Caring, are or Have you cared for a loved one with dementia? Then your words can help

Caring, Have you cared for a loved one with dementia? Then your words can help

Hi  

I have been collecting life stories, thoughts and opinions from people over the few years that has helped me to paint a picture of caring for a loved one with dementia.

I have taken the information from these letters to the Scottish Government, Social Work departments in Councils, NHS and beyond.

My promise is to do all I can to raise awareness to wider society. I am using the life stories, thoughts and opinions to the people I feel need to hear them. Not as a petition, not in protest, but to bring more understanding and raise awareness of the lives we lead. Can your story help others? If you would like to help me do this, then please send your thoughts to tommy@i-woz-there.com, or complete our online survey here.

The letters I have received to date have raised motions at councils and produced papers at SW with more papers in the pipeline.

I hope your words can help me do this

From Crowded rooms to this empty house and heart

From Crowded rooms to an empty house and heart

2013 had been a busy year .I have had the great privilege to have been the guest  speaker at many talks ,met so many amazing people in person - on social media and read their life stories 

It has been a hectic year . I am grateful for the opportunities to raise awareness as this in my passion and to be honest I have not had much time to think between talks and travelling. But each time I return  home and approach  the house in darkness ,the emotions of the six years caring for mum and all that has happened since hit hard 

I sat in the sitting room in the dark as I have done a few time before and it all got a bit much almost not wanting to walk up the stairs to the empty room that mum was confined to over the last months of her life and for longer this house felt more like a prison thank a home for us both And I just miss her

My wee ,mum in amongst our struggles and over the last  years was my best  pal .I have spent the last year  in crowded rooms speaking at events and in meetings  but in many ways papering over the cracks of a broken heart .And my heart IS broken.

We suffered great loneliness over the last years but I was never truly lonely not with my  mum by my side. Tonight I feel lonely and so sad inside for a mum who deserved much better than   she got and to often I was able to give

I struggle often coming home from those crowded rooms to an empty house and this empty heart  and I miss my wee mum who no matter what she faced made sure her big boy was ok

Tommy

Merry Christmas

Hi

It's Christmas morning and a quiet day of reflection on the past year,and years gone by.

I have had many emotions,had a wee cry this morning and then a smile from my heart thinking of childhood Christmas mornings ,how special they where how special both mum and dad made them growing up 

Someone kindly called late last night to ask if I would be ok on my own.To be honest the last seven years have been quiet affairs.thats the life of caring or living with a long term condition all to often 

Days blend into one,weekends ,weekdays and holidays all become one and the same 

But you ,we can change that for people ,we can include,involve and encourage others not just on Christmas Day but on any day we choose .so make that call, knock on that door, your support ,kindess,inclusion and encouragement is a wonderful gift to give and can be given on any day you choose ,you might just make someone's day ,you might just change theirs and your own life even if just for a day 

Thank you for the kindess shown to my wee awareness campaign,to me and to others 

And as you sit with family today tell them you love them and remember the ones no longer round the table 

Merry Chritmas and thank you 

Tommy 

Glasgow December 2013 

My campaign is not a petition or protest it's about love and life stories

Hi 

My tommy on tour campaign, now Dementia Carer Voices started whilst caring for my wonderful mum as a result of the struggles we faced, the crises we tried to avert and the way that for so many people, my mum became defined by her condition.

My mums life was a love story, full of kindness and understanding and I struggled to keep that love story going over the 6 years caring for mum. It felt too hard too often and the painful loneliness we felt still hurts till this day. 

Of the letters I have received to date, many are difficult to read to, others make my heart smile but they are all, in essence, love stories. That's the point of this campaign, as a society we should be doing all we can to support and encourage love stories, keeping tragedy, fear, isolation, loneliness and lack of understanding as far away as possible.

In every case it has been the kindness and understanding of others that help and the lack of both that hold people back. 

Yes we need policies, strategies, rights, but they mean nothing if not in the hands and hearts of the people we meet, the people who we engage with when needing care or support. 

I truly believe our experiences good or bad can help others understand how important the part play matters 

You can help me ,we can help others by sharing your story at tommy@i-woz-there.com 

My promise is the same promise i made to mum the day I started this awareness campaign to take those life stories to all who need to read them ,who have to read them to understand the part they should play and can play. 

Kindness and understanding and a human listening understand ear can make the biggest difference of all. 

