Supporting Eating and Drinking – Resource for Carers

Eating and Drinking Guidance for Carers

This booklet has been designed for all who support someone living with the later stages of dementia. It has been developed by a leading team of researchers and health & social care professionals including GP’s, speech & language therapists and palliative care experts. It has also taken into consideration the views and experiences of people with dementia. 

As dementia (and diseases like multiple sclerosis) advance, it is typical for people to experience difficulties around eating, drinking and swallowing. This booklet explains the physical and psychological reasons for these issues and offers a comprehensive series of strategies and resources to support carers & guide their discussions with key health professionals.  

With helpful tips on nutrition, how to offer food/drink and when to seek help, it also includes topics ranging from oral health to end of life hydration. An invaluable resource that has clearly been developed with considerable input from a leading team of experts in the field. 

Click here to download

In conversation with Anna Park

I first met Anna through the dementia care awards, when I was one of the judges and she was representing one of the shortlisted companies. Impressed by her passion and drive, I started to follow Anna on Twitter, and soon saw how she brings that same passion and drive to the wide range of issues that she cares about, whether it’s nature, dementia care or circle dancing!

So I’m delighted that Anna is now working with us to improve people’s experience of care, and I’m sure you’ll find her comments and observations here as insightful and thought-provoking as I did.

What first drew you to the world of care?

I think it has to be said that experiencing a vicarage childhood meant care homes, hospitals and hospices were familiar places to me from an early age. This no doubt gave me an understanding of life’s challenges, an ability to sit and talk to anyone and a determination to always try and see the person and listen to their stories rather than focus on appearances or diagnoses.

During my degree, I had a wonderful placement teaching in a special school and a summer volunteering in a day centre for young adults with learning disabilities. I had fully expected to train as an English teacher and specialise in SEN but these experiences and a temporary position working in a Mencap group home changed my direction and shaped my understanding of what person-centred care could and shouldn’t look like. I realised then that there was far more needing to be done to train and support adults in care than I could achieve in the mainstream classroom.

I went on to take the position of a Day Services Social Worker in a Multi-Purpose Day Centre where I joined a fabulous team of passionate creatives who fully recognised the value and contribution of every individual. There was a clear focus on self-advocacy, accessing the arts and fulfilling individual potential. For eight years I ran sessions in collaborative song-writing, IT/magazine production, symbol/communication techniques, skills for work as well as dance and drama performances for all ages and abilities. The aim was always to support people to develop the skills and confidence to create, express themselves and fulfil long term goals.

The opportunity to install and assess the learning opportunities provided by a new interactive sensory music & coloured light system became the subject of my Post Grad study (P.G.C.P.C.E) and led to my next position as a consultant and trainer at OptiMusic and later OM Interactive. It was my work developing the Mobii interactive table that would further immerse me in the world of dementia care.

From a family viewpoint I was also being drawn into the world of care through the experiences of my grandparents, one on each side developing dementia whilst in their 80s. My Grandad’s lifeline in care was continuing to play his keyboard, having spent his whole life playing the organ for his local church. For my Grandma, a teacher, collector and keen gardener, it was important that she was surrounded by familiar objects and photos and had essential access to a garden. I continue to advocate the vital importance of fresh air and nature to anyone who will listen! The years my Mother worked as a care home relief manager also gave me an insight into the daily demands and rewards of life working in a care home.

You work / have worked with some other great organisations, can you tell us a bit more?

Yes, my work with sensory technology, from the mid 90s onwards, led to some exciting collaborations working alongside the creators of the first interactive musical light beams (OptiMusic) and then pioneering the use of interactive projection technology in dementia care (OM Interactive). I had always been passionate that music and the arts should be accessible by everyone, and my Post Graduate research evidenced the enormous benefits of using technology to give people creative control.

