I’m often asked during training: “How can we measure quality-of-life and happiness?” It is a good and seemingly complex question.
Of course, there are observational tools such as MCM’s Quis and Dementia Care Mapping (a much more complex tool that requires specialist training, which I undertook some years ago).
However, I think we instinctively develop the main skill for measuring happiness from birth and parenthood – that essential skill? Observation.
I was reminded of this when my 10-month-old great-niece visited yesterday (Covid restrictions have meant we haven’t seen her as much I would like). Isla taught me a valuable lesson in measuring well-being and happiness.
Initially Isla was a little disconcerted – my two cocker spaniels were very over-excited: her eyes crinkled up, her mouth turned down – I feared she may cry.
So, I exaggerated my facial expressions into a big smile and said “Hello Isla.” Almost instantly, her demeanour changed: she made a half-smile; I smoothed her cheek: I got a full-beaming-smile and her eyes twinkled.
Obviously, Isla cannot communicate her well-being and happiness verbally. Nevertheless, through her body language, facial expressions, verbal sounds etc. I could ‘read’ her mood: through observation!
As we develop as babies, through childhood to adulthood, we become (I believe) increasingly reliant on verbal (and written) communication to express our feelings and emotions. I would argue that we neglect our observation skills, even our listening skills.
Take the word SILENT. Do you notice anything about the word?
If you rearrange the letters, you get the word LISTEN.
In other words, to actively listen we need to silence our instinct to interrupt, reflect our feelings/opinions, or our ‘noisy-wandering-thoughts’ (What I will have for dinner tonight?).
It’s human nature to do these things, so we mustn’t criticise ourselves for it – just be aware that actively listening requires being silent in words and thoughts, so we can truly listen and properly hear others.
Isla reminded me of all this in her visit. The changes in facial expression that told us that she was upset whilst toddling around and tripping over; when she was getting hungry; when her nappy needed changing! (She may not appreciate me mentioning that in a blog when she gets older!)
So, what does all this mean for measuring quality-of-life and happiness in people living with dementia?
It’s important that we shouldn’t think of people with dementia as babies or children. However, many care-workers say to me: “It’s so hard working with them because they can’t communicate with us and tell us how they are feeling.”
My response is that dementia care-work is obviously very hard work. Nevertheless, it doesn’t have to be complex, especially if we draw upon those skills that we developed from birth and we instinctively use as parents, aunts/uncles, grandparents etc.
My point is that we need to change our expectations of people with dementia. For example, I didn’t expect Isla to articulate her feelings or needs through words. However, she did express them very clearly and eloquently – especially when my over-excited dog Oscar whacked her face with his tail.
Sometimes, we focus on the wrong things (the things a person with dementia cannot do, rather than what they can do). So perhaps, the first step in measuring quality-of-life and happiness is to focus on the small things – that sparkle in the eye, the sounds a person with dementia makes or that tiny change in facial expression.
In ‘Magical Moments’ – Part 2 of this blog, I’ll share some practical examples of how I’ve observed magical signs of happiness and well-being.
Some questions for learning and practice development
- What parts of this article rang bells for you, what are the main insights, how did you feel whilst reading?
- How do you currently assess how people who are in your care may be feeling?
- Think of a baby or young child. What are the things you see, hear or sense that indicate if they are feeling happy, sad or angry?
- What signs of well-being and happiness could you look out for when observing people living with dementia in your care-setting? (Agree a list with team-members)
- How can you develop your observation skills in your care-setting? How can you make this part of the daily routine?
Associate Trainer
MCM