Therapist and mindfulness teacher Nicola Kendall has written a new book about how professionals and family members can provide Namaste Care to people with advanced dementia. Here she tells ehospice about the benefits of this type of therapy, and plans to expand its reach to people with other life-limiting conditions and prisoners needing palliative care.
When and how was Namaste Care developed?
Namaste Care was developed by a social worker called Joyce Simard in the USA. It was originally intended as an end of life programme for people living with advanced dementia in care homes. Namaste Care is a gentle, sensory-based approach which aims to enhance quality of life. It was a response to requests from care home staff that something special be developed for people in the advanced stages of dementia who could no longer participate in traditional group activities.
At St Cuthbert’s Hospice in Durham, we have developed a community based Namaste Care Project where trained volunteers visit people with advanced dementia in their own homes. This leads to the building of a lovely, close relationship between the volunteer, the person living with dementia and their family, which is treasured especially by the families as their loved one reaches their final days.
How does it benefit people with dementia?
Studies carried out by Joyce Simard in the USA and St Christopher’s Hospice in London show a number of measurable benefits, but a lot of Namaste Care is intangible and difficult to measure. Benefits include reduced falls and reduced numbers of chest and urine infections, due to a concentrated approach to encouraging fluid intake during sessions.
There is less agitation and improved sleep, thus reducing the need for anti-psychotic medication. Staff morale improves and family satisfaction with the service is enhanced.
From our own session records we have seen an increase in eye contact, smiles and laughter, people appearing calmer and more settled and the person being more alert and engaged.
Northumbria University undertook a realistic evaluation of the project which showed that families valued the visits as a form of respite for themselves from their constant carer duties and felt that a very special, emotional bond quickly developed between the volunteer and the person they were visiting.
Due to the fact that we have volunteer visitors, we are also able to deliver an awful lot of Namaste Care hours into the community, making it a very cost effective service.
Can it benefit people with conditions other than dementia?
I recently delivered a day’s Namaste Care training to our North East Hospice Collaborative, and the participants identified for themselves how relevant the approach would be to anyone approaching the end of their life with any condition. It’s a very loving, kind and compassionate way of spending time with a person and ‘honouring the spirit within’ even if that person is struggling to express themselves.
We deliver Namaste Care in our local acute hospital on Saturday mornings, and we are often asked by staff to spend time with patients who do not necessarily have dementia, but who are approaching the end of their life, especially if they have had few visitors.
How widely used is it?
Namaste Care is still predominantly used in care homes in the UK, but the principles have proved for us to be entirely transferable into a variety of care settings.
St Joseph’s Hospice in London were the first to develop a community-based project, and we followed their lead. The approach would lend itself well to befriender services, using community venues or day services. We have developed a ‘Potting Shed’ Men’s Group using the sensory approach of Namaste Care and we are also in the very early stages of discussing how it could be introduced into prisons for prisoners requiring palliative care.
What are the challenges to delivering Namaste care?
Given that Namaste Care is not viewed as a statutory service, one of our main challenges has been in securing funding to run the project. We were incredibly fortunate to gain Big Lottery funding in 2018 for three years, which secured my post and enabled us to employ a Namaste Care Support Worker, but in 2021 the search for further funding will begin again.
The other main challenge is recruiting the number of volunteers we require given the increase in the number of referrals. Our most reliable volunteers tend to be people who are retired or who work part time. Every one of our volunteers have very big hearts and are fabulous at the role, we just need more of them.
How can someone be trained to deliver Namaste Care?
St Christopher’s Hospice and St Joseph’s Hospice in London both offer Namaste Care Training. St Joseph’s Hospice is now also rolling out training in Scotland. In the North East, I run courses at St Cuthbert’s Hospice which people can access and I also have delivered training around the country, such as to Trinity Hospice in Blackpool. Anyone interested can contact me by email.
What do you hope to achieve with your book Namaste Care for People Living with Advanced Dementia?
The book came about after the senior commissioning editor at Jessica Kingsley Publishing spotted my poster presentation about the project at the Dementia Congress in 2017. He felt it would be interesting to share what we had learned from the project – the successes and the challenges.
As I began to put a proposal together for a book, I realised it could be very helpful for families who are caring for someone with advanced dementia and also to professionals who might like to set up a Namaste Care Service. By sharing what is possible, at a time when families will often tell me ‘you can try, but you won’t get a response’ we can truly to fulfil Dame Cicely Saunders’ wish to offer services that help a person to “live until you die.”
Namaste Care for People Living with Advanced Dementia by Nicola Kendall is out on October 21 on Jessica Kingsley Publishers. A 10% discount is available by quoting ‘Y19’ at checkout from jkp.com