It has been exciting to be part of a new era in person-centred technology, I thoroughly enjoyed developing the content and purpose of the Mobii interactive table and researching its effect on people’s emotional and physical wellbeing. It was very humbling to have this work acknowledged as the Most Outstanding Product at the Dementia Care Awards in 2018.

However, my years in sensory product development have also taught me the huge importance of training, care culture and emotional intelligence. Any interactive tool relies on the skills and abilities of those using it, the more person-centred the session delivery, the greater the response. No product can be a ‘fix all’, they have to be in the right hands, our carers are still our greatest resource.

I have been very lucky to meet some incredible people in the world of dementia care. I was particularly honoured to be asked to become a Special Adviser (Learning Disability Inclusion and Technology) for NAPA last year. NAPA (The National Activity Providers Association) is a charity who do so much to support and promote the delivery of meaningful activities in care with quality resources, training & guidance, newsletters/magazines, a helpline, annual conference and a fabulous awards ceremony; recognising the skills and dedication of care staff nationally. So I was more than delighted to join the NAPA team in a voluntary capacity.

Intergenerational work and exposing ageism are areas I am particularly passionate about, there is so much we can learn and gift to one another over the life course. As a Trustee of the charity Ready Generations I’m looking forward to encouraging greater connection across all generations with innovative community projects, an intergenerational nursery in a care home and research-led investigations aiming to shift perspectives and value the contributions of everyone.

As a teacher I still enjoy piano tutoring, particularly when that means re-igniting someone’s passion for playing. I have weekly sessions with a lady who is living with vascular dementia which have been both moving and joyful for both of us. I also call ceilidhs and barn dances as Hedgerow Tipple, which for me is the perfect way to share my love of music and dance with all ages and abilities.

What is it about Mycarematters that made you agree to work with us?

I have admired your mission to improve the experience of care since we first met at the National Dementia Care Awards in 2018. Your determination to ensure the needs of your late husband were made known to all staff in his care homes and hospital resonated so strongly with me. Having also lost a close family member to a progressive disease I understood the daily challenge of ensuring care remained person-centred when speech had virtually gone. Our family experienced the same frustrations and miscommunications whilst also recognising the difficulties staff faced when vital information was locked away in a file on an office shelf.

Honouring someone’s personal preferences can make the difference between a good day and a bad day. We experienced first-hand the consequences of information not being passed on with one oversight by cover staff sadly leading to a serious injury.  We would certainly have used Remember-I’m-Me Care Charts if we had known about them at the time. It’s so important for all carers to have an at-a-glance snapshot of needs and preferences and for families to be reassured that what’s important for their loved ones is actively shared and understood.

I also believe that Mycarematters profiles are important for encouraging conversation and connection, a reminder to always acknowledge the person directly and explain what’s happening rather than carrying out physical care tasks in silence. As a supporter of the Butterfly Approach I believe sharing this sort of information is essential for maintaining a sense of identity and belonging. We made sure that Sarah’s O.T certificate was above her bed alongside important photos including one of her proudly completing a helicopter flying lesson. These insights help carers to see the person behind the condition and talk about things that will be meaningful for them.

More recently I have been impressed by the My Future Care Handbook, an interactive guide which we personally found useful when navigating difficult conversations with my Mother-in-law, helping us to record her care and end of life preferences. A fabulous piece of work that everyone should be encouraged to complete for peace of mind about the future!

As a not-for-profit social enterprise I admire the ethos of Mycarematters and fully support their aim to celebrate the work of other small organisations who similarly strive to improve the care experience for all. So plenty of reasons to want to join the team!

What have you got planned for Mycarematters and its customers?

Well, firstly I hope to build on the fabulous work that’s already been done by continuing to raise awareness of our social enterprise and its mission to provide solutions, training and resources to improve the experience of care.

I also plan to expand our offering by inviting partner organisations to showcase their products, guides and training resources, because there is so much good work out there that deserves a wider audience. My monthly newsletter will help to keep our customers informed of our latest additions with specialist insights and our latest news and product updates.

