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Changing Lives: Care Charts UK

Zoe Harris

Should you ever visit a friend or relative staying in a care home, you may well see a chart hanging on the wall or the back of a door.

There's nothing overly complex about it. Just a few small sticker illustrations of a bed, some teeth, a bath, a cup of tea and things like that, and perhaps a few scribbled comments too. But it could be that this simple chart is
making make all the difference to the life of the person in care.

These simple 'Remember I'm Me' charts, now found in 650 care homes across the country, are the brainchild of Zoe Harris, founder of Care Charts UK, which operates from a unit at Blatchford Road Industrial Estate in Horsham. Whilst thousands now benefit from its simple format, it was just one patient – Zoe's husband, Geoff – who provided the inspiration.

"Geoff was older than me and he was 60 at the time we had our first child," said Zoe. "But he was very fit, young at heart, and we would go sailing and skiing. When he was 70, I started to wonder whether things were quite right. I knew nothing about dementia, but we did visit the doctor . He told us that memory problems were normal for people of Geoff's age.

"But in a period of about three years, he went from living and working at home, to not being able to be left alone. Friends and family had given us great support in terms of helping to care for Geoff, but it reached the stage where it was not fair to ask them to help us any longer, so we started to consider carers. Things changed in 2009. I arranged a weekend away with our two teenage daughters, as they had been taking a backseat. I booked Geoff into a respite care centre. He walked into that care home and came out in a wheelchair and never walked again.

"I returned from our weekend to the sight of a carer trying to give Geoff a cup of tea that he didn't want to drink. He was batting her away, as it wasn't made how he liked it, but he couldn't express that in words. They recognised he was dehydrated and finally were able to get some liquids into him. It was an example of how a small piece of information can make a big difference."

A short time later, Geoff was placed into Iris Ward at Horsham Hospital, to be assessed for dementia. Whilst Zoe describes the care he received there as 'fantastic', Geoff's condition worsened. She said: "He couldn't feed or dress himself. It was never diagnosed exactly which form of dementia he had, as there are hundreds, but he may have had a mixture of several, including Alzheimer's and Lewi Body, which sometimes causes hallucination.

"On one occasion, he rushed into the road to save a little girl from oncoming traffic. There was no little girl there.
"It was terrifying for Geoff, as he thought he was going to stay young forever, and of course he not only lost his youth but also his mental capacity, which was dreadful.

"When he had this time in the assessment ward it was accepted that he had to go into a care home. I assumed that the assessment ward would be writing reams of notes to go with him, but Geoff had left with just one paragraph of information highlighting his basic needs. One thing he was prone to do was push himself backwards off his chair. They recognised this in Iris Ward so always put him against a wall.

"But I received a call from the care home and they said he had tipped his chair over. I said 'Surely you knew about that?' and they responded with a breezy 'Well, we know now, don't we!' That and the way he drinks his tea are classic examples of information that a care home should have."

This proved to be the trigger for Zoe's Care Charts. She started scribbling information down on Post-It notes, like how Geoff took his tea, and that he had his own teeth but could not brush them. The notes developed when Zoe decided to add some basic images to the notes, and created her first 'Remember I'm Me' care chart for her husband. It proved to be such a useful guide that the Activities Co-ordinator said 'I'd like to send the chart up to head office.'

The Care Manager there saw its potential and asked Zoe to produce 30 charts so it could be trialled amongst all of the residents. Everyone's problems are unique, but the common denominator is communication," said Zoe. "If they can't communicate their own needs and preferences, how do the carers who go into the room know what matters to them?

"One of the simplest things is your name, and what you like to be called. It might say John Smith, but actually you've always been known as Jack. If you just look at a chart it'll say John Smith, but the first thing on our chart is 'What I like to be called.' We've adjusted a few symbols and added others since that first chart. We always had personal needs, bedtime routines, allergies, teeth details, medicinal requirements, food and drink preferences and things like that. In the next version we added religious beliefs, mobility needs and important dates. We also have space for more information, because everyone is different.

"It is a very dynamic document and an easy way of communicating messages between carers and the family too, as it's all done with a removable marker pen. People found the chart an immediate help. One of the most powerful results of the chart is that it triggers conversation. One new carer looked at Geoff's chart and read that he had seven grandchildren and started talking about it.

"There is a tendency, which is quite normal, for carers to forget that the people in these homes are human beings. They can be seen as a list of medical or caring needs. You forget that they have a family, a past career and may have been influential in their day. Sometimes simply reading the information on the wall reminds you it is a human being you are dealing with."

Geoff Harris, a property developer who was well-known in Horsham, died in 2011, but Zoe was determined to carry on expanding the idea of the 'Remember I'm Me' care chart so it could help other people with dementia across the UK. As more care homes reported great feedback to the charts, more placed orders. There are now over 15,000 charts at 650 care homes, and a distributor is interested in offering the charts in America.

New products such as a twist and view version have been created, allowing for better privacy, and a file-sized version is ideal for people who do not want such detailed information on a wall. A pocket chart has also proved to be useful on occasions, as it allows paramedics and doctors to find out information quickly when a patient is transferred to hospital.

Zoe said: "The charts helped me make some meaning out of Geoff's illness and his death. Dementia is a dreadful thing for the individual and the carer. It can be all-consuming. Geoff was quite fortunate in that he was only in the care home for 13 months. Some live on for many years with a much-reduced quality of life.

"Geoff had a dreadful quality of life for a couple of years but these charts have made me feel that it hasn't been for nothing. My experience of his dementia led me to develop it and it is rewarding to hear that it was making a difference. I have incredible admiration for carers who do their job well. They get a bad press as we only hear about the bad ones but actually there are some excellent carers out there.

"There are some good programmes going on in places that are improving the level of care. But life history work can take months of collating information whereas these charts can be immediately helpful, especially in the first few days of somebody going into a care home.

"I work on the principle of being not for profit, with all money going into developing further projects. I'm selling a solution to a problem, and if there is a better solution then that's what I'd like to find."

For more details call 01403 210485 or visit www.carechartsuk.co.uk