Living with dementia magazine, April 2010

For staff at the Limes, an Alzheimer's Society day support service for younger people with dementia in Bristol, the main aim is to ensure that everyone has a good day.

For the last 14 years, the Limes has been supporting younger people with dementia and their families. The service has become so popular it not only has an extremely long waiting list, but is frequently visited by other service providers as an example of good practice in dementia care.

The focus is entirely on the experience each individual with dementia has when they attend. A considerable amount of thought and care has been taken over every aspect of the service, from the dementia-friendly environment to the activities on offer, and of course the need for good staff who are trained in dementia care.

The Limes is open every weekday between 8am and 6pm. The extensive opening hours take into account the needs of younger people with dementia and their families, whose primary carers often still need to work. To attend, people must be under the age of 70, have a diagnosis of dementia and be continent and mobile.

Drop the label

Joanne O'Neill, Manager of the Limes, is insistent that the Limes is not a day centre. She says,

'We wanted to drop that label because there's a stigma attached to day centres. It doesn't readily describe what the Limes does and it's old fashioned. The Limes is more of a social club where staff support clients to enjoy their day and do whatever it is they would like to do.'

The activities take into account the physical needs of younger people with dementia. Clients can choose from tai chi sessions, walking, gardening, drum therapy, sitting gym sessions, and playing games and sports on the Wii player. Many people enjoy the regular Singing for the Brain sessions and taking part in quizzes or playing cards and board games.

Each Friday, Alan Hull - DJ Al - plays records from the fifties and sixties. Alan, 69, has vascular dementia and has been attending the Limes for the last eight years. He says,

I've always loved coming here. I do DJ-ing on Friday mornings and people get up and we have a dance. I used to be a teddy boy so I love that.'

Fun is a big element of the Limes. Joanne says,

'We spend a lot of time laughing and having a lot of fun. The themed days are hilarious. We had an Elvis themed day when we dressed up and ate burgers and chips and made knickerbocker glories. Then we did karaoke in the afternoon and watched an Elvis movie with popcorn.'

Clients are encouraged to choose what they want to do on the day. If a group activity such as tai chi is taking place in the lounge, the high client to staff ratio means there is tailored support for people who don't want to take part. For those who don't, internal windows and glass panels in doors enable people to see what is going on in rooms.

The environment

The Limes is based in an old school. It is a fairly small facility, which can accommodate nine people a day. A back door leads into a bright, homely room incorporating a lounge and kitchen. There is a separate dining room for lunch.

Joanne says,

'A lot of thought has gone into refurbishing the Limes, taking into consideration the latest thinking on what a good dementia care environment is. Everything is about minimising a person's anxiety and distress. There's a good use of colour with a sharp contrast between the furniture and walls.

'The most appropriate colours to use for highlighting things are red, yellow and orange, so we have red toilet doors, red toilets, and red furniture. The doors to the outside are yellow so they are bold and stand out, and the signage and arrows are on a yellow background. This helps people to remain independent without having to ask questions all the time.'

Michael Hancock is 62 and has fronto temporal dementia. He says,

'I come on a Wednesday and I really enjoy the social side of it. We have a good chat and a good laugh. We play games and walk around the area. When the weather's bad we can go to the café or go on the Wii machine - that's really good.'

Joanne says,

'I don't mind if clients can't remember what they've done when they go home, as long as they go home feeling that they've had a good time. Family members tell me that they are often in a better mood, and that the feeling can stay with them for days after.

'I think the service could be duplicated elsewhere, and why it isn't I don't know. I'd like to expand here. I'm just waiting for the secret millionaire.'

Watch a film about The Limes