6. Module 5 · Person-centred care & life history

6.2. Application: from life story to a personal offer

Application

From life story to a personal offer

This page shows how a few facts about a life become a concrete, respectful offer. Work through the example, use the phrases as a starting point and put them in your own words. Rigid scripts sound false, and people with dementia notice quickly.

Worked example: Mr Okafor and the bus

Return to Mr Okafor from the beginning of this module. He has moved into the home three weeks ago. He eats little, sits at the window and sometimes stands up at half past five in the morning, saying that he must “start the early shift”. A carer, Sofia (fictitious), speaks to his daughter, with Mr Okafor’s agreement, and fills in a short life-history sheet. Figure 5.3 shows the route from the sheet to the offer.

From life history to a personal offerFive steps from life story to offer1AskPerson andrelatives, withtheir consent›2NoteShort, neutral:bus driver 35years, early shifts›3ThinkWhich need isopen? Identity,occupation›4OfferA small task:check the bustimetable at 6:00›5WatchDoes he smile,join in? Adjustand shareStep 5 leads back to step 1: stories and wishes change, so the sheet stays open.The example is fictitious and shows one possible route, not a fixed rule.
Figure 5.3: From life history to a personal offer, using a fictitious example. Source: own illustration.

Look at what the sheet changes. Without it, Mr Okafor’s early rising looks like restlessness or confusion, and the team might ask whether he needs something to calm him (compare Module 4). With it, the behaviour makes sense: his body clock and his sense of duty still belong to a bus driver. Sofia suggests a calm morning routine. At six o’clock, a carer greets him by name, brings a coffee and asks him to check the timetable and “the day’s route” on a large sheet. After a few mornings he stays in his room until then and eats breakfast with more appetite. He still has bad mornings, and the team keeps an eye out for pain, loneliness and other causes. The offer does not cure anything. It gives him a role.

Phrases to adapt
SituationYou might say
Asking relatives“What did your father enjoy? What helped him when he was upset? Is there anything he would not want us to ask?”
Asking the person“I would like to know you better. What did you do for a living?”
Recognition“Good morning, Mrs Lund. It is good to see you.”
Offering a choice“Would you like to help me with the cups, or shall I do it?”
To a colleague“Let us talk with her, not about her.”
Exercise (voluntary self-check). Mrs Lund (fictitious), 88, was a primary school teacher for forty years. She now spends most of the day in the day room, speaks little and tears small pieces from paper napkins. A colleague says: “She is just destroying things.” Name the needs that may be open. Write one strengthening sentence for her and one small offer based on her life story. Say what you would observe afterwards.
Hint 1
Look at the flower in Figure 5.1. Which petals might be weak for a retired teacher with nothing to do? What might tearing paper mean, other than “destroying”?
Hint 2
Think of what a teacher does with paper and with a group. Choose an offer that is dignified and not childish. Remember Figure 5.2: recognise her, give her a choice and let her use her abilities.
Suggested answer
Possibly open: occupation, identity and inclusion. The tearing may be a search for something to do with her hands. A sentence: “Mrs Lund, you taught for many years. Could you help me sort these cards for the group?” An offer: sorting and labelling cards or reading aloud to a small group, with sheets of paper she can handle. Observe whether she looks engaged, speaks more and feels relaxed, and not whether she “performs” well. Adjust if it frustrates her. Report the new approach in the care plan and speak with her family about her profession.
In German practice you will hear …
  • Personzentrierte Pflege – person-centred care; Kitwood’s approach is widely taught in German care training.
  • Biografiearbeit – life-history work; the document is often called “Biografiebogen”.
  • Biografiebogen – life-history sheet, filled in with the person or relatives.
  • Würde – dignity, the central word in German care ethics.
  • Bezugsperson – a person of trust, such as a relative or a carer who knows the resident well.
  • Angehörige – relatives and close persons.
  • Ressourcenorientierung – building on what a person can still do.
  • Datenschutz – data protection; life-history data fall under it.