Dementia Care: More Sherlock Holmes than Florence Nightingale!
Florence does things FOR or TO a patient.
Sherlock deduces WHO the person is, WHAT the person is communicating [albeit non-verbally] and WHICH needs of the person are being overlooked.
Florence prides herself on keeping ORDER and ROUTINE. Things running like clockwork for her nurses and thus the result of the tasks performed in the best interest of the patient.
Sherlock thrives in CHOAS, sees the nuances and differences in every individual and thrives on those differences. Each case is unique and revolves around the individual.
Florence looks at the bigger picture; the cleanliness, the efficient delivery of care, the success of best practice documented and proven.
Sherlock looks at the details, the result for the individual, and accepts that success is different for every client.
Deduction of the details is fundamental to mapping or observational best practice, and the master of that game is Mr Holmes. I grew up with two uncles that were Holmesian scholars, and they encouraged me into reading all of the Sir Arthur Conan Doyle stories by the age of twelve. I recall sitting between them in our lounge glued to the Basil Rathbone/Nigel Bruce films on telly. Now in my fifties I can attest that I have been a life long fan. So it should come as no surprise that I naturally lean towards the deduction method of dementia care. During my training in mental health nursing I started to see parallels in the writings of Carl Rogers and Thomas Kitwood to the art of deduction I had known so well from Conan Doyle. It is interesting that Doyle based Holmes on a physician friend at the University Of Edinburgh, so maybe the analogy is not too far from the original source.
In my practice today as a trainer and consultant in dementia care, covering the entire UK, I have adapted the observational model as my primary tool to help carers see the PERSON before the dementia. I tell them daily; put down the lamp and put on the deerstalker! They all understand and can utilize immediately.
[Just for fun watch the skit video from Mitchell and Webb, in a weird way it depicts good practice of entering a person’s reality and meeting the occupational and identity needs]