JUDE BARBACK takes a closer look at the Spark of Life approach and how it is transforming dementia care around the world, including here in New Zealand.
To be honest, when I was first confronted with the Spark of Life approach, I was ever so slightly underwhelmed. A person-centred approach focused on meeting the emotional needs of a person seemed a lovely, but fairly obvious notion. Yet as I visited more rest homes and dementia units, I heard more and more about what a difference this ‘Spark of Life’ approach was making. I sensed I was probably missing something …
And as I became more aware of what dementia care involved, I realized what it was I was missing: just how challenging dementia care can be – not least because the people being cared for may not know they need care, or because they may have difficulty communicating their needs which can result in challenging behaviour.
With no cure in sight, and some skepticism around drug treatments, it seemed that carers, in both the home and aged care facility setting, needed to look to other methods in order to bring some joy and meaning to the lives of those living with dementia.
If I were a carer – and this is very much a hypothetical scenario; even with the benefit of training, I don’t believe I would be very good at it – I imagine it would be difficult to look beyond the daily motions of basic care. Simply ensuring residents are all dressed, clean, fed, toileted and so on, sounds rather onerous without factoring in engaging with them and enriching their lives.
I think my other issue with Spark of Life was that initially it seemed a fairly touchy-feely sort of approach. Talk of ‘lifting the spirit’ and ‘restoring happiness’ did not appeal to my practical, let’s-see-results way of thinking. How could such tactics bring the ‘lasting results’ the approach promised?
But there is actually a raft of evidence-based research out there to give the approach clinical validation. A qualitative study from Curtin University of Technology in Perth examined the perceptions of carers and families of the impact of the Spark of Life Club Programme on the personal and emotional well-being of people with dementia and found, among other things that reigniting the spirit helped people gain confidence, improve social and communication skills and reengage in life with renewed energy, demonstrated improvements in memory and were oriented in time, events and dates. The study also found that staff and family members perceived people with dementia in a new light, and recognised their potential for improvement and learning.
The Spark of Life approach hinges on the notion of person-centred care, a philosophy largely championed by Professor Tom Kitwood, who identified 17 negative behaviours of people in care environments. His concept provides a method to transform those behaviours into actions that lift the spirit and add to a person’s wellbeing.
In addition to Kitwood’s research, on closer reading, it transpires there are many scientific principles underpinning the Spark of Life approach. For example, quantum physics helps provide the scientific background behind the philosophy of igniting the human spirit, which affects the thoughts, which in turn affects the health of both body and mind. Occupational science acknowledges the importance of focusing on a person’s strengths and abilities, which helps them redefine their disabilities in terms of their abilities. Neuro-linguistic programming has also influenced Spark of Life by looking for the underlying cause of challenging behaviour, and identifying preferred sensory channels and tools for communication.
The Spark of Life approach is the brainchild of Australian Dr Jane Verity and began as a therapeutic club programme specifically developed for people with advanced dementia. When the results of this programme showed that people with dementia could improve, the framework and principles were then adapted to all levels of dementia and to the frail elderly. It was then researched as part of a Masters degree and from its findings the Whole Systems Approach to dementia care and rehabilitation was developed. Subsequently, Spark of Life as we know it today was launched in September 2007 and the first International Master Practitioners graduated from the Inaugural Master Course in March 2010, including some from New Zealand.
The Spark of Life approach is fairly new to New Zealand, but is growing in popularity among rest homes and dementia units up and down the country.
Mercy Parklands, a residential care facility in Auckland, has worked hard over the past four years to implement the Spark of Life Whole System Approach to dementia rehabilitation.
In recognition of its efforts, the facility became the first in the world to receive Centre of Excellence status for a specialised programme for dementia care.
Since the programme’s introduction in 2009, the facility reports a dramatic 51 percent reduction in the number of falls and an overall decrease of 31.5 percent in incidents of residents’ challenging behaviour. Most significantly, there has not been the need to transfer a resident to a dementia secure unit for the past two years, due to the improved understanding and management of residents. Nor have there been increases in medication or other forms of restraint.
This was achieved partly through a complete restructure of one of Mercy Parkland’s wings, providing a more homely environment for its 13 residents, all with dementia.
“The residents in this wing feel much more strongly that this space is their home,” says Helen Delmonte, the facility’s OT and manager of its Allied Health team. “The programme in place enables the resident more involvement in activities that are meaningful to them with participation in specific Spark of Life clubs and contributing to daily living tasks such as cooking and gardening. The environment helps facilitate rementia – recovery of lost abilities when the social and emotional environment becomes more supportive and understanding.”
And it isn’t just the residents who are benefitting from the changes. A 2013 Press Ganey survey showed improved resident and family levels of satisfaction, improved staff knowledge skills across disciplines. An impressive 41 staff have achieved certified Spark of Life practitioner status, including Master Spark of Life practitioner status for Delmonte.
The cynic in me is certainly quelled when I hear such success. However, I have heard some facilities describe Spark of Life as an ‘all or nothing’ approach; that it is only really effective if the whole package is implemented across the whole facility; that it doesn’t lend itself to working alongside other programmes or initiatives. Some have told me it is better suited to rest home level care and is not really sufficient for the more intensive requirements of more challenging residents, such as those in psychogeriatric units, for example. Then there is the cost to consider; Spark of Life is not cheap to implement properly and facilities do need to think very carefully about whether it is right for them before forging ahead.
But that isn’t to detract from the amazing things being accomplished through the Spark of Life approach in facilities like Mercy Parklands. It is not easy to pithily sum up what Spark of Life actually involves – the approach is so multi facetted, which is a reflection of dementia itself. It is easy, however, to take a look at the outcomes being reported from facilities all around the globe, to conclude that the approach is having a great impact on those with dementia, their families, and caregivers.