Tommy 

'Living it Up' Community Engagement Year One Report Now Available

The end of year one report for the Living it Up Project is now available to download here. The report aims to describe the activities of the Community Engagement Team (CET) during the first year of the project

Living it Up is a three year programme working with five local partnerships across Scotland aimed at empowering people to improve their health and well-being.

Living it Up will deliver innovative and integrated health, care and wellbeing services, information and products via familiar technology enabling people to keep better connected with their communities and those they care for and receive care from. These technologies will include TV, mobile phone, games consoles, computers and tablets.

The five partnership areas are - the Western Isles, Forth Valley, Lothian, Moray and Highland/Argyll & Bute.

It is initially aimed at the over 50s but will also be of benefit to people living with long term conditions, care givers and those who just want to keep healthy, happy and safe.

Thank you all the team Royal Alexandria Hospital Paisley December 20th

  

 Hi

With great thanks to Tracy Donaldson and all the team who attended  my wee awareness talk  earlier today
at the Royal Alexandria Hospital Paisley

Today was my last talk this year ,so a wee bit emotional

Thank you to all the who took time to attend

Hi 

With great thanks to Tracy Donaldson  Practice Education Facilitator.NHS GG&C Acute Services RAD/Regional Services for inviting me to speak to staff at Royal Alexandria  hospital Paisley on December 20th 

I have been invited to speak for Tracy Before and it was Tracy who kindly nominated me for the NHSGG chairmans awards which I was awarded last month 

So thank you Tracy for the invite to speak to the team and a thank you once again for the wonderful kind nomination for the chairman's award

Thank you for the kindness thank you from a son 

Tommy 

Dementia Carer Voices -Resource Page - Films - Information -Links -surveys

Dementia Carer Voices is a Scottish Government Project funded project to 2016 to engage with Health and Social Care professionals and students to promote a fuller understanding of the carer journey, provide a platform where carers can express their views and experiences of caring for a loved one with dementia and to harness the awareness raising activity undertaken by Tommy Whitelaw. 
Find out more about the project
Have a look at the project's most recent resources
Meet the team
Browse upcoming events
Browse all of our videos and resources (links to the project's resources page)

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The Project:

• Captures the experiences of carers across Scotland with a view to informing future policy ans service provision
• Raises awareness of the issues around caring for someone with dementia including among health and social care professionals, students and the wider public
• Highlights the role of carers as natural resources; carers as people with needs; carers as people with independent lives
• Empowers carers by providing information based on the Charter of Rights and Carers Strategy about caring for someone with dementia

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Most recent project resources:
Read Dementia Carer Voices e-News Issue 6, the latest issue of the team's newsletter. You can sign up to recieve future updates by clicking here.
The project team have put together a short survey to enable them to capture key messages from carers which will be used to influence future policy.

If you have experience of caring for someone with dementia you can contribute and have your say on your hopes and concerns for the future by visiting 
http://www.surveymonkey.com/s/V7SYL2G 

Dementia Carer voices welcomes the launch of Scotland's National Action Plan on Human Rights and fundamentally supports the objectives of the Charter of Rights for People with Dementia and their Carers, which adheres to the PANEL approach to carers rights - that is that carers have the right to

• Participate in decisions which affect their human rights;
• Accountability of those responsible for the respect, protection and fulfilment of human rights;
• Non Discrimination and equality
• Empowerment to know their rights and how to claim them;
• Legality in all decisions through an explicit link with human rights, legal standards in all processes and outcome measurements.

For more information about Dementia Carer Voices' human rights based approach click here .

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Meet the team:

From left to right: Christopher Doyle, Laura McCulloch, Irene Oldfather, Tommy Whitelaw
Programme Director Irene.Oldfather@alliance-scotland.org.uk
Project Engagement Lead Tommy.Whitelaw@alliance-scotland.org.uk
Policy & Information Assistant Christopher.Doyle@alliance-scotland.org.uk
Administrator Laura.McCulloch@alliance-scotland.org.uk
Telephone – 0141 404 0233

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Upcoming events:

20^th – Celebration of Caring in Scotland Concert

21st - speaking Watford starlight center 

22^nd - Speaking at London 6Cs Live  Conference

27^th - Speaking at Carers Event in Birmingham

February

3^rd - Speaking to Edinburgh University Nursing Students

5^th - Speaking at St Andrews Hospice in Airdrie 

6^th – Presentation to NHS Education Promoting Excellence Board (Morning)

