Using Life Story Work to Enhance Care - Essay Example

? Using Life Story Work to Enhance Care By of [Word Count] Introduction In its general sense, life story work refers to a kind of social intercession for both old and young clients, which emphasises and recognises the roles and influences of one’s past, present and future in the immediate problems or conditions. This intervention is specially applied in reminiscence therapies during which patients are reminded of or aided to remember some current or past feeling and to imagine or think of some good future feelings (Rusell & Timmons, 2007). In most of these instances, therapists use image aid to remind patients of some likable events or memories. The idea of life story work could be traced to the 1960s or just before this period. However, many of the discussions on the use of this intervention on dementia patients, foster care and adoption children became more widespread in the 1980s and later years. Due to these discussions, life story work is currently a well documented concept, especially in the UK where the concept has even been integrated into the adoption legislations (Rusell & Timmons, 2007). Academic and professional discussions and debates have not discussed the application of life story work but also the professionals supposed to be involved in life story work. One of these professionals is the social worker. In this regard, social workers are required to take the critical role of making certain that clients such as children under adoption care or soon to be adopted have a life story record or book. Since social workers are perhaps the bearers of the most accurate information on a child’s background and upbringing and the reasons for which such children were placed under foster or adoption care, it is essential that such information is availed for use in life story work interventions. Besides social workers, the other people expected to use life story work are foster care givers, residential support workers and adoptive parents. In addition, children’s carers have the best information on their daily lives and achievement, which they should give for the benefit of life story work. Birth parents are also important bearers of children’s life events and achievements and should provide such information for use on adopted children or on their own children (Rusell & Timmons, 2007). In addition to the named groups, any willing adults or bearers of any important information on the lives and times of life story work clients should come forward and present such materials. Importantly, such a person should be willing and able to spend time with such a client or a child so that a strong and trusting relationship is built between them. Nonetheless, some stakeholders opine that untrained persons should not support clients with life story work even if they are nurses, social workers or foster carers. A point worth noting about life story work is that the gender, ethnicity, religion or culture of the parties to a life story work should be taken into account and respected (Rusell & Timmons, 2007). The Principles and Benefits of Life Story Work As a social and medical intervention, life story work is based on several core principles, which practitioners such as nurses and social workers should uphold. As must have been understood by now, life story work targets people (children and adults) who may have forgotten or have a fragmented idea or understanding of their own history or a broken sense of themselves. Thus, life story work seeks or attempts to assist such people to have a redeemed or stronger sense of their history and identity, in the process helping them make sense of their lives, situations and history. In general, life story should aim at answering clients’ and carers’ questions regarding what happened, when, how and why certain events occurred to clients. Thus, a rather holistic approach to life story work is recommended. In this approach, the influences that every individual in a person’s life may have on his or her life and experiences are recognised as likely to have made tangible contribution to their lives (Social Policy Research Unit, 2000). These individuals could be teachers, residential workers, family support workers, birth relatives, foster carers and social workers. There are several benefits that clients and professionals enjoy from life story work interventions. First, social workers, nurses, foster parents and social workers are able to gather a lot of details and expand their understanding of their clients’ current lives and history. To clients, life story work allows the building of a sense of identity with regards to religious, cultural and ethnic uniqueness. In addition, life story support enable clients, especially children to share their past with others. For both care givers and clients, life story work gives a rational explanation of the early events of a person’s life, thus dispelling any fantasies or fears that might shroud an individual’s life and family. Life story work also makes the linking of one’s past and present easier, thus helping all stakeholders to appreciate how one’s earlier life events may continue to impact on their conduct and feelings in their adulthood or late childhood. The other way in which life story work benefits clients is by enabling the acknowledgement of life issues such as separation and loss (Life Story Steering Group, 2010). Through life story work, carers are empowered to understand their clients, thus developing empathy for them. A rather important effect of life story work is its ability to augment one’s self-esteem and self-worth. Through re-unification, closeness, transfer to another foster home, carer or permanent placement and moving to adulthood, independent life, residential care, life story work helps its clients to prepare positively for the future and any planned changes in their lives. Techniques