Ask Sheila

Sheila will try to answer as many of your questions as possible, giving priority to frequently asked questions and questions regarding current events and trends.

Using photos of residents to identify rooms?

Is it advisable to have photos of residents on their bedroom doors?

 

Dear Roger,

Thank you for your question. I presume that you are providing care for people with dementia.
I believe that it is a question that you have to decide the answer to in consultation with your service users, their families and yourself. There is, however, a great deal of information on the internet.

I think that you need to begin by always bearing in mind that people with dementia may not recognise photographs of themselves if taken today and instead may recognise photographs of their younger self.
There is one other important point that I would like to make. I believe that if possible the family of the service user should pick the photo or fill the memory box outside the door and update it from time to time. This is a lovely thing for a family to be able to do not least because in most cases what they have done will bring real pleasure to the service user and other visitors.
As I have said there is plenty of advice available on the internet. These are just a few of the helpful advice I have found:
SCIE…
This is what the Social Care Institute for Excellence says about assisting people to recognise the door to their bedroom:
"Helping a person with dementia to get a good night's sleep is vitally important. For a person with dementia, just finding your bedroom when faced with a number of doors can be confusing.
Painting the bedroom door in a contrasting colour to the surrounding wall is crucial for finding the door.
Also, personalise the door by having a sign and perhaps incorporating pictures or photographs.
An American website says this…
Consideration should be given to how contrast is used to highlight key features and hazards. Using the same colours or ways of contrasting both could lead to confusion. Care must be taken to ensure there is no risk of hazards being mistaken for important features and vice versa.
People may not always find it easy to remember the significance of colours, so it may be helpful to have other visual cues in addition to colour and/or contrast differentiation, e.g. appropriate pictures or signage.
The American Alzheimer’s Association says:
Maximize awareness and orientation
Dementia often creates confusion with respect to time and place, particularly in unfamiliar settings.
• Keep signs simple since residents may not be able to comprehend complex language.
• Place signs at eye level (48 to 52 inches from the floor; lower if there are many wheelchair users).
• Use bright contrasting colours.
• Personalize room entry to make it more relevant and understandable to the residents (e.g., hang favourite photos or small mementos on the bedroom door).
Australian website
In early stage dementia, clear, simple signs, in words or pictures, are helpful. In later stages other cues, such as hanging a person’s dressing gown or other known objects on the bedroom door, seem to be more useful.
Other ways to personalise bedroom doors include signs in large lettering with the person’s name, or photographs of the person with family members and friends. Putting a portrait and personal memorabilia in a display case outside people's bedrooms may help room finding.
This low-cost, simple approach to a common issue can have other benefits.
Just as pictures and memorabilia help personalise living spaces, photographs of people as younger adults remind staff of a person's life history beyond their present situation. These items can start off conversations between staff and the person with dementia. As early life events are often recalled more easily than recent ones, photographs and other items from the past may bring back memories.
This article from another US website is my favourite…
http://designingfordementia.com/index.php/2017/05/22/how-to-design-compelling-memory-boxes/
Many dementia-friendly communities offer frames or “shadowboxes” on the wall outside of residents’ rooms. These shadowboxes are customizable and meant to be unique to each resident.
Unfortunately, many communities stuff their residents’ shadowboxes full of knick-knacks and call it a day. While you are absolutely able to put knick-knacks and trinkets in your loved one’s shadowbox, I cannot guarantee it will help your loved one find their room.
For me, the purpose of the shadowbox is three-fold:
• It helps a resident find their own room
• It helps the staff get to know the resident as a person
• It is a great conversation starter for the resident and others who walk by
My favourite thing to do with an empty shadowbox is something very simple. I like to get an image of the resident from when they were younger, preferably in their 20s or 30s, and enlarge the photo. Many people with dementia do not recognize themselves as older adults. They think of themselves as being much younger, so they will often recognize younger photos of themselves. This, in turn, helps these residents find their rooms in a large hallway.
I had one resident, Pete, who thought of himself as a 22-year-old man. When we talked about his photo, he noted that it was taken “only a couple of years ago.” This made me smile. He spoke of his time in the military (this photo was him in his military uniform) very proudly.
I have also had residents who know that they are older, but still like to see photos of themselves as young adults. I had one resident in particular, Marie, who loved telling people passing by about her photo. “Oh, yes, I just threw my hair together that day,” she’d say, nodding to the glamorous photo. “I was such a mess!” Marie looked like a model from a magazine.
Staff members connect with these photos more-so than trinkets in a resident’s shadowbox. I have watched staff members tear up seeing a favourite resident in their younger days. “This photo was taken when she was my age,” one caregiver said quietly, wiping a tear from her eye.
While I think adding a couple items to the shadowbox is great, I believe that the main focus should be a residents’ photo.

One final comment from me: there is nothing sadder when visiting a care home to walk by occupied bedrooms and see empty photo frames or memory boxes.
I hope this is helpful.

Best wishes.

Sheila


What would you like to ask Sheila?

Sheila Scott OBE from National Care Association (NCA). Care is Sheila’s life; she possesses a strong command of the issues facing the care sector informed by her long career as a nursing professional, the owner and manager of a care business and as a leader in the care sector.

Sheila will try to answer as many of your questions as possible, giving priority to frequently asked questions and questions regarding current events and trends.

Please note that Sheila can not offer answers to matters requiring legal advice. If your matter concerns a specific service provider, please contact the CQC.

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