6^th - Speaking at University of Abertay Dundee (Afternoon)

17^th  – Speaking at Royal Edinburgh Hospital

19^th - Speaking at Victoria Hospital in Kirkcaldy

24^th - Speaking at Palliative Care Conference in NHS Highlands

25^th, 26^th and 27^th – Speaking at NHS Grampian - 3 day tour

March

5^th – Speaking at conference in Argyll

19th - speaking Caledonian university 

28^th - Speaking at conference in Middlesbrough

April 

10th - giving 2014 Dementia MasterClass Caledonian Universty 

Dementia Carer Voices engages with Health and Social Care professionals to highlight the importance of a person-centred approach to dementia care, with carers as equal partners. If you would like to organise an event for your staff or colleagues, please contact Tommy.Whitelaw@alliance-scotland.org.uk. 
Follow Dementia Carer Voices on Twitter  .

G8 Dementia so many unanswered questions - so many broken hearts

Hi

So last week we had the G8 Dementia Summit and below is a brief outline of promises and I think predictions 

What I did not hear was any discussion or answers to the questions we asked each day whilst caring for mum ,from the letters I recive ,from the people I meet 

Another day another announcement of what might be, and there is a theme ,we need policies and strategies ,but how many times do the ideas or promises come knocking on your door ? 

In my experience not often enought 

We need a reality  check on dementia and the impact it has on families ,less talk ,less rhetoric more action ,kindness understanding door reaching  and support for families is what we really need 

Below is a letter I Recived a few months ago and none of the answers or promises seem to  answer the questions below from the G8 summit , it means nothing to me Oh Vienna 

Dear Tommy - March 2013 

I am writing to see if anything can be done to help Us 

I am 80 years of age and my husband almost 77 years old and he suffers from VASCULAR DEMENTIA and life is very tough for me as his carer.  He is in the middle stages of Dementia.

As said I am finding it very tough and there is no one to share and help me get through.  I feel so low at times and so VERY LONELY – I NEED a human listening ear and also an understanding one.

Family do not seem to understand – only the person or the carer who lives with  dementia  knows what it is like.

We have been married 53 years and had a very happy marriage until my husband took dementia now I Am  LOSING MY  MARRIAGE AND LOSING  MY HUSBAND.

PLEASE CAN ANYONE DO ANYTHING – TO HELP US .

Yours truly

Summit round up 

At this week’s G8 summit on Dementia, called by the UK as part of its presidency, health and science leaders agreed a package of measures to address the growing global health, social and economic issue of the condition. Currently 36 million people across the world have dementia and the World Health Organisation predicts that numbers will nearly double every two decades.

The commitments made this week by the G8 countries – Canada, France, Germany, Italy, Japan, Russia, the UK and USA included;

• setting an ambition to identify a cure or a disease-modifying therapy for dementia by 2025 – backed by a commitment to together significantly increase the amount spent on dementia research and increase the number of people involved in clinical trials and studies on dementia;
• a new Global Envoy for Dementia Innovation, following in the footsteps of global envoys on HIV and Aids and on Climate Change – the Global Envoy will bring together international expertise to stimulate innovation and co-ordinate international efforts to attract new sources of finance, including exploring the possibility of a new private and philanthropic fund to support global dementia innovation;
• developing an international action plan for research – in particular to identify current gaps and how to fill them; sharing information and data from dementia research studies across the G8 countries to work together and get the best return on investment in research; and
• encouraging open access to all publicly-funded dementia research to make data and results available for 
• further research as quickly as possible.

Today Invited to speak to the Regional Services Deputy Charge Nurses Beatson

Hi 

With great thanks to Margaret Coleman senior  Organisational Development Advisor Old Medical Refectory Stobhill  Hospital for inviting me to speak to Deputy Charge Nurses. from the Beatson Oncology Unit, Renal, Spinal, Neurological Sciences and Theatres.December 16th 

I look forward to speaking about my wonderful mum ,the letters I receive ,the letters I receive people I have met on my tour 

Thank you Margaret 

Tommy 

Today speaking at performance ‘Seeing Auntie’ play Caledonian University

Tuesday 17^th December 2013 Dementia Awareness and ‘Seeing Auntie’

