Donald’s Journey Through Enablement

Donald had been a teacher. At the time of the Improvement project, he was living alone in his flat. He had family but no children. Over time he became depressed and alcohol became a problem for him. He was diagnosed with dementia and his family took out a Power of Attorney.

By the time he was 75, Donald had ceased to care for himself. He stopped washing himself and his diet was very poor. His self-neglect was so severe that he was doubly incontinent and had a sacral pressure sore. In 2014, he was admitted to a nursing home and Scottish Care Enablement Trainers started training the staff in the Enablement approach. Though Donald walked independently without any aids, he isolated himself, rarely leaving his room. He spent hours in bed, uncommunicative and very challenging with staff when they tried to encourage his personal care. It became obvious that he engaged best with one staff member. Though she only worked two days a week, he allowed her to tend to his wound.

The Enablement Trainers guided care home staff to write support plans which ensured that all staff behaved in a consistent manner with Donald. They were to warmly and gently engage with him to win his trust but allow him to set his own pace. The staff did not give up on him and gradually, over nine months, Donald started to engage with his daily care. His family remained supportive and through them it was discovered that Donald loved dogs. Therapets were brought in for him.

By 2015, Donald was no longer incontinent, he washed daily and changed his clothes appropriately. Regular medication and a nutritious diet improved his mood and bodily functions. He liked to help so he was given the task of serving the drinks at mealtimes. Then he began to help with the garden, enjoying weeding and picking up litter. He took such an interest in his life that he would edit his own support plans, deleting certain instructions and writing ‘I can do this’. It was important to him to remember staff names so he wrote them down and always addressed staff by their proper names. He expressed a desire to go into town, so working collaboratively with his family, Donald started taking the bus into Aberdeen. Initially he was accompanied but over time he became fully independent.

By 2016, it was mutually decided that Donald could leave the nursing home. He has since moved into sheltered accommodation. Before he left, he got a card and had each staff member sign it as a memento.