Changing care practices and culture in a specialised unit for people with behavioural and psychological symptoms of dementia

There are significant challenges in creating and maintaining positive care cultures for people with dementia. My Home Life is a UK initiative that provides staff with frameworks and tools to facilitate the development and implementation of strategies that support compassionate, relationship-centred care. Staff at a neurobehavioral unit used one of these tools, ‘A Way with Words', and developed this into a language intervention, flipping language, which was grounded by the principles of My Home Life. This qualitative study explored how flipping language impacted on care provision and culture in a neurobehavioral unit. Five focus groups were held with staff (n = 23) and family members (n = 3) to understand their experiences of the flipping language intervention which involved staff and families exploring everyday clinical communication with individuals living with dementia. Using reflexive thematic analysis, seven themes were identified from the data. Flipping language resulted in staff having a better understanding of the person which facilitated tailored support. Conversely, families believed that knowing a person fosters language about them being flipped. The power of language was highlighted by all participants. Families spoke about the impact that clinical language had on their care journey. Staff spoke about their experiences of the playful and curious approach to flipping language fostered a culture of openness and connectedness. In summary, flipping language was perceived to promote a care environment that was enabling for staff to connect with residents, families and other staff, facilitating personalised and relational care. Flipping language has the potential to be implemented in any care setting seeking to challenge and improve care practices and culture. Unique components of this study include the intervention being led by a lived-experience staff member.