of Life Story Work There are several techniques through which life story work is delivered to clients. These techniques include life story book, digital life story book, interactive approach, story-telling and service user group. Perhaps among the oldest life story work techniques, life story books have used in adoption by adoption and social workers for the last three decades. Generally, such a therapy takes twelve months but could be updated depending on a client’s understanding and situation (Social Policy Research Unit, 2000). It is important that one distinguishes life story work and life story book. Whereas life story work entails assisting an individual to understand and internalise their past, present and future events and feelings, life story book need to incorporated a professional such as a nurse or a social worker. For instance, a social worker may use life story book on a child after placing him or her under adoption. The social worker does not need to be present once the client has a book on his or her past life’s events, feelings and experiences. A life story book should record the information to answer the questions that one might seek answers to in the future, especially with regards to recalling and understanding one’s past. One advantage of this book is that it helps children to avoid having misinformed and fictional events, feelings, friends and families and misplaced sense of identity. Besides adoption and foster care, dementia is the other area in which life story work is applied, in which case it is referred to as reminiscence therapy. Life story work helps dementia patients to tell their lives’ stories and to create imagery tools to assist them remember past events. Through these remembrances, dementia patients may be able to identify present and future goals or plans. Life story work is also useful as a therapy for friends and families of dementia patients to review their patients’ life before dementia set it. Carers and staff such as nurses also find life story work rather useful for the provision of better health care. What’s more, present and past studies have confirmed that many loved ones feel reassured about nursing care in cases where life story work is complete (Social Policy Research Unit, 2000). One way in which life story work encourages recovery in dementia patients is by identifying patients’ achievements, thus making them proud of themselves. Life story work has also been associated with person-centred or individualised care for dementia patients. In such care, it is advised that care staff learn more about individual patients’ life stories. One criticism of life story work is the apparent lack of enough trained and qualified staff to do and complete the work. Second, there is some level of reluctance to get involved due to other nursing care commitments and responsibilities. Third, the limits on the amount of time available for the completion of such work in addition to lack of resource accessibility (Social Policy Research Unit, 2000). Specifically, computers and scanners have been identified as quite unavailable or inaccessible by life story work staff. Roles and Responsibilities of Nurses and Social Workers Nurses, social workers and caregivers have the sole responsibility of implementing any care plan recommended for their clients, which may include the life story work plan. These individuals are mandated to ensure the care plan under their watch is recorded and updated in the appropriate section of their clients’ files (Thompson, 2009). In other words, in connection to the orders from and consultation with their supervisors, these professionals should coordinate all the activities agreed on and ensure the right and appropriate actions are undertaken. Although a social worker or nurse may undertake these activities themselves, there is room for delegation of duties to colleagues or workers from other teams or agencies (Thompson, 2009). Birth relatives also have roles, responsibilities and rights in life story work, especially if children and dementia patients are involved. There views must therefore be taken into consideration during the entire time their relative is under care. Worth mentioning is the fact that almost all the important information on a child’s or a dementia patient’s past life and experiences is obtained from birth relatives and other close family members. Thus, birth relatives are quite crucial in the entire life story work process during which they should ensure that children grow up and dementia patients recover with as much information about their future, present and past as possible. In cases where not much information is available about one’s birth and close relatives, efforts should be made to ensure as much information as possible is gathered from relevant social services agencies (Thompson, 2009). In situations where birth and extended families are reluctant or opt to withhold information from care proceedings in situations of contentions, they may be encouraged to contribute at later stages through direct contacts or indirect communication such as letters. Besides social workers, nurses and other caregivers, those with roles and responsibilities in life story work are foster carers, fostering supervising social workers, placement agencies, care leaver personal advisors, adoption social workers, managers or supervisors and independent reviewing officers (Thompson, 2009). Beyond Life Story Work In many cases, life story work is never sufficient to help foster or adopted children or dementia patients to overcome the various barriers they encounter in society with regards to sustaining relationships beyond a surface level. Thus, a more in-depth assessment may be recommended for such clients by involving skilled therapists to carry out a more effective work using different suitable methods. In general, it pays to handle deep-seated emotional difficulties