I’d love to see Mycarematters become a hub of excellence, a first point of call for our care providers to source reliable information and a wide variety of tried and tested tools to help them deliver person-centred care to the people they support.

I’m also very conscious that Rogers & Kitwood’s term ‘person-centred care’ is in danger of being watered down through over-use, becoming synonymous with simply ‘caring’. I think it’s vital for us to focus on what it truly means i.e. to place someone at the ‘centre’ of their care, to see the world from their viewpoint and imagine how they are feeling; to literally climb into their chair. I’m reminded of Sara Livadeas becoming a resident in a Fremantle Trust care home when she was appointed CEO. A fabulous way to try and understand how it felt to live in one of their homes.

As the newest member of the team I’m conscious that any fresh initiatives will stay true to the Mycarematters ethos, supporting people in care to always feel included, valued and their presence acknowledged, regardless of cognitive or communication difficulties.

I look forward to supporting all our customers, sharing their stories and acting on any feedback so we can continue to improve the quality of our products and services. Carers, both paid and unpaid, are doing the most incredible work everyday, they are the greatest resource of all and our aim must be to support them with the right tools and guidance to carry out their important work to the best of their ability so the caring experience is better for everyone.

 

How difficult can it be to draw a star?

I was introduced to this little exercise at a recent regional Dementia Action Alliance meeting, and thought others might also find it useful; care home managers may like to do it with their staff.

Click here to print a star on to both sides of enough sheets of paper to provide one to each person, and on one side invite them to draw an unbroken line between the two stars, thereby drawing a third star, without taking their pen off the paper. They are unlikely to find that too difficult. Then, ask them to turn it over, position a mirror (you’ll find suitable ones in Poundland apparently!) at the top of the paper on the table in front of them so that the star is in view in the mirror, and ask them to do the same thing, but this time only looking in the mirror.

The idea is to create a sense of what it must be like to live with dementia where you are unable to complete what seems like a simple task. Don’t be surprised to see people experience shame, embarrassment, frustration, irritation, impatience… exactly what people living with dementia experience every day.

Please Tell Me… a new Life Story book

We are often told that nothing can beat our Care Charts for getting information in front of everyone interacting with a person, but that’s not to say the learning should stop there. Our charts provide a snap-shot, at-a-glance view of a person’s needs and preferences, but should not be thought of as a replacement for life story work.
Regardless of whether it is family or staff members who spend time with a person to collect their memories and what matters to them now, the process can be extremely rewarding for both parties. And that information can of course help carers provide personalised and appropriate care, either in someone’s home or in a care home.
So we were very excited to see John’s Campaign new book Please Tell Me… a place to help someone share a childhood memory, the words of a favourite song, what made them happy in their early years. It is designed to follow the chronology of the person’s life, and the open questions provide opportunities for conversations.

Available as single books or in packs of 10. Click here to purchase…

 

Oreo, spreading happiness and joy

Orleo the cat

How Therapy Cats Can Bring Countless Joys to Older Adults.

St Augustine Health Ministries, a nursing home in Cleveland, Ohio, has a very unusual 4-legged occupant, Oreo the cat. Previously a stray cat, Oreo has become a beloved member of the St Augustine family. Her main job is to keep everyone happy. The residents love having her around and enjoy taking photos of her, something which stimulates their creativity, while employees can’t help but smile when they see the black and white feline doing her rounds at the home.

Many of the residents had to leave their beloved pets behind when they moved into the home, one of the challenges facing elderly people who choose to make the transition into a care facility. Oreo the nursing home cat lends a personal touch to the environment, making residents feel more at home. Here are some of the many ways in which having a cat around can improve the quality of life of nursing home residents.

Mood improvement

Elderly people often become lonely and depressed and cats are ideal to help them overcome this loneliness by offering independent companionship, affection, entertainment and a sense of responsibility.  It’s a known fact that cats can lighten any mood and lend purpose to the lives of anyone who comes into contact with them.