Hi 

with great thanks to Caledonian University for inviting me to speak at  the performance   ‘Seeing Auntie’ play

thank you to all involved and i look forward to both speaking and attending

we will also have a Dementia Carer Voices information stand 

  

09:30                   Registration and networking

10:00                    Professor Stevenson; Welcome / aim

10:10                    Seeing Auntie; Breeze   Productions  

10:50 -11:20        Tommy Whitelaw; Dementia Carers Voices Project  

11:30                   Patient Information Centre Team; who we are and what we do

11:45                           Gill Ryan; NHS Education for Scotland Equal Partners in Care (The EPiC Project)          

12:00                   Andy Lowndes: Connecting music, people and memories (Playlist for Life)

Stands                         Alzheimer's Scotland;

Carers Trust;

Equal Partners in Care (Epic) 

Project; Dementia Carers Voices Project 

POWER OF ATTORNEY - START THE CONVERSATION advice - films - website

POWER OF ATTORNEY  -  START THE CONVERSATION

Link to website http://www.poastarttheconversation.org.uk/ 

 twitter @starttalkingpoa

A new campaign is being launched across Glasgow City to raise awareness about the importance of having power of attorney granted to a trusted relative or friend.

NHS Greater Glasgow and Clyde and Glasgow City Council have joined forces with Alzheimer Scotland, Scottish Care and local law firms to highlight the need to ‘Start the Conversation’ with family members on putting a power of attorney in place.

The campaign aims to encourage people to talk to their loved ones about establishing a power of attorney so that if the person takes ill and is unable to make decisions someone can step in.

Having a power of attorney in place really can make a difference and can ensure that people’s wishes are carried out quickly without prolonged legal negotiations.  If a loved one is in hospital and there is no power of attorney this can delay the patient’s discharge and have them remain in hospital longer than necessary. 

The campaign includes three TV adverts to be shown at peak view time from Sunday (December 1^st) featuring the actor/director Johnnie Beattie and his daughter Maureen, and acting/broadcasting brothers Sanjeev and Hardeep Kohli. 

The campaign has a dedicated website http://www.poastarttheconversation.org.uk/

which provides valuable information and highlights the case of three families and their experiences in putting a Power of Attorney in place.  Additionally, the campaign has utilised the power of social media to reach people with a Facebook page and a twitter feed.

Jill Carson, Adult Services Manager, North West Sector, Glasgow City Community Health Partnership, said:  “A lot of people don’t know that if they become ill or injured and are unable to make decisions for themselves no-one else can do this for them unless legally they have been given power to do so.

“There is also a misconception that Powers of Attorney are for the wealthy or elderly but anyone over the age of 16 can grant a Power of Attorney as accidents or illness can happen at any time.

“A Power of Attorney is not just about looking after someone’s financial affairs.  It also allows for welfare issues to be decided if someone is unable to make a decision about medical treatment or about where to live.  This can be the biggest problem facing someone in hospital.  For example, if no-one is appointed to act in the patient’s best interests, then a legal process is required before the patient can be discharged to an appropriate setting such as a care home.  

Ann Cummings, Glasgow City Council Social Work Planning and Performance Manager added:  “Social work services fully supports this campaign to promote advanced decision making through Power of Attorney with the citizens of Glasgow. 

“Social Work is in a difficult position where someone lacks capacity and there is no Power of Attorney in place - in terms of the law we are unable to move someone without their consent and this can often mean that older people need to remain in hospital for long periods of time when they have no medical needs.  Guardianship needs then to be pursued by families or the Council,  this can be costly and lengthy. 

“A few years back up to 60-70 older people in any one month were unable to leave hospital and at this time guardianship applications were taking up to 300 days.  Last months figures show Adults With Incapacity delayed in hospital over four weeks is 33. While there has been progress, there remain high numbers of vulnerable older people who whilst being medically fit cannot leave hospital”

FREQUENTLY ASKED QUESTIONS

What is a Power of Attorney

A Power of Attorney is a written, legal document giving someone else (your Attorney), authority to take actions or make decisions on your behalf (the granter). You choose the person(s) you want to act as your Attorney and what powers you want the Attorney to have. A Power of Attorney is intended to ensure that your financial affairs and personal welfare can still be dealt with/protected in the event of you being unable to act on your own behalf.

Are Powers of Attorney not just for elderly people?

