Namaste Care Intervention UK - careinfo.org · Namaste is a Hindu greeting which can be interpreted as meaning to honour the spirit within. Namaste Care is a multi-component daily

© The Association for Dementia Studies

Nicola Jacobson-Wright & Faith Frost---------------------------------------------------

Association for Dementia Studies

University of Worcester

Namaste Care Intervention UK

Implementing Namaste Care in UK care homes

1


Joint Working: AcknowledgementsCo Investigators; Caroline Baker (BarchesterHealthcare), Professor Darrin Baines, (University of Bournemouth), Roy and Ros Dibble (University of Worcester LINK group).

Collaborators; Joyce Simard (University of Western Sydney), Ladislav Volicer (University of South Florida), Min Stacpoole (St Christopher’s Hospice) John Killick (Dementia Positive).

Alzheimer’s Society Research Monitors; Rosemary Clarke, Peter Riley,

Elaine Beardsley-Turton.

With special thanks to participating Care Homes, Residents, Staff & Families.

Association for Dementia Studies, University of Worcester Research Team: Professor Dawn Brooker (Principal Investigator), Isabelle Latham (Research Programme Manager), Faith Frost, Nicola Wright-Jacobson, Dr Claire Garabedian, Teresa Atkinson & Jennifer Bray.


What is Namaste Care?

“Namaste” is a Hindu greeting which can be interpreted as meaning ‘to honour the spirit within’. Namaste Care is a multi-component daily intervention, developed in

the USA to reduce distress behaviours, depressive symptoms, pain, use of antipsychotics, hypnotics and

inappropriate hospitalisation in people living with advanced dementia. Namaste Care combines best

practice through a range of different care interventions, including physical, sensory and emotional approaches.


Namaste Care: Background

Joyce Simard, founder of Namaste Care in the USA - in response to lack of appropriate stimulation and activity for people with advanced dementia

Translating to a UK context, following up the work of Min Stacpoole at St Christopher’s, London. Collaborative project looking to learn more about implementing Namaste Care in practice.


Namaste Care: Overview and Key Elements

• Daily sessions of approximately 2 hours once or twice daily

• A dedicated ‘Namaste’ space for use during sessions –creation of a special sensory space

• A dedicated Namaste worker for that session – based on usual staff/resident ratio

• Provision of physical and psychological comfort, skin care, nutrition and hydration

• Focus on the 5 senses, with an emphasis on the use of therapeutic touch

• Opportunities to support improved end of life care


Once or twice a day - every day

“Namaste Care should be like lunch. When it’s busy or we’re short staffed we don’t say: ‘Oh sorry, we didn’t have time to give

people lunch’.”

Min Stacpoole

• A dedicated, undisturbed space

• A group of residents (4-10)

• No extra staff, but reorganisation of the team


Session structure

• Individuals are welcomed into the Namaste Room

• The Namaste room has low lighting, aroma in the air, images of nature and calming music

• Everyone is made comfortable – assessment of pain

• Repeated food and drink opportunities

• Hand massage and other sensory interactions

• Elements of nature and cues for the season

• Livelier interactions towards the end of sessions

• Session ends with thank yous and goodbyes


Researching Namaste Care

Establishing the theory &

evidence behind

Namaste Care

Learning from current practice of Namaste

Care in the UK

Implement the ‘Namaste

Care Intervention UK’ in 6 case

studies

Establishing the health economic

costs & benefits of

Namaste Care

Involving people living

with dementia

Developing an ongoing

community of practice for

Namaste Care practitioners

3 year implementation grant from Alzheimer’s Society to:

1) Explore the implementation of Namaste Care within UK care homes

2) Explore the impact and experiences of Namaste Care from perspectives of residents, staff and families.


Initial Findings: What’s going on already?

• There are pockets of Namaste Care Practice in the UK taking place in care homes, hospices and people’s own homes.

• The structure and content of this existing Namaste Care practice is highly varied and there is a need for more definition.

