Breakfast Seminar

“My dream was about how we’re going to get to a point in the care sector where we guarantee comfort instead of sterility, where instead of ‘them and us’ barriers there are engaging staff, lots of interactions and a family feel,” David Sheard told Care Conversation delegates.

People with dementia could live up to three times longer in care homes that provided a genuinely positive, active environment, he said – those that were “a microcosm of the outside world”. Thirty-six years in the care sector had taught him that a “malignant social psychology” was still the norm, however.

“We have a societal problem, and it’s not peculiar to the UK,” he said. “Everyone talks about person-centred care, but it’s become an elaborate con,” with no correlation between the term and people’s lived experience. His organisation had developed 44 Butterfly Care Homes to take his vision forward, and was now seeding them in Australia and Canada. “Our core belief is that a new culture of care comes from focusing on a model of emotional intelligence,” he stressed. This meant that before staff could implement person-centred care they had to experience it themselves.

However, the system remained focused on tick boxes, he said, with “no relation to the experience of the people sitting in those care home lounges”. Homes needed to reflect the world outside, but culture change would require compulsion – his organisation had carried out 700 audits in care homes across the UK, and found that around 70 per cent of people’s time was spent in “boredom, lethargy, staring into space. And that’s 700 care homes that were enlightened enough to have us in the door, that actually wanted to improve. Think what the others might be like.

“Care homes, managers, boards of directors all fight when I say I want to get rid of uniforms, get rid of separate staff toilets, have staff sit and eat with residents,” he continued. “We know the system is broken, we know it doesn’t feel right inside. We have to get rid of the societal dread of going into a care home.”

New models were being developed across the world that challenged the status quo, however – breaking up care homes into small houses with their own front door, for example, proved no more expensive than the impersonal, large-scale model. “Building a home is a very easy concept, yet it seems very difficult for the care sector to grasp.”

Dementia Care Matters’ own ‘household model’ had three core beliefs, he told delegates – renewal of the spirit, reframing the organisation from the top down, and renovating all homes into real homes. “You also have to get rid of the language. In all my life I’ve never lived in a ‘unit’ – what’s wrong with ‘house’ or ‘home’?

“This is a massive society issue,” he continued. “Every taxi I get in, when I tell them what I do, I hear people’s own stories. We’ve got to want to do something radically different. It’s painful, and it requires a complete mind-shift” but it was possible to be an “attached professional”, he stressed. “You don’t need to be detached. You wire up a care home with emotional intelligence.”

Finally, it was vital to understand that the language of dementia was really about searching, he told the seminar. “When people say ‘I want my mum’ or ‘I want to go home’, they’re actually saying, ‘Why am I in a place where I’m not being protected?’ It’s about helping people to be who they were as people. It’s about accepting that the language of dementia is not literal. My question is, what can we all do to be part of a society that’s proud of its dementia care?”