Improved health

Cats generally require fairly little human care but the care they do require results in much-needed exercise among older people. Even those suffering from arthritis or with other physical limitations can care for cats without too much effort. Caring for a cat may call for new activities and routines that are important for both mental and physical stimulation. Caring for an animal is very rewarding and can be of great benefit to the overall health of the older generation, to the extent where it can help them live longer.

Why cats and not dogs?

  • Dogs also make for great pets but they require a lot more general care, training and exercise than cats do, things that elderly people are simply not always up to.  Cats are definitely a more suitable pet option for a nursing home environment for the following reasons:
  • Cats are generally more than happy to remain indoors for most part, unlike dogs.
  • Cats require approximately 20 minutes of playtime a day which does not necessitate the owner being mobile. Cats are more than capable of entertaining themselves with the help of kitty-friendly toys such as a ball of yarn or a wind-up mouse.
  • Cats enjoy sleeping on a human’s lap or bed and don’t require a special bed like most dogs prefer.

Pet ownership brings a great deal of joy to the elderly and should be encouraged when viable. The benefits, both emotional and physical, speak for themselves and in terms of companionship now one will be more loving and loyal than a much-cherished pet.

Photo by kitsanoo on Unsplash

Many thanks to Lucy Wyndham for sharing this story.

Mycarematters Display Options Now Available

Mycarematters Tablet and Chart

There’s now an alternative way to collect and share a person’s needs and preferences, using a simple online tool. Mycarematters has primarily been designed to ensure that a person’s needs and preferences are available without delay in the event they are admitted to hospital.

But the information needn’t languish unseen until that point. It can be used in a person’s home or in a care home to help paid carers develop a relationship with the person they are caring for. A person’s Mycarematters record can be viewed on a tablet or printed out and displayed in a number of ways to suit different environments.

We offer a selection of display options: click here to see the current range, or contact us by phone on 01403 210485 or by email so we can offer some suggestions on the best way to use Mycarematters in order to meet your needs.

The Mental Capacity Act explained

Mental Capacity Act Guide

We were delighted to be invited by SITRA to collaborate, together with Carers Trust, on a new Guide to the Mental Capacity Act, funded by the Department of Health.

It has been specifically designed to support carers of people with dementia and was shaped by input from individual carers, carers groups, professionals and specialist support groups.

The Guide contains advice and support for carers in supporting those they are caring for to make decisions, or when they have to make decisions on their behalf, and gives useful information on when and how to get support and when to involve other people as well as on ‘best interest’ decisions and Lasting Power of Attorney.

It also contains a diary section to record key decisions or events.

“Wonderfully laid out for harassed carers to quickly navigate through.” Family carer

“I have found it such a useful tool to give to care workers as part of their MCA training.” Healthcare trainer

Click here to download a copy of the Guide.

Should you wish to place a bulk order please email enquiries@carechartsuk.co.uk .or call 01403 210485.

Introducing Mycarematters…

Mycarematters

It’s already been an exciting year for Care Charts UK, seeing the adoption of our Remember-I’m-Me Care Charts by hundreds more care homes and hospitals, and receiving lots of positive feedback about the beneficial impact achieved by these simple, cost-effective tools.

We’ve also made a start on a range of products to help with the care of people living in their own home (we’re still looking for input on this from carers, both paid and unpaid, and those being cared for: please complete our homecare survey if you haven’t already done so.)

But there’s more to be done. I’ve been conscious for a while, now that we are working with increasing numbers of hospitals, of the difficulties faced by staff in collecting the information to go on a Care Chart. A number of hours, even days, might pass before nursing staff can build up a picture of the issues that matter to a person if they are unable to communicate these things for themselves. Even in that short time a person living with dementia might suffer trauma and discomfort purely because the information isn’t reliably available which would enable staff to allay concerns, meet a person’s dietary needs or understand what might look like inexplicable behaviour.

