Director of Nursing at Saint Josephs' Centre, Norma Sheehan, presents the Butterfly Model
“Creating a family like atmosphere and sharing closeness, matters in dementia care”.
It was with this simple concept that David Sheard founded the ’Feelings Matter Most’ – ‘Butterfly Model of Care’ for people living with dementia in 1995.
It was started at Merevale House in Atherstone, England – a care home for 36 people living with Dementia – since then the approach has spread across the UK and Ireland.
Known as Butterfly Service Homes, there are currently 60 project homes adopting this model in England, Wales and Ireland. There are 5 nursing homes in Ireland; St. Joseph’s Centre would be the 6th. Beginning with Tom Kitwood’s original theory of person centredness, the model also draws on ideas from neuro linguistic programming about personal congruence in leadership (Kitwood, 2007, Goleman, 1999, Dilts, 1990).
It emphasises the need to embed dementia care training in the development of staff’s emotional connection and emotional intelligence.
The Butterfly Model is about staff ‘being’ rather than ‘doing’. The traditional way of care is focused on staff moving from task to task with a sense of ‘doing to’ rather than ‘being with’. Relationships between staff and people are shaped by: out of bed – wash, dress, - feed - toilet, - back to bed, with over 78% interactions being task based (Ward and Vass, 2005).
In order to achieve this change of staff ‘being rather than ‘doing’ a culture change process which frees the whole staff team up to ‘be’ rather than ’do’ more has to happen.
The ‘Butterfly Model’ centres on eight key components.
Being – person centred care - involves helping staff to shift their focus from only doing ‘tasks’, to being able to reach people on the inside (Sheard, 2007).
Enabling – quality of life starts with really seeing, hearing, and feeling the lived experience of people. This also involves measuring the minute-by-minute experiences of people, and being determined to improve the moment (Sheard, 2008).
Inspiring – leadership this means guiding people away from detached management to a new professionalism of attached leadership. Attached leadership is where people lead from the heart-not just by the hand (Sheard, 2008).
Nurturing – staff’s emotions-in dementia care, there is a need to foster positive team relationships, whilst requiring the development of an emotion led organizational strategy (Sheard, 2009).
Growing – training that works moves away from tick-box courses and awareness level competency training. The focus should be on the development of people’s emotional intelligence-through reflection, modelling and coaching (Sheard, 2008).
Achieving real outcomes – this is all about focusing on policies, procedures and systems as secondary. Instead, balancing, measuring quality of service and quality of life, become the focus (Sheard, 2011).
Supporting nurses in dementia care – to modernise and to restore compassionate cultures of care – is critical. This involves nurses being developed to merge clinical best practice with the new focus of nurses knowing how to lead and personally model person centred care and relationship focused support (Sheard, 2013).
Mattering in a dementia care home centres on the core skills in staff of Feel, Look, Connect and Occupy whilst creating culture change through developing a community based on Share, Reach, Relax and Matter (Sheard, 2012, 2013).
Norma Sheehan
Director of Nursing
Saint Joseph’s Centre
