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Understanding Dementia from the inside out

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Caroline Baker

Director of Dementia Care at Barchester Care Homes, dementia specialist and author

Barchester Care Homes’ innovative approach to dementia care aims to have significant impact on standards not only within its 200+ homes but in local communities and beyond.


Many of us have visited parents or grandparents in a care home but how would we feel about being a resident ourselves? It’s a question being tackled by dementia specialists at Barchester Healthcare, where Caroline Baker came on board as Director of Dementia in April 2015. Caroline and her team are developing tools and techniques with a strong element of empathy. She explains how in their new 10-60-06 programme, shortlisted for the 2016 Patient Safety Awards, “We get staff to experience life as an individual living in a care home – what it might feel like, not to have dementia, but to receive care.”

“We do things unexpectedly, such as starting to brush their hair without any warning. One became quite upset when given orange juice instead of tea – she felt her wishes had been disregarded.”

Their own reactions help them understand why a resident might jump in these situations.

“It’s important to share these learnings beyond Barchester staff”, says Baker. “Other care homes can take the 10-60-06 dementia care principles and develop their own approach, and the public can become more aware as we publish our latest findings. We’re providing new standards and taking dementia care to the next level.”

Her team are also developing tools to help understand the causes of stress for people who can’t always articulate. “Pain or depression can cause confusion,” explains Baker.

It’s not always dementia causing distress. We can look out for non-verbal signs, chart emotional states and relieve stresses wherever possible.

Activities can help considerably: as part of the 10-60-06 approach, each new Barchester resident receives a ‘Getting to Know Me’ booklet which helps to capture their interests and life history. An accompanying Board Game supports in the discovery, of what makes that person unique, whilst a slideshow of 1950s music and pictures created by the team proved to be “a massive hit – even quite isolated residents came out of themselves.”

Results from the 10-60-06 pilot also showed a significant increase in general wellbeing, including a 17 per cent reduction in the use of anti-psychotic medication, 11% fewer falls, and weight gain in 38 per cent of residents.

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