There is increased understanding of the value in treating the whole person to improve overall outcomes, and the power of Care Charts lies in providing quick, easy and reliable access to a person’s needs and preferences to assist in that aim. However, research suggests that nursing staff spend an average of 100 minutes per patient trying to collect the information that will help them provide that person-centred care.mycaredata note

So a few months ago I had one of those exciting lightbulb moments, with an idea that just seems so obvious I can’t believe it’s not already out there (not unlike my experience when I developed the first Care Chart for my husband Geoff). If we could provide a secure place online for people to upload their non-medical information, it could be made immediately available to all healthcare staff, cutting that 100 minutes by more than 90% and immediately improving the potential for better outcomes for both staff and patients.

In that moment Mycarematters was born, and in true ‘JFDI’ style (so often referred to by my friend Gill Phillips of @WhoseShoes’ fame), we’re about to start building the platform.

I want to reiterate the point that this is not about medical notes; there are others working on ambitious projects to digitise those, and they face many challenges. Mycaredata will focus instead on details like preferred foods and drinks, what assistance is required for a person’s mobility, why a particular routine is important and any other issues that matter to a person: reassurance for example that their pet is being cared for whilst they are in hospital, or that they need assistance to eat.

Uploading the information will be simple and straightforward, guided by a series of prompts, and it will be a quick and easy process for hospital staff to access it. We’ll be making use of the best encryption and data security software to protect the data (talktalk IT staff need not apply!) and the best news is that we’re going to try and keep it free for both individuals and hospitals.

If you would like to follow our progress you can do so at www.mycarematters.org and/or comment on any aspect of the project at info@mycarematters.org. I’m sure the end product will be quite different to what I was envisaging when I scribbled that first note to myself, but the aspiration won’t change: to improve the experience of a hospital visit for those people who struggle to communicate their needs, thereby improving their outcomes as well as those of the staff and of the NHS.

Supported by

BGV snip

 

 

Sight is precious

Jim took a lot of falls in 2012. His eyesight, dementia and arthritis were all conspiring against him. He’d wake up in the morning, forget he could not walk and think the lights had all been turned off.

We are introduced to Jim in a video produced by scie, dealing with sensory loss (see link below). The staff in the Cumbrian care home where he lives have had to learn to be very patient, and use concise, effective communication.  They try to communicate with Jim in a quiet area, so background noise doesn’t distract and confuse him.

It seems nothing can be done about Jim’s blindness, but that is not the case for many of those living in care homes and trying to cope with impaired vision. Whilst many homes diligently arrange sight tests for their residents, there are probably many more that do not see the need.

There is generally thought to be a correlation between dementia and sight loss, so a certain shrugging of the shoulders is inevitable, but dementia is already confusing enough for the person living with it so if there is anything that can be done to help them maintain senses like eyesight and hearing, it should be done.  Regular sight tests are important – it is possible to have an eye examination at nearly all stages of dementia  – to diagnose cataracts, check prescriptions are up to date and to assess for other conditions, treatable or otherwise.

Even if nothing can be done to improve a person’s sight, it is important to assess the quality of their vision so that carers can take it into account in their behaviour towards and around that person.

Yet, in a survey in 2014 the College of Optometrists asked their members how frequently they carried out domiciliary eye examinations in people’s homes or care homes.  Just 10% said they did so regularly in people’s homes and this dropped further to 6% for regular care home visits.

Such low numbers are not down to cost. If you are over 60, or over 40 with a close relative who has been given a diagnosis of glaucoma you are entitled to free eye examinations (in Scotland they are free for everyone). And for those unable to visit an optician unaccompanied due to physical or mental disability they are entitled to a free eye test at home.

So why are the numbers so low? First of all, there is undoubtedly a sense that ‘it’s just the dementia’. What’s the point in finding out about a person’s eyesight because it’ll make no difference? Those with that opinion should read the story of how the life of Suzy Webster’s Mum has been transformed (and how a potentially traumatic experience can be made so much more pleasant by involving the family) – see link below.

