiting him for eight hours a day, speaking up for him, and bringing him food and drinks and helping him to consume them. We would also assist him with his personal care - without that help a man who liked to be clean shaven would have begun to grow a beard. But what happens to people without this family support? Do they get inappropriately medicated, starved, dehydrated or left dirty, uncomfortable and neglected? The variations exposed in the quality of hospital care suggests that this is likely to be a reality for some people with dementia who are inpatients today.

 

Despite the many difficulties we encountered with hospital care, however, I don't want to paint a completely bleak picture. There were good experiences, staff who genuinely cared and understood what dad needed, as well as providing great support for us. This was particularly evident in dad's last stay in hospital when he'd been rushed in with an aspiration pneumonia. 

 

His care was excellent, with the doctors treating him taking a lot of time and trouble during their interactions with dad and in their care for him, alongside explaining things to us and giving us time. Our decision to seek end of life care for dad from a care home wasn't because we were unhappy with his hospital care, but rather that the hospital couldn't offer the homely environment or privacy we felt he needed as his life approached its final stages. 

 

So, how do we ensure that hospital care is a high quality experience for every person with dementia? In my view providing comprehensive dementia education for all hospital staff (which Health Education England are tasked with delivering) and making environments more dementia friendly will only go so far.

 

The root of much of what is wrong stems from compartmentalisation. Hospitals work best when a person is admitted with one condition and treated for that condition. However, people with dementia often live with other conditions alongside their dementia, and are usually always admitted into general hospitals not because of their dementia but because of infections (mostly notably chest and urine infections), another long-term condition (like diabetes, heart disease or asthma) that hasn't been well managed, or because they've had a fall in their own home or in a care home.

 

This was never more evident for us than when dad needed hospital care during the last four years of his life when he had dysphagia. Treating a gentleman with dysphagia who also had dementia and all the challenges that brings around communication was an alien concept for most hospital staff, with approaches varying from the starvation I mentioned above, to trying to force a tube through his nose into his tummy rather than orally proving food (a tube he promptly pulled out), and providing ice cream (that quickly melted) as a suitable 'thickened' food for him (which in reality was as liquid as the water out of the tap).

 

What is needed to combat these issues is more holistic, joined up care that sees each person as a whole human being and treats them as such regardless of how many problems they have with their health and which of these problems has led them to be hospitalised. This approach needs to be combined with a comprehensive 24/7 service that enables individuals to access the care and support that they need when they need it. People can become unwell on any day and at any time - prompt treatment and, crucially, the availability of care and support when they are ready to leave hospital, is vital. 

 

Furthermore, if hospitals that are underperforming (as highlighted by the Alzheimer's Society Freedom of Information Requests) learnt from the hospitals who are providing some of the excellent care that the Alzheimer's Society found, these huge variations in care would become a thing of the past. It heartens me that some outstanding care does exist, but I remain saddened that so little seems to have improved since my dad was living with dementia. Clearly we still have a lot to learn.

 

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook 

 

Dementia takes... and dementia gives

The start of a new year is a time that many people find themselves in a reflective mood, and I have more cause than most to feel that way as 2016 kicks off.

As some readers may know if they follow me on social media, I became a first-time mum last November.

A very proud mummy to a very beautiful daughter, Sophie Rae, born 21 November #totallyinlove pic.twitter.com/gUdhBHlWww

— Beth Britton (@bethyb1886) December 4, 2015

Parenthood opens up a whole new world, and inevitably makes you think about family life in a totally different way. Amongst the flurry of people eager to meet the new addition, you inevitably think about those who will never meet your child, and for me the person at the forefront of my mind is of course my dad. 

In the film I made for the G8 Dementia Summit I said of dad’s dementia: 

"It’s robbed him of opportunities that, obviously, now he will never have"

When I said this I was particularly thinking about potential future grandchildren. My dad loved children, and would have adored being a grandparent. The look on his face had he had a newborn grandchild placed in his arms is one I can picture vividly in my imagination, and I feel a huge sense of loss that I cannot experience that in real life.

Dementia has robbed us of that opportunity, that moment that would have become etched into our family history and captured by camera to preserve forever. The reassurance that comes from feeling dad's constant presence is a consolation, but it doesn't replace the real thing and never will. For that I hate dementia and I hate the fact that by developing it, dad's life was limited and, in my view, ended before its natural conclusion.

In the midst of those feelings it's hard to see positives, but they are there. Dad's legacy is one our daughter can learn from and be proud of. Dad's life with dementia left a story for me to tell that has much to inspire an enquiring mind as it grows and develops, and nothing will make me prouder than having our daughter in an audience one day when I'm speaking at a big event. I hope that even if she doesn't want to follow in her mum's footsteps in her working life that she will see the good, the kindness and the love that goes into what I do every day.

None of those things will replace learning from my dad's wisdom or having his cuddles, but she will come to know and appreciate everything that made him such a special man. In that way, dementia gives a little - it gives her lessons to learn, kindness to emulate, and a foundation to lead her life embodying the qualities my dad so admired and strove to teach me every day - humility and respect.

Since I would give anything to be able to introduce our daughter to her maternal grandfather, it makes me very sad to think of the many children that could be part of the lives of their older relatives and aren't. Without any reservations whatsoever I would have ensured our daughter was part of my dad's life during his years with dementia, including taking her to visit him during the nine years he spent in care homes.

I am certain that the interaction between the two of them would have been magical. Children don't judge people with dementia in the way that adults often do. Babies in particular have an innocence and a vulnerability that could never threaten, intimidate, or make a person with dementia feel inadequate or less of a human being. There is so much that we as adults could learn from the unconditional love and trust a tiny baby gives us, and use those lessons to impart the aforementioned qualities into our interactions with others, particularly people who are living with dementia.

My memories of my dad, and the many things I learnt from him both before and during his life with dementia, will undoubtedly influence the kind of parent I am and will grow into being in the years ahead. I can't help feeling that those lessons belong in some way, shape or form in parenting classes - proof, if it were ever needed, that intergenerational learning and intergenerational work in dementia awareness has never been more relevant, or more needed.

Until next time...

You can follow me on Twitter: @bethyb1886

LIKE D4Dementia on Facebook