For most people, spreading a slice of toast with jam is a task that takes but a moment from our busy lives, but for Audrey Payne, an 85 year old, living with dementia, this prosaic act is unusual as is frowned upon by some care homes. Audrey resides at the Edenmore Nursing Home in Ilfracombe, where they provide award winning nursing and dementia care for 47 older people. They are part of the Bristol based, Evolve Care Group.
They refer to their residents as “family members” and treatment is based on the six paragons of Comfort, Identity, Occupation, Attachment, Inclusion and Love. These are part of their “Household Model of Care” which aims to promote enablement wherever possible. One of the most confusing aspects that make living with dementia difficult, are changes to routines.
Audrey came to Edenmore, in March, after living on her own for many years, and her former breakfast routine always included tea, jam and toast. Minimising change was considered essential if her care was to be effective, so she was carefully assessed to be capable of making toast and using a butter knife, without posing a risk to herself or to others. A staff member is always on hand, keeping a respectful distance away, but giving Audrey enough space to feel like her routine is unchanged.
To foster inclusion, “Family members” are encouraged to eat together, sat around family style tables, in a relaxed way. To an observer, anyone watching Audrey’s slight smile as she carries her breakfast plate to her chosen table, her expression may not seem important, but it is not the look of somebody worrying about changes they do not understand. It is the smile of somebody looking forward to nicely browned toast, laden with scarlet raspberry jam.