In 2006 Gentofte Public Libraries renewed and modernised the library service at one of the nursing homes in the municipality to make it more streamlined and relevant. The service has been a success and has resulted in an increasing demand from other institutions in the municipality.
Is library service in nursing homes still a relevant offer? And are librarians still the most relevant facilitators in a nursing home? In its old shape and form – not any more, but maybe if the service is adapted and the role of facilitator developed.
Change in the composition of residents
The senior policy of “As long as possible in your own home” has been a decisive factor in the change of composition of residents in Danish nursing homes over the past few years. Today, we are talking in terms of many of the residents suffering from dementia; their reduced ability to cope with everyday life, poor memory and confusion have meant that they cannot any longer manage in their own homes. The libraries have, therefore, also been forced to change their service to the nursing homes to make it relevant to the target group. A service not adapted to residents with dementia would be irrelevant.
Dementia is a condition where brain function has been reduced. The most important symptom is reduced memory, but also the ability to reason and one’s judgement is affected, and often there will be changes in the person’s personality, mood and behaviour. As a rule the person suffers from reduced short-time memory, and forgets what happened hours or minutes ago, but often has no problem in remembering what happened many years ago. It is therefore often memories from childhood and youth that seem most vivid.
The nursing homes are more and more concentrating on stimulating people with dementia socially in the form of reminiscence work. By evoking memories a person’s identity can in some cases be reinforced, thereby increasing the quality of life. In other cases it might just produce the good feeling of something recognizable for a brief moment.
Dementia can cause changes in the perception of reality, so that evoked memories can mean that the person experiences a feeling of living in the past.
As a librarian and unskilled in reminiscence work I could easily make a wrong move. I might, for example, recommend to an older gentleman an illustrated book about the resistance movement from the Second World War, which might have been quite an excellent suggestion, if he did not suffer from dementia. Because he has dementia, he could – if he has had a traumatic experience in connection with the Second World War – by remembering it suddenly perceive himself in the midst of the atrocities of war. Firstly, due to my lack of insight into dementia I would not realise the kind of risk I was running, and secondly – I would not know how subsequently I could help him to get out of the war again!
Apart from their professional competence in relation to dementia, nursing home staff have an insight into the former lives of their residents, and they also have their trust, which are important factors in a mediation context.
The new library service
Previously I would be pushing the book trolley round six wards, that is to say after 2 p.m., because the residents were having their midday rest. When I arrived, they were either just waking up, had gone to the toilet or on their way to the lounge to have a cup of coffee. Altogether it could be quite difficult to get to talk to the residents, and when it did happen, I felt that most of them rejected me, which is understandable as they neither knew me nor read books.
The actual mediation of the library service is now placed with the staff on the individual wards. And this mediation is done when the residents have plenty of time and by people they know – and as such this is a much more user-friendly library offer.
In the future the nursing home staff will make sure that the residents are informed about both materials and any other services the library has to offer. By working in an interdisciplinary way with the staff and letting this cooperation happen as an iterative process, where the service to the common target group is constantly evaluated and developed on the basis of both professional groups’ knowledge of both target group and the library’s possibilities, it will at any time remain a relevant library offer.
In the nursing home in Gentofte Municipality, which has implemented the new library service, one library contact among the staff in each of the six wards was chosen to handle and order changes to the ward depot.
The ward depot arrangement works out differently in the six wards and to a great degree reflects the staff ’s involvement. There is no doubt a definite connection between success and active, targeted mediation of the library materials.
“They have started chatting to each other in the lounge”
In one of the wards the success has really exceeded our expectations. This is Mona Lisa’s ward, because she is a great enthusiast who is very keen on reminiscence work. The first time Mona Lisa called me to arrange a change of depot, she said, “They have started chatting to each other in the lounge”.
Before, they would just be sitting there, staring into space, without making any contact with each other. Often the residents have not asked to go into a nursing home, but have been placed there. Apart from not knowing each other and perhaps not immediately having anything in common, they might not be able to remember how to start a conversation, and what one really talks about.
Now they suddenly started talking – because of the books. An elderly gentleman, who was looking at a book with pictures of cars from the 40s, pointed to one of them and said to the person sitting next to him, “I once had a car like this – it was green”. The other person looked at the car and answered, “My father had a red car”.
Mona Lisa interviews the residents and is interested in information about both their own and their parents’ previous jobs, leisure interests etc. That is why I know that one of the residents in the ward worked on the building of the old Lillebælt Bridge, another was a cabinet maker and a third always enjoyed visiting the Louisiana Art Gallery. My knowledge of the residents is obviously reflected in the materials I select for the ward depot so that these can meet the residents’ needs in the best possible way.
Last time I spoke to Mona Lisa, she said: “Isn’t it wonderful, they now carry picture books in the baskets on their rollators, they bring them everywhere and are so fond of them. One even took a couple of books with him for the Christmas holiday with his son.”
Cooperation between library and nursing home
My ‘contacts’ and I have evaluation meetings where we exchange experiences from the different uses of the scheme, and adjust this to suit both the institution and the library. At these meetings I also tell them about the library’s various types of material and other offers.
Apart from my ward contacts, I have a primary contact in the nursing home, namely the head of the activity centre, with whom I have agreed and developed the primary framework for the scheme.
As something new, and together with the local-historical archive, I have produced two memory bags with original objects which evoke past events and feelings: One featuring the theme ‘school’ and the other ‘Sunday out of doors’; these two bags are to be tested in two of the nursing home wards and in the activity centre. This is a pilot product meant to examine the need for the loan of such library material to be used in reminiscence work.
So naturally, the libraries must also lend yesterday’s objects!
Gentofte Public Libraries
jeal AT gentofte.bibnet.dk
Translated by Vibeke Cranfield