Ask Graham Stokes

Update: This Q&A has now closed. We will be featuring more Q&As in future so please keep your eyes out.

Dr Graham Stokes is responsible for driving forward the quality and scope of care for people living with dementia in Bupa's care homes in the UK, Spain, New Zealand and Australia.

Dr Stokes is a leading expert in person-centred care for people with dementia and his insights help to ensure that Bupa's care homes residents around the world achieve the best quality of life.

Graham has taken part in a Q&A on the site before. You can ask him any questions on caring for someone with dementia.

Graham will respond to your questions on Thursday, so make sure to get them in Wednesday at 5pm.

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Permalink Reply by Jill D on June 19, 2012 at 18:59

Sam

Could I throw in another question for Graham, on the Alzheimers boards there has been mention of Hogeway Dementia Village in Holland, has that been tried in the UK, have there been any attempts to replicate this in a smaller environment such as a dementia home?

I would like Graham's views on Hogeway, I could imagine it might be frightening and with fights breaking when people remove items from other residents, how is this avoided?

From what I read about the place it does sound ideal, but possibly a bit surreal.

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Permalink Reply by Graham Stokes on June 26, 2012 at 9:50

Hi Jill,

Without an ability to acquire new memories and a limited if any awareness of their dependency and vulnerability, to a person with dementia care homes are not seen as such and consequently can resonate with mystery. So to reduce feelings of bewilderment and insecurity care settings need to be meaningful and as remote emotional memories in dementia are better preserved than recent memories, even if they are fragmented and incomplete it makes sense to draw on nostalgia and a person’s own history to create bedrooms, communal rooms and areas that are familiar and have the potential to be reassuring.

This is not to create a social history museum but is to provide those who need to be cared for with settings that are easy to relax in, are of a source of joy and interest, and help them feel they belong, as well as assisting those who care to have conversations that tap into the experience of people with dementia. While the settings are pleasurable, for me what it is most important is that these reminiscence settings support relationships and encourage people to chat with each other. I just think it is easier to have a conversation with somebody in a room that resembles a sitting room rather than a ‘day room’ or eat together in an old-style café than in a ‘dining-room’.

What is provided in the village of Hogewey is what some dementia specialist care homes in the UK are currently doing, albeit on a smaller scale. Care homes have nostalgia areas and bedrooms that resonate with a person’s life and while there is debate about do they ‘work’, at the level of common-sense it feels right proposing that being somewhere that feels familiar must be better than being somewhere you cannot relate to. At some point in our lives who hasn’t felt homesick?

To protect people’s possessions staff have to adopt a more active style of nursing by walking corridors and visiting people in their homes (‘a room as your home’) checking all is well, putting possessions away in drawers, closing doors and putting things back because if they have moved for they are rarely far away. Creatively, bedroom doors can be personalised and disguised all of which will serve to protect possessions and privacy.

Graham