• An evidence base exists for some aspects of Namaste Care and this should be used to build a defined Namaste Care intervention

• Care homes are keen to start implementing quickly, but planning and patience are essential for success

• Finding ways to link and motivate practitioners over the long term is challenging

• There is concern and reluctance regarding the ‘twice a day, every day’ requirement


Initial findings: the Namaste Care Intervention UK


Namaste Care UK Training & Support: 6 Case Study Care Homes

Lead

ers

hip

Tra

inin

g 1 day training

For those who manage staff and resources

Focus on leading change and supporting team to implement Namaste Care in practice.

Info

rmat

ion

Ses

sio

n

Nam

aste

Wo

rker

Tra

inin

g 1 day training including an experiential element.

For staff who are interested in directly delivery Namaste Care.

Follow up sessions to support practice.

1 hour information session for whole care team, family and visiting professionals.Overview of Namaste Care UK and opportunity for questions.


Initial findings: how to implement successfully

• Genuine leadership from management is required from the outset and in practical ways

• Planning is more effective than rushing ahead • Enthusiastic ‘drivers’ in the care team are needed • It does not take extra staff, but it does take reorganisation and

support of staff – using a rota• A small enough group of residents to ensure sufficient care and

attention can be provided to everyone • Not every member of staff feels comfortable running the

sessions – that’s ok! Not to expect this role will suit all staff• Once people see the effects it will help motivation• It needs to be seen as a care intervention not an activity • It’s not as complicated as it seems


Initial Findings: getting started

“Once we’d started Namaste Care it made me a little sad that we hadn’t started sooner. (Residents who had

recently passed away) would have really benefited from it. It feel like we let them down by not starting

sooner,”

Having the project helped – it gave us a structure at the start. I’d identified my “research” staff and gave them

responsibilities, then we identified (a volunteer) for the session role. In the (other) home I will try to replicate that


Initial findings: positive outcomes for residents

Weight gain

Decreased agitation and restlessness

Increased alertness and awareness

Increased communication – “words when there were no words before”

More accepting of personal care – residents who struggle to have nails cut, hair cut etc. are able to tolerate it within Namaste care

Reduction of repetitive phrases or actions

“And the effects carry on outside Namaste too. Like L,

its like he’s a different person. Alert, looking

around. Before he would call out all the time and we just didn’t know what to do with

him,”


Initial findings: positive outcomes for residents

D is sitting in the high backed chair in her room as before, nightdress on and

dressing gown over the knees.. She crosses her feet, her hand fusses with the collar of her nightdress, then up to her hair. Her body language now seems agitated/activated compared

to before. Her eyes are open and she is repeating ‘please help me lord,

please help me lord’ over and over again, non-stop for the next 15

minutes.

A resident’s usual care experience

The same resident’s Namaste Care experience

D is brought into room in wheelchair by staff and transferred into a large arm

chair. She is repeatedly saying ‘Please help me lord, please help me lord.” No pauses, just over and over again. Namaste worker

comes over once she is in the chair and kneels down near her and puts her arms

around her, hugging her firmly and closely. She is soothing her, stroking her arm and whispering ‘shhhh, shhhhh’ quietly into

her ear. Towards the end of the minute D quietens down and stops saying ‘please help me lord’. She closes her eyes. She remained like this, occasionally looking

around, for over an hour.


Namaste PoemIt seemed to be about sitting quietly.

I think it was rather good.

It’s a change from the noisy things

we need to get away from.

It’s nice and cosy, isn’t it?

That we can sit here in peace and quiet

and hopefully be safe.

I like the speciality.

We had some fun today,

especially the bubbles.

We do get lots of laughter,

and I join in.

The people who run it

have obviously created

an interesting situation.

It does seem to work.

Residents’ words, captured by John KillickSeptember 2018


Thank you for listening!

Nicola Jacobson-Wright & Faith WrayUniversity of Worcester Association for Dementia [email protected]

http://www.worc.ac.uk/discover/association-for-dementia-studies.html

Photographs of people living with dementia taking part in ExtraCare Charitable Trust Enriched Opportunities Programme

mailto:[email protected]

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Namaste Care Intervention UK - careinfo.org · Namaste is a Hindu greeting which can be interpreted as meaning to honour the spirit within. Namaste Care is a multi-component daily