LBU Impact Series: Pioneering playwork in a dementia care home

Playwork and dementia

Dementia is one of the leading causes of death in the UK. Around 900,000 people are living with dementia in the UK with that number set to increase as the population ages. Of the 440,000 people living in care homes across the UK, 70% have dementia or memory problems.

A better understanding of the needs of those living with dementia and effective person-centred care can significantly enhance their well-being and that of their families, friends and carers.

Playwork has enormous potential to improve quality of life. Playwork regards play as critical to children’s healthy development and well-being.  The play process is controlled by children. Limited adult intervention can support or protect children’s play, whilst preserving the child’s control, freedom and flow of their play.

Playing in this way is widely regarded to have autotherapeutic benefits and is associated with increased positive affect.

Bringing playfulness to a care home

With applied backgrounds in creative, arts and play-based interventions, we teamed up to devise, implement and evaluate a pilot study to see whether the benefits of playwork for children might also be experienced by care home residents living with dementia. We put together a playwork team, including final year students, to deliver weekly hour-long play sessions in a care home in Leeds.

Eight residents participated in the play sessions that included open-ended play materials that the residents could use in whatever way they chose These included cardboard boxes, balls, hoops, cones, balloons, juggling balls, beanbags, skittles, tennis racquets and many other items bought from the incredible Scrap in Leeds.

An immediate impact

Play, from the point of view of a playworker, is constrained only by the imagination of the player, and it was evident from the outset that these players weren’t going to be constrained.  Over the course of the five sessions, we saw residents develop relationships with one another that allowed them to play in increasingly complex and collaborative ways.

Those who had never previously spoken or responded to the care home’s attempts to engage showed signs of enjoyment through facial expressions and sounds celebrating victory during the sessions. Residents who’d been assessed as having restricted mobility got up from their seats to kick, throw and bat balls and balloons across the room.

Each play session was characterised by high levels of laughter and energy and as each week went by the energy-levels increased. This culminated in a final session in which residents built tall towers of carboard boxes that they enthusiastically demolished by kicking them over and knocking them down with balls and bats. The care home’s Wellness Coordinator believed that the high energy and freedom given in the sessions was one the key reasons why residents had a higher level of engagement in the playwork sessions compared to other activities offered in the home.

Promising results

Our research paper is currently under review, but the findings of this innovative intervention are positive.  Residents who engaged in the playwork programme demonstrated heightened social interaction and engagement with one another that lasted beyond the duration of their play. There was a sense of increased recognition amongst the residents, some of whom appeared to recognise the playworkers and look forward to the sessions. The Wellness Coordinator felt that taking part in the sessions led to an improvement in residents’ mood and observed significant change in one particular resident who had previously never shown positive emotions while at the care home.

The project’s benefits were also felt more widely by carers and family. Care staff commented on how they had uncovered new aspects of the residents and began to reassess their capabilities, and some found the experience so enjoyable that they voluntarily skipped their break to keep playing with the residents. One of the resident’s family members reported a much more positive visiting experience, which was attributed to their engagement in the playwork programme.

"We don't stop playing because we grow old. We grow old because we stop playing."

The playwork students’ perception of dementia has been transformed during the pilot project. It has also opened their eyes to potential new career paths, with half of the group now considering a career with adults as an option.

We’re now working on funding applications and with external partners to continue this work, including Play Bradford.  Play Bradford has recently employed one of the student volunteers who graduated last year, and has secured funds to put some of what has been learned from this project into practice through a co-production of a sensory garden with people living with dementia.

We are disseminating the findings of this pilot project at the National Dementia Congress and National Playwork conference, and interest within both sectors is unsurprisingly growing. In words attributed to George Bernard Shaw: "We don't stop playing because we grow old. We grow old because we stop playing."

With thanks to Anchor care homes for hosting the pilot research.