Research done by the College of Optometrists suggests that it is often the families who are not convinced of the benefits of an intervention, and there is plenty of anecdotal evidence to suggest that many professionals feel the same.

This is borne out by Thomas Pocklington Trust’s report (link below) quoting the RNIB who estimate that over half of older residents in care homes have some form of sight losss, yet care home residents’ co-morbidities mean that eye care interventions are overlooked or thought unnecessary.

What’s to be done?

As with so much in this world it comes back to communication. Bust those myths about it making no difference. Make it known that everyone in a care home is entitled to a free NHS eye test at least every two years. Build awareness about the importance of regular eye tests and the difference it can make to the individual’s quality of life where improvements to their sight can be made. As Suzy Webster says of her Mum after her cataract operation: “She’s a different person. She’s really got her spark back… she’s walking steadier, her mood is happier and she’s interacting with us all better.”

A look into the future

Simply slip a small device over the in-built camera on your smartphone. Turn on the Peek app, hold the phone close to someone’s eye, click and forward the picture to a trained eye care specialist.  This is the technology of the future to detect signs of glaucoma, macular degeneration, cataracts and other issues like high blood pressure. Social enterprise Peekvision claim that 80% of blindness is avoidable, and tools like theirs can replace an eye exam at a fraction of the cost. They should be shipping in early 2016 and expect it to be transforming lives in remote corners of the world… there’s a few lives waiting to be transformed right here on their doorstep. http://www.peekvision.org/

Photo by sk on Unsplash

Resources

Scie has a section on Dementia and sensory loss in their Dementia Gateway

The Age Page: Interview with Suzy Webster

Thomas Pocklington Trust: Undetected sight loss in care home

Vision2020 The Right to Sight UK (Dementia and Sight Loss Interest Group) working to increase the knowledge and information available for people living with dementia and sight loss has a useful  factsheet

Thomas Pocklington Trust: Design for Dementia and Sight Loss

The College of Optometrists’ Guidance for Professional Practice has a section ‘Examining patients with dementia or other acquired cognitive impairment’.

 

 

 

Pets as Therapy

The idea that pets can play a therapeutic role is not new: the charity Pets as Therapy was founded over 30 years ago and 4,500 dogs and 108 cats now visit over 130,000 people every week. That’s a staggering half million bedside pet visits each year, giving both young and old the pleasure and chance to cuddle and talk to them. What is more recent, however, is researchers’ attempts to understand why this can have such a positive impact on people’s health and wellbeing.

“Pets hold a special place in many people’s hearts and lives, and there is compelling evidence from clinical and laboratory studies that interacting with pets can be beneficial to the physical, social and emotional wellbeing of humans,” says Lori Palley, DVM, of the MGH Center for Comparative Medicine. “Several previous studies have found that levels of neurohormones like oxytocin – which is involved in pair-bonding and maternal attachment – rise after interaction with pets, and new brain imaging technologies are helping us begin to understand the neurobiological basis of the relationship, which is exciting.” More details of Lori’s research and report can be accessed here.

The Alzheimer’s Society touched on this in their Living with Dementia magazine back in 2011, quoting Jane Fossey, a clinical psychologist and a trustee of the Society for Companion Animal Studies (SCAS), which promotes the health and social benefits of human-animal interactions. “A number of small-scale studies suggest that introducing animals into care homes can have positive effects for people with dementia. For example, spending time with visiting animals has been shown to reduce blood pressure and anxiety, and improve social interaction and sleeping patterns. It can also reduce the late-afternoon restlessness that can affect people with dementia.”

No wonder then, that no less than 7,721 care homes in the UK declare themselves to be pet friendly (see the full list on the carehome website) with some organisations placing animals centre stage in their daily life. In Eden Alternative nursing homes, for example, dogs, cats and birds live among and interact with the residents, “lessening their sense of loneliness and boredom”.