No - anyone over the age of 16 can grant a Power of Attorney. Accidents or illness can happen at any age.  The sooner a Power of Attorney is completed, the better. The deed does not need to be registered straight away – it can be stored in your solicitor’s safe and only registered when your attorneys are required to commence acting.

Are Powers of Attorney not just for the wealthy?

No – a Power of Attorney is not just about looking after your financial affairs. It also allows you to choose who should decide personal welfare issues (e.g. where you live/who looks after you etc).

What sorts of powers can be included in the Power of Attorney deed?

The deed can cover both financial and welfare provisions or you can have separate deeds to cover your financial affairs and welfare matters.

The financial provisions can include power to purchase and sell heritable property (i.e. your house), power to operate bank accounts, power to claim and receive all pensions, benefits, allowances, etc. There are many other powers which can be included or left out as appropriate, depending on your circumstances.

Welfare powers can include power to decide where you should live, to have access to your personal information, to consent or withhold consent to medical treatment. There are many other powers which can be included to ensure that all appropriate powers are available to meet your needs.

Who should be appointed as an Attorney?

You can appoint anyone you wish to be your attorney, e.g. a family member, friend, solicitor

or other professional adviser. It is up to you whether you include the same person(s) as

both financial and welfare attorneys, or if you have separate attorneys to carry out the different function.

It is better to appoint more than one attorney in case your attorney is unable to act for any reason – you can appoint joint attorneys with similar or different powers, or one or more substitute attorneys to take the place of an attorney who dies, loses capacity or resigns.

G8 Summit information -round up

At this week’s G8 summit on Dementia, called by the UK as part of its presidency, health and science leaders agreed a package of measures to address the growing global health, social and economic issue of the condition. Currently 36 million people across the world have dementia and the World Health Organisation predicts that numbers will nearly double every two decades.

The commitments made this week by the G8 countries – Canada, France, Germany, Italy, Japan, Russia, the UK and USA included;

• setting an ambition to identify a cure or a disease-modifying therapy for dementia by 2025 – backed by a commitment to together significantly increase the amount spent on dementia research and increase the number of people involved in clinical trials and studies on dementia;
• a new Global Envoy for Dementia Innovation, following in the footsteps of global envoys on HIV and Aids and on Climate Change – the Global Envoy will bring together international expertise to stimulate innovation and co-ordinate international efforts to attract new sources of finance, including exploring the possibility of a new private and philanthropic fund to support global dementia innovation;
• developing an international action plan for research – in particular to identify current gaps and how to fill them; sharing information and data from dementia research studies across the G8 countries to work together and get the best return on investment in research; and
• encouraging open access to all publicly-funded dementia research to make data and results available for 
• further research as quickly as possible.

Dementia Carer Voices  Director, Irene Oldfather said “Whilst the global focus on Alzheimer's and dementia which the G8 has brought about is very welcome, we must move from rhetoric to reality to ensure the summit has a lasting legacy for people with dementia and their carers.  Until these aspirations for dementia research are realised, it is vital that we do more to recognise and support our unsung heroes who display incredible resilience living with and caring for those with the condition.”

Thank you NHSD&G for the kind words within your on - line article - learn a singe trick

Hi
a few weeks back I had the great privilege to speak at the Person Centered Scotland  learning collaborative
at the SECC in Glasgow

along with having the great honor to speak at the event i met so many inspiring kind people

so thank you NHSD&G for the kind words within your on - line article looking back at the event

thank you for the #kindness

you can view the whole article at the link here http://dghealth.wordpress.com/

“Learn a single trick” by @personcntrdDG

Posted on December 6, 2013

On November 21 -22 2013 a delegation from NHS Dumfries and Galloway attended the third Learning session on People at the Centre of Health and Care at the SECC in Glasgow.

This blog is an amalgamation of thoughts and experiences from that group of nurses, managers, doctors, carers and social and third sector workers who attended the two days and hopefully will provide you with some insight into what proved to be a very interesting and thought provoking learning session.

One of the themes of the two days was #hellomynameis. For those of you not familiar with Twitter the # sets a trend and this particular one was started by a young doctor called Kate Granger.  Along with being a junior doctor and accomplished author Kate has terminal cancer and writes eloquently about her disease and experiences on her blog and twitter. Earlier this year Kate was admitted to hospital and she noticed that not everybody introduced themselves. She writes about this on her blog and we would recommendreading it here. The upshot was her campaign to ensure that every encounter between healthcare professional and service user started with ‘hello my name is…’  and this quote, complete with #, was put on every delegates name badge – along with the request to take ‘selfies’ (a picture of oneself taken with a smartphone)and post them on twitter. Some examples can be seen here.

