A black and white photograph of a street with brick buildings and old shop fronts with a horse and cart into front of them.
A photo of The Shambles in Worcester (1951) from the collection. © Worcester Historic Environment Record
A photo of The Shambles in Worcester (1951) from the collection. © Worcester Historic Environment Record

Worcester Life Stories: A Partnership Between Heritage and Health

A story of how a Historic Environment Record came to support Older People and People living with Dementia.

 

Developing the Worcester Life Stories Project

Five years ago, I was working on an inpatient ward at Worcestershire Health and Care Trust (as it was then). I was recollecting working for the Black Country Partnership NHS Foundation Trust, when our Occupational Therapist invited a historian to talk about the city of Wolverhampton.

For the people on the dementia and mental health ward, this event was an opportunity to come together, share their stories, hear facts never heard before and connect through shared experience. Reminiscence is known to enhance wellbeing, and a sense of connection and inclusion with others.

I wanted to do something similar with within my current Trust. In conversation with Sheena Payne-Lunn, an archaeologist at the Worcester Historic Environment Record (HER), which is the official Worcester database, an idea began to form. Within the HER there exists a collection of 35,000 images of Worcester from the 1950s onwards, a resource of great potential benefit to patients suffering from mental health issues if only it could be made accessible to them.

In considering how to exploit this material, Sheena spoke of an online platform called Know Your Place (KYP, 2020), first developed in Bristol by Peter Insole, Principal Historic Environment Officer. This provided online access to heritage material related to the historic city as well as an opportunity for the public to upload their own photos and memories.

As we discussed this further, I started to consider not only having ready-made ‘Worcester packs’ which hospitals, care homes and so forth could access, but also developing the ability for people to create their own personal digital Life Story. As a Clinical Psychologist within an Older Adult Mental Health Inpatient Service, I already routinely used life story work and reminiscence for people living with dementia who came into hospital.

Within our thinking we planned to extend the current offer by people being able to create a private digital life story where they would be able to draw images and information from the KYP platform, as well as by uploading their own memories and photographs. Two distinct but inter-related platforms were envisaged, one led by the HER and one by the NHS, but their unique character would be the interaction between the two.

We engaged other organisations which work with older people, for example housing agencies and carers, and these became stakeholders from the start. They could see the value of the project and the difference it could make to people’s live and their care. They pledged their time and commitment to the project, which was a genuine partnership between diverse bodies. The KYP platform is funded by the National Lottery Heritage Fund and Worcester City Council, and the Life Stories platform by the Herefordshire and Worcestershire Care and Health NHS Trust, and the developers of the platform VerseOne. Historic England pledged their support and agreed to fund the research looking into heritage and wellbeing.

The visual below encapsulates the idea and an outline of the project.

What we want to achieve

Life story work has been found to have a number of benefits for patients, their families and those who may be providing care for them. I strongly recommend the book Life story work with people with dementia. Ordinary lives, extraordinary people by Polly Kaiser for an excellent overview. Our ward life story books were usually created in word documents, with the families or friends bringing in photos and memories to hospital. Compiling the life stories could be time consuming, and there was an ever-present fear of important memories being lost. The books were held by the ward and a copy printed for the family.

When Sheena started talking about the HER and her hopes to develop a Worcester Know Your Place, Polly’s suggestion that Digital Life Story Work, as opposed to the traditional pen and paper methods, could potentially be a more powerful tool in triggering memories and enhancing relationships came more to the forefront.

Often it can be difficult to find photos but with the HER so accessible with the development of a public facing platform, it would be easier to pull meaningful photos or facts into a life story. It also means that people can more easily create their book from wherever they were, not just when they were coming into hospital. The ability to add sound would mean that another sense would be used. People could write or talk about the significant places in their lives, for example, school, where they were married, the hospital the children were born in and so forth.

Digital life stories have a number of benefits; they can be completed by family members who are not local, meaning important information is shared more quickly. It can be easily changed and updated. It can be shared in different formats e.g. printed, on a screen or shared as a scrolling video. Ward staff can access the life stories more easily, allowing them to share meaningful moments with the patient about their life when family and friends are not there as well as updating the life story if is needed.

Through this process I have been struck by the importance of place to our wellbeing. This has also been evidenced through Sheena’s weekly quizzes during the COVID-19 lockdowns, where people rejoiced and connected over pictures of ‘old Worcester’ online although they could not meet in person.