and barriers in children and elderly people through the recognition of the critical role of expert advice prior to starting a life story work (Thompson, 2009). Expert advice is particularly important given the various types of experiences or events that people face to warrant life story work interventions. Among these traumatic experiences are wars or other types of armed conflicts, civil unrests, society breakdown, forced military recruitment or forced engagement in violence, political, religious and ethnic persecution of families, human trafficking, sex industry, domestic servants, murder or imprisonment of families and missing families (Thompson, 2009). Others are dropping out of school, relying on others such as relief agencies or refugee camps for upkeep, rape experience, torture, tribal conflict and political repression. In the UK, the British Association for Adoption and Fostering (BAAF) is an example of the organisations that may assist with life story work-related care for whatever type of client seeking such help. Life Story Work and Dementia Dementia treatment and strategy are some of the areas in which life story work has been largely applied, especially in care homes. The intervention is especially effective on disruptive, restless, neuroleptic and angry dementia patients. The reason life story work works for dementia patients is the fact that accurate and adequate information about dementia patients is rather essential for the development and delivery of person-centred care (McKeown et al., 2010). In addition, it is important to have a thorough understanding of the patient in question. In this regard, life story work informs and furnishes care staff with the appropriate care strategies and delivery methods. Importantly, research has shown that life story work helps in the building of good relationships among dementia patients, their carers and families. Life story work’s success on dementia patients stems from the fact that the intervention points out a patient’s dislikes, likes, spiritual and contextual aspects, thus largely augmenting care staff’s capacity to understand and respond to individual dementia patients (McKeown et al., 2010). What is more, care staff has been able to design, tailor and deliver a framework for personal and engaging care for dementia. The benefits of life story work to care staff include improved support for people with dementia, improved understanding and engagement, appreciation for the patient first then dementia, improved communication skills, and facilitated collaboration with patients and their families (McKeown et al., 2010). Effects of Poor or Lack of Life Story Work There cases in which barriers to life story work intervention result in certain detrimental effects. The effects of lack of life story work are enough to alert those involved on the importance of this intervention. First among these effects are deterioration of cognition and mood of dementia patients and increases in the strains experienced by patients, care-givers and relatives (Thompson, 2009). The third effect is decreased functional ability of dementia patients. Fourth is the worsening of the symptoms of depression (Thompson, 2009). The other effects of lack of or poor life story work intervention are reduced empowerment, lowered self-esteem, poor communication, poor stimulation and fun and deteriorated moods. Conclusion Life Story Work is an intervention or a tool that enhances the care given to various types of clients including fostered and adopted children and elderly persons, especially those suffering from dementia. In general life story work entails the reviewing and evaluation of a person’s past life events to help develop his or her biography. In addition, it helps in unearthing how an individual dealt with or overcame past events and feelings. Life story work is often shared among the affected individual, his or her family, friends, carers and staff, depending on the immediate situation. The emergence and rapid rise of life story work could be explained on the basis of its myriad benefits to individual clients as well as friends, families and care staff. For example, life story work improves all the stakeholders’ understanding of a patient and promotes good relationships between clients on one hand and their families and care givers on the other hand. Third, life story work facilitates the achievement of person-centred care. Despite the huge strides made and the increased growth of life story work, a lot of challenges are still encountered in its implementation, not to mention the resultant criticism. However, to support the growth of and emphasis on life story works are numerous guidelines and recommendations. Most importantly, the role of leadership in the facilitation and development of positive cultures that ensure and promote the proper implementation and effective sustained use of life story work is emphasised in these recommendations. References Life Story Steering Group (2010) The positive contribution of life story work to individuals and carers. North East Mental Health Development Unit, NHS County Durham, Yorkshire and Hamber Improvement Partnership and North West Joint Improvement Partnership. McKeown, J., Clark, A. et.al. (2010) The use of life story work with people with dementia to enhance person-centred care. Scotland's National Dementia Strategy. Rusell, C., and Timmons, S. (2007) Life Story Work and Nursing Home Residents with Dementia. Nursing Older People, 21(4): 32. Social Policy Research Unit (2000) Improving care for people with dementia: Development and initial feasibility study for evaluation of Life Story Work in dementia care. University of York and NHS. Thompson, R. (2009) “Realizing the Potential: Developing Life Story Work in Practice.” Retrieved on June 20, 2013 from http//:www.dementiauk.org/assets/files/info_and.../Realising_the_Potential.pdf? Read More