“The real voyage of discovery consists, not in seeking new landscapes, but in having new eyes” Marcel Proust. It is a quote that resonates with many of us, but particularly with Sylwia Palmowska, who heads Age UK Medway’s Dementia Services. Sylwia, spent nearly two decades working as a purchasing and recruitment manager in her native Poland, before coming to the UK in 2012. After studying Sociology at university, she joined Age UK Medway in 2013, and put her training and her wealth of managerial experience to good use by bringing new ideas and fresh perspectives to Age UK ’s Activity Centre.
“Age UK Medway was my first job in the UK. I started as a carer and worked my way up to become a head of services. It was really important for me to work on the frontlines because I believe working in this way is the only way you really begin to understand the strategic challenges faced by the activity centre and those who use it. Only then can you begin to find solutions.”
However, it was while working closely with the clients that Mrs Palmowska began to see the bigger picture. She realised that there was no framework in place for day activity providers to assess the functional ability of clients. This meant that many people could not join in, or make the most of activities. Secondly, she noted that there was no way of assessing, logging and evidencing individual engagement levels for group activities.
She says, “Putting such a system in place, which could help us to accurately assess clients and then monitor and record their progress, was key. We realised that this would not only transform the lives of our service users, but their families and friends too, who sometimes – particularly when symptoms of dementia develop very suddenly – don’t understand the condition or how they can support that family member at home. We knew, therefore, that making these changes, would enable relatives to play a focal role in their loved one’s dementia journey.”
The QCS PAL Instrument
But, while understanding the problem was an important first-step, Sylwia and her team knew that the most pressing task was to put a robust and cohesive framework in place. Sylwia began trawling the web for best practice research, and it wasn’t long before her perseverance paid off. The answer she was looking came courtesy of Jackie Pool’s QCS PAL Instrument.
Twenty-five years ago, Jackie, who is Quality Compliance Systems’ (QCS) Dementia Care Champion, developed the Pool Activity Level instrument (PAL). With QCS’s help it has now been digitally recrafted for the web.
Sylwia says, “When I discovered Jackie’s work, it was a wonderful moment for me and my staff. The QCS PAL Instrument was just the tool that we were looking for, as it provides a framework that ensures that our staff can assess the level of functional ability of service users with cognitive impairments, that have been caused by dementia. Acquiring it was a great first step.”
For anyone not familiar with the QCS PAL Instrument, it has been expressly designed to determine the level of dementia that each client is living with. There are four levels of ability. The first one ‘Planned’ means that a person with dementia can carry out a task by themselves, although they may need help with activities that require high-level thinking such as problem solving. At a PAL Exploratory level, someone living with dementia would need guidance, while those functioning at a PAL Sensory level, need a carer to demonstrate each single step. At a PAL Reflex level, the person needs extensive support from their carer and will engage through the therapeutic connections with them.
Says Sylwia, “The QCS PAL has revolutionised the way we assess new and existing clients. We begin by creating an individual profile and are usually able to place the person we’re assessing on one of the four PAL levels. We assess them again after a fortnight and once more after a six-month period.”
After making contact with Jackie, Sylwia and Jackie are currently pooling almost forty years of knowledge and experience into further developing the PAL Instrument to make it more accessible to a wider variety of users. Their pioneering new work will be published later this year and in the meantime QCS is supporting making the Digital PAL Instrument available to all for free.
Watch this space…
You can now download the Digitial PAL Instrument for free here
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