How we implemented the Life Stories project

Due to COVID-19 restrictions, face-to-face events with the public was not possible, but this made us more aware of how important the Know Your Place, and Herefordshire and Worcestershire Life Stories platforms could be in times of restricted physical access to archives and visitors coming into hospital, for example digital access would allow patients and their families to create online life story books without the need to come together.

For nine months we held a series of online workshops with the public, using our local stakeholders and social media channels to advertise the events. Two workshops were held to publicise the Know Your Place platform with the aims of introducing people to the upcoming facility, showing what it was capable of, and exploring accessibility and potential minor changes. Within the overall project, four consultation workshops were devoted to developing the Life Stories platform, starting from the original idea above and moving from initial concepts through to constructing the finished product. This was really interesting and took the platform further, especially through the voices of people who had worked with those who had had a stroke or who understood the barriers to older people accessing technology. All the workshops can be viewed on the project’s YouTube Channel

Although full integration between the two platforms was not possible at this stage, the Know Your Place platform is a feature of the landing page of the Life Stories Platform and the developers worked to ensure that copying an image would be possible so that users could easily add them to their Life Stories. Users report that it does not detract from either platform and that the increased accessibility for users was met.

The platforms can be accessed at the following links:

Our next steps

Within Older Adult Mental Health services, we recognise the value of knowing and understanding a person to be able to meet their needs, and the important role that heritage has in people’s lives. At a recent Dementia Programming Board meeting, the Clinical Commissioning Group Leads for Dementia across Worcestershire and Herefordshire were so impressed about how the Life Stories platform could be used for people living with dementia that they were keen to consider how to take the initiative into the future. They secured funding. As a result, the platform will now become part of an offer for people in hard-to-reach communities, and for people who are house bound, by taking the materials to them in the form of a ‘coffee and memory bus’.

As well as the Coffee and Memory Bus, the Life Stories platform is used within our inpatient services and we are working with the local Housing Associations to take both KYP and Life Stories into their sheltered schemes and homes. The Life Stories resource also forms part of our materials for people who have been given a diagnosis of dementia.

The success and importance of the scheme is evidenced by the fact that the Life Stories platform is being taken up by other Trusts as part of their offer for people across their life span and with a range of needs, for example in hospices, and in learning disabilities services. Know Your Place continues to grow and Pete Insole, developer of KYP has further examples of how the materials can be used. His ideas also pave the way for further health and heritage collaborations.

Because of the partnerships within the project, Museums Worcester is holding a series of workshops for people with early onset dementia through their Worcester Life Stories exhibition which is currently running.

Research

We have two research projects being undertaken, the first looking at Heritage and Wellbeing across both Know Your Place and Life Stories being led by the Association of Dementia Studies and funded by Historic England, and the second examining the use of the Life Stories platform in inter-generational engagement which is being undertaken by the University of Manchester.

For me as a Clinical Psychologist, I can see how heritage makes a difference for people living with dementia; the fact that others can see this too accounts for the expansion and development of the programme. I am so pleased that the partners in the project were able to come together because the interaction between Health and Heritage services has added immeasurable value to the scheme, to the great benefit of participants.

I sincerely hope that this increased understanding leads to many more collaborations.

About the author

Dr Natasha Lord is a Clinical Psychologist working with older people in Herefordshire and Worcestershire Health and Care Trust. Natasha’s main work is within mental health needs and she is the Lead for Psychological Interventions. Natasha is also very active in improving the standard of practice for older people. She is the Chair for the Accreditation Committee for the Quality Network for Older Adult Inpatient Mental Health Services (QNOAMHS) and Vice Chair for the Faculty of Psychology for Older People (British Psychological Society/ FPOP). She is also part of the FPOP Psychological Therapies Workstream. Natasha was nominated for the Una Holden award in 2014 for her innovative work for Older People Inpatient Services and a NHS Trust staff award for striving for older people in 2021. She won a Staff Award for Quality Improvement and for Patient Experience in 2016.

Further information

Kaiser, P & Eley, R., (2017) Life Story Work with People with Dementia. Ordinary Lives, Extraordinary
People

Know Your Place Bristol

Know Your Place Worcester 

Worcester Life Stories

Suggested Reading:

The Journal of Dementia Care has excellent articles on the different ways you can support people living with dementia.

The Faculty of Psychology of Older People Bulletin produces information on both people living with dementia and older people including interesting service evaluations.

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