Meet Nala the Teacup Poodle, lifting the spirits of residents at a care home in Minnesota.

The Spark of Life approach, which has been adopted by a number of care homes in USA, Scandinavia, Australia and Europe, claim that “the interaction that occurs with an animal companion diffuses loneliness and gives the person with dementia a reason to live and get up in the morning. Caring for a pet automatically enables the person with dementia to be needed and useful, gives them the opportunity to care, they have someone to love and who loves them back unconditionally, and their self-esteem is boosted as a proud pet owner.”

So pets can play a valuable role in care homes, either in the form of a visiting therapy or as permanent residents. But Dementia Dog are extending the role of ‘a man’s best friend’ further still. Every year, 25% of the puppies bred to be a guide dog for the blind fail to pass the rigorous tests, but there now may be an alternative role for them. Dementia Dog aims to pair people in the early phases of dementia who live with a full time carer with a dog trained specifically to assist them in their day to day lives.

The dogs provide at least three assistive tasks to their partner, such as support for daily living routines (waking, eating, getting exercise and going to the toilet), reminders (such as prompts to take medicine, drink fluids and other user identified regular tasks), or soft support issues (such as companionship and acting as an icebreaker in social situations).

Then there are projects that harness the benefits of other animals, such as HenPower, a heart-warming project which caught the attention of the media recently. A 12-month study of the project by Northumbria University found HenPower is: improving the health and wellbeing of older people, reducing depression and loneliness in older people and reducing the need for antipsychotic medication. Pippa Kelly’s excellent blog on HenPower provides more detail.

Ann Napoletan’s experience sums it up beautifully, so she should have the last word: “Anyone who owns a dog or cat can attest to the beauty of their unconditional love, and animals often forge a special connection with Alzheimer’s and dementia patients. My mom had a cat for a number of years, and their bond was inexplicable.  Holly wore a perpetually annoyed expression on her feline face and loathed most humans, yet she never left my mom’s side; as much as she detested being picked up, that darn cat would even let Mom carry her around like a rag doll. It never failed to amaze me. Somehow Holly knew that her special person needed a special kind of love.”

Photo by Joel J. Martínez on Unsplash

Further contacts:

Therapaws, North and West London. “Therapaws is a visiting animal therapy programme delivered by The Mayhew Animal Home. We recognise the benefits of taking animals into the care setting to engage with older people, encouraging social interaction to promote emotional and physical wellbeing. We specialise in visits to people with dementia and to palliative care centres. Our volunteers and their dogs go on regular visits to care homes, day centres, hospices and hospitals across North and West London.”

Owls About Town, Selsey West Sussex. “Our ‘Wise Owl’ experience is delivered by the calmest and most tolerant of Owls. We have found these sessions to be particularly beneficial to older people and those suffering with memory issues, such as Dementia. These experiences are very touching at times, seeing the joy on peoples faces when they interact with such majestic creatures.”

Wings of Freedom visit care homes and offer a very personal experience for everyone, giving a real life skill view of all things Owls and Birds of prey. For those people who may not wish to join in or get to the group, they do walkabouts to rooms.

For trips out, what better way of getting back to nature and into the fresh air than visiting your local Care Farm? Care Farming UK have a list of suitable venues near you, and award-winning journalist Pippa Kelly has written in interesting article on the subject of care farms and dementia.

The Donkey Sanctuary “Our team of specially trained donkeys offer an outreach service visiting hospices and local residential homes including those dealing with dementia care. The donkeys prove to be a great stimulation and provide valuable assisted therapy to residents… The donkeys also love the warmth and affection from vulnerable residents so the animal assisted therapy goes both ways!” You will find Donkey Sanctuaries in Sidmouth, Belfast, Birmingham, Derbyshire, Ivybridge, Leeds and Manchester.