Although the title of the event suggests a focus on patients and service users we would like to stress that staff experience, staff support and staff values are recognised as being equally important and there were several workshops to this effect. If your workforce are unhappy and feel poorly supported then your patients experience will consequently suffer.

At the core of the Person Centred Collaborative are the 5 “Must do with me” elements. These are:

1. What matters to you?
2. Who matters to you?
3. What information do you need?
4. Nothing about me without me
5. Personalised contact

Throughout the two days we were asked to focus on these elements and consider improvement plans to take back to our workplace based upon them. We shall list a few from Dumfries and Galloway later in this blog but for now here are some of the highlights…..

Tommy Whitelaw – Tommys mother died following a 6 year fight against progressive dementia and throughout this time he was her main carer. Tommy delivered an extremely moving speech highlighting how some small acts of kindness can make all the difference and unfortunately that lack of kindness can have such a negative impact. He speaks best for himself and his videos can (and should) be viewed here. There not many events like this where a speaker gets a 5 minute standing ovation.

‘F for frailty’ – a workshop focusing on the Comprehensive Geriatric Assessment (CGA). This tool is used in the Emergency Department and has proved very successful in reducing elderly care admissions. One hospital reported a reduction of admission by one third using this tool, which has a very person centred approach.

Staff experience – a number of workshops focused on this. Supporting our staff to ensure they can come to work safe, confident and able to offer care compassion and respect to their patients and then go home with a sense of worth and value is vital to ensuring that we are delivering person centred care. One tool to support this is Values Based Reflective Practice (VBRP). VBRP offers a safe environment for a team to discuss difficult cases in a non-judgemental or accusatory way. No blame is apportioned and no ‘solution’ expected. This is evidence based and can significantly improve staff well-being and morale. We will be starting a course of VBRP training sessions in the New Year so watch out for adverts and emails offering places.

Visiting – this is a controversial area. Strict visiting hours and not always in the patient or families best interests but are felt historically necessary to protect them. There were two lively debates around relaxing visiting hours and moving to more person centred visiting ‘contract’ which felt very positive. If we wish to deliver this in DGRI then we need to involve staff in its implementation and we plan to do so early next year.

Teachback – This is a tool which is used to ensure that a patient has understood what you have been telling them. Some concerns were raised that doing this with every patient would make clinics unbearably long. However the counter argument was that taking 2 minutes to ensure understanding would save time in the future when it became clear that patients didn’t understand and required a further clinic appointment etc. In this workshop there was also a discussion about ‘going Italian’ which essentially meant encouraging families to attend clinic appointments with loved ones to help with both understanding and difficult decision making.

Leadership – our very own Hazel Borland led a workshop where she described her experiences of putting on her nursing uniform and doing a shift ‘back at the coal-face’. Hazel does this once a month and freely admits that it is important to her but has found that it matters to the staff as well. There was quite a buzz around this workshop and I heard several clinical leaders planning to do likewise on return to work.

Another powerful moment was when we were shown a youtube video of Dartmouth Childrens Hospital performing Katy Perrys ‘Roar’. This was extremely moving and in case you are wondering why it was included its because of the the lyric  “I am the champion and you’re going to hear me Roar.” You can watch it here, which we strongly recommend.

The team returned with many plans to improve services in Dumfries and Galloway including; the use of ‘Getting to know me’ booklets for every referral to the social care hub, a change to visiting hours (from visiting to welcoming), a neonatal passport, training in VBRP,  further enhanced patient experience events and many, many more.

A final point is that we now have a Person Centred Health and Care Committee  which reports to the Board and will be the driving force behind many of the improvement plans mentioned above.

This is a brief summary of some of the excellent work experienced by the person centred team from Dumfries and Galloway. It would be an understatement to say that we all came away enthused, excited and keen to get working on improvement. The key message isthat when we are considering any changes to service we need to not only think of the service user but include them in the decision and continually be asking the question “What matters to you?” We are doing some great work but more needs to done – change is clearly ahead.

“If you just learn a single trick, Scout, you’ll get along better with all kinds of folks. You never really understand a person until you consider things from his point of view. Until you climb inside of his skin and walk around in it.”