Life Story Work
What a difference a story makes; using life story work to enhance care
Life Story Work is a tool to enhance the care provided to older people, particularly those with dementia. The benefits for individuals, families/friends and for staff providing care include improving understanding of the individual, promoting relationships and facilitating delivery of person-centred care. However despite increased emphasis on using life story work to support care delivery, there are often difficulties in implementation.
A range of life story tools are considered as well as tips offered for gathering life story information. The importance of leadership, facilitation and developing positive cultures, to ensure implementation and effective sustained use of life story work are also highlighted.
- Life Story Work is an activity which involves reviewing and evaluating an individuals past life events, in developing an individual biography of that person.
- It is used to help develop an understanding of a persons’ past experiences and how they have coped with changes in their life.
- Life story work is a shared activity between the person, their family carer(s) and staff as appropriate.
Life Story Work describes a biographical approach, which gives people the opportunity to talk about their life experiences. It involves recording relevant aspects of a person's past and present life with the aim of using this life story to benefit them in their present situation. The potential benefits of Life Story Work as an intervention for people with dementia and their families have been recognised for some time, in terms of promoting individualised care, improving assessment, building relationships between care staff and family carers as well as improving communication. (Clarke 2002, Bryan and Maxim 1998)
A template for putting together Life Story books has been developed by Dementia UK and the Central and North West London NHS Foundation Trust.
The chapter headlines include:
Introduction to my life (date and place of birth, parents, siblings etc), My childhood, My working life, Significant life events, Significant places, Significant events, Social activities & interests, Later life and retirement, My life now (What I Like to Eat and Drink, Things I Enjoy, My likes and dislikes) and My wishes for the future.
This framework is used by staff to collect information about the people they are working with in order to help them understand more about them and to provide information, which can help them to deliver person centred care. This is a collaborative process with family members and friends and emphasis is placed on using images and photographs to bring the life story book ‘to life'. The template can be adapted and updated according to individual needs or preferences and a copy can be stored electronically in case of loss or damage.
A recent project supported by the Foundation of Nursing Studies (FoNs) and Dementia UK involved the facilitation of life story work within 7 NHS Older Adult Mental Health in-patient areas. Admiral Nurses facilitated the work in each area using systematic approaches to developing practice and supporting staff members in developing their knowledge and skills.
The results of this project indicated where Life Story Work was successfully implemented within in-patient settings; this resulted in improved understanding of patients and family carers by staff. The experience of doing life story work was overwhelmingly positive and there was evidence that the delivery of care had become more person centred as result.
Whilst successful implementation of life story work was achieved within all the in-patient settings, outcomes were better in areas which had the following characteristics:
- Strong and consistent leadership
- Higher ratio of qualified staff to unqualified staff
- Context or culture that supports change and encourages communication
One family carer commented:
‘Doing life story work with my husband has made a difference to our relationship. I thought we had nothing in common these days but doing the life story made me realise we had a lifetime of experience and joy. My husband loves looking at the photos of us all'.
Resources and further information
The Life Story Project was developed by:
Rachel Thompson, Dementia Project Lead For the Royal College of Nursing and Admiral Nurse
Sally Knocker, Dementia UK Asscoiate Trainer and Director of The National Association for the Providers of Activities for Older People