An approach called Namaste Care is being used in some care homes to provide stimulating, comforting and person-centre care for people with very advanced dementia.
Park Avenue Care Centre in South London has been using the structured programme, which was developed in the US, for over two years.
Namaste involves one-to-one care during daily sessions in a comfortable, communal space with gentle stimulation of the senses.
Namaste brings people together to create a warm and positive environment as a person approaches the end of their life.
Staff say that Namaste allows them to change how they work without spending money on expensive resources.
Jargon, with its tendency to confuse and over-complicate, has a deservedly poor reputation. So it was with mixed feelings that I approached Park Avenue Care Centre in Bromley, South London on a quest to discover the meaning of ‘Namaste Care’.
Mid-morning and the lounge curtains have been drawn, the lights dimmed. A nature DVD plays on the TV, soft music replacing the commentary. From a sensory lamp in one corner of the room, undulating waves of light add to the sense of peace and calm all around. Do I detect the faintest hint of lavender in the air?
Residents with advanced dementia sit around the room in comfy, amply-cushioned armchairs. A trolley, laden with goodies, stands centre stage. Hand towels, face cream, hair care products and at least half a dozen named toiletry bags containing residents’ personal items compete for space with food and drink – water and orange slices, ice lollies and chocolate, yoghurt and biscuits.
A couple of people doze. Others chat quietly. Three care workers are present, each closely involved with someone. One is lovingly styling a lady’s hair. Another, seated on a stool so as to be close, is deep in conversation with a lady whose drink she holds between sips. A gentleman, completely at ease, watches as a male care worker massages his hands with gentle stroking movements.
Bindu Cyriac, the Deputy Manager, tells me that Namaste (pronounced na-mas-the) is a Hindu term that can be translated as ‘to honour the spirit within’. Many of her predominantly South Asian colleagues will have known the word long before arriving at this comfortable 51-bedded care home for frail older people, many with advanced dementia.
‘We were using some of these techniques before Joyce Simard, the Namaste Care programme’s American founder, visited us in 2001’, says Bindu. ‘The following year we were invited to take part in a research project, adopting the structured programme in full.’
Under the stewardship of the home’s Manager, Arlette Beebeejaun, they have not looked back. Their work attracts professional interest from far and wide.
In a nutshell, Namaste seeks to engage people with very advanced dementia through sensory input, soothing and calming through sound, touch, smell and taste. Delivered systematically, these care techniques take place daily, for a set time in a dedicated communal space.
Pampering for a purpose, you might say. Some of the benefits are immediately obvious to this casual observer – the one-to-one care and attention and that sense of peace and calm are particularly striking. But Bindu claims more for it than that.
‘People with advanced dementia and approaching death can still experience comfort and pleasure. Namaste brings people together, enhancing the lives of all concerned, including our care workers and relatives – they find the approach rewarding. It gives them things they can do.’
The clinical benefts, says Bindu, are also significant. Residents take more fluids, helping to maintain good skin and decrease urinary tract infections. Circulation is improved by massage and gentle exercise. Person-centred care makes assessment of pain much easier. The homes use less antipsychotic medication since the programme was introduced.
For Mary Crosby, Pastoral Assistant at nearby St Joseph’s Roman Catholic Parish Church, Namaste ‘nurtures a caring attitude in the staff’ and ‘a warm and welcoming atmosphere for visitors.’
Susan, daughter of Lilly, is grateful ‘for the quality of time it gives us’. With calmness all around, the hand massage Susan administers and which her mum so enjoys speaks for itself.
Comfort and dignity
Would Namaste be too costly and resource intensive for some settings? Bindu says the outlay on materials is minimal, and that it’s more about changing the way things are done.
A day’s training is usually enough to equip staff with all they need, and there’s no odenying it puts the onus on them to be tactile, attentive and compassionate. Why should we except or accept anything less for vulnerable people approaching the end of their lives?
Park Avenue’s excellent work shows that care for the frail elderly can improve through advances made in other settings, such as the multisensory rooms found in all good special schools or the holistic care provided by the best hospices.
I leave hugely encouraged. Namaste isn’t empty jargon, it’s a beautiful word, with the dementia-friendly promise of comfort, pleasure and a dignified death.