I recently spent a weekend away with my daughter and grandchildren, we were visiting relatives in the Peak District and decided to stay in a swanky hotel and make the most of the time away. We shared a huge room with two massive beds and it felt like a pyjama party, it was lovely. During the night, my grandson, who’s 5, got up to go to the toilet. In his half-sleep like state he didn’t realise that the loo seat was down and managed to pee all over the seat and the floor. Bless him, he tried to clean it up himself because he was embarrassed and thought he might be in trouble. He wasn’t of course, and no harm was done.
Imagine you’re living with dementia and when you go to the bathroom you can’t tell the difference between the floor, walls and toilet, especially if everything is white. The confusion can lead to a patient not only being unable to find the toilet seat and therefore being able to pee in the right place, but can also lead to them having a fall.
At St Joseph’s Hospice we’re seeing more and more patients with dementia and we need to make sure that they’re safe. We also want to do everything we can to help them feel relaxed and feel more in tune with their surroundings. That’s why we started ‘project toilet seat’. Actually, it wasn’t called that but I like to think it adds a touch of intrigue.
We were given some funding from Hospice UK and the Rank Foundation to make simple adjustments to the wards to help people with dementia and cognitive impairment feel calm and safe (see why I went for project toilet seat).
With the funding we bought some toilet seats, iPods and some other ‘dementia friendly’ equipment including large analogue clocks that show the date and time in big letters.
We did some thinking around the colours for the toilet seats, actually a lot of thinking and disregarded some colours for various reasons; red meant danger or looked like blood to some people; purple with glitter (you can’t get just plain purple toilet seats) looked like they were dusty and black ones just looked like black holes. So we settled on blue, simple. Well not so simple, the company we first approached had gone bust and another company only had one in stock. And we needed 31 seats plus fixings. We found them eventually and they’ve made such a difference, becoming quite a feature. We’re doing some research to see how the number of falls have reduced and will publish that later.
The ‘dementia friendly’ clocks have also been a big hit. A man with dementia came in for respite care recently and he was hugely reliant on his wife. He became distressed when she wasn’t there and he didn’t know when she was coming back. We spent some time with him pointing out the new clocks and how they would help him know when his wife would return. He was instantly calmer.
Music is a big part of looking after people with dementia, it can soothe and calm people and help them reconnect with their past. The iPods have been really good. They need more music loaded on to them (any volunteers?) and different genres as everyone has different taste but we have plenty of CDs in our jumble collection.
Now, we don’t claim to perform miracles but one thing came close. An elderly man came to stay on the respite ward; he had a number of health issues including late-stage dementia and he couldn’t communicate. In fact, he had been silent for two years. Our respite ward manager felt that he was trying to communicate with his eyes as they would become more expressive and lean forward if she asked him questions or commented on something that was amusing.
She took him aside to play some music to him and used hand touch so that he had a human connection while listening to the music. His wife said he hated classical music so not to play that as people with dementia can become distressed if they don’t like something. So they played him some jazz and massaged his hands and he spoke, “that’s really nice” he said. The ward manager said “you like that don’t you” and he replied “yes”.
With dementia it’s the small things that make a difference. As I said there are no miracles but those moments of clarity are precious and priceless to loved ones and if we can make a difference then we’ll take that.
Thanks to Hospice UK and Rank Foundation for the funding.