by Andrew Farthing and Lesley Davies
The Metropolitan Borough of Sefton is a local authority nessling on the North West coast of England, north of Liverpool. Like most of the country, Sefton is experiencing a continuing rapid increase in the proportion of older people in its population. Older people in Sefton generally enjoy good physical and mental health, and they are a great asset to their communities through their many contributions to local organisations, neighbourhoods and their own families. Nevertheless, this increasing proportion of older people in the population is making increasing demands on health and social care services, including those with dementia. Dementia can affect adults of any age, but is most common in older people. In the UK, one person in 20 over 65 has a form of dementia, rising to 1 in five in those over 801. Dementia in people aged under 65 is relatively rare less than 3% of all those with dementia. Positive, proactive approaches to service development providing individualised support can help ensure that physical and mental health are sustained as long as possible. Helping people live at home for as long as possible is crucial to keeping the use of costly intensive services to a minimum.
The borough of Sefton has a population of 274,0002 and has one of the highest percentage rates of dementia in the UK. It's estimated that around 46003 residents are living with dementia, with approximately half of these people not being diagnosed with some form of memory loss. Faced with such stark statistics, the local authority has developed a dementia strategy to help tackle the problem. For Sefton's small library service with only 6 libraries, the problem has been approached in a number of ways and the library service has proved a leading light in the Sefton Dementia Action Alliance, a forum of concerned community groups and interest parties. Sefton's library service developed a new initiative to support the Dementia Strategy and Sefton's Lost Voices was born.
The Lost voices project was the brainchild of two of Sefton's librarians Andrew Farthing and Lesley Davies, and like all great ideas it's marked by it's simplicity. The project came about through the Sefton Libraries' role within the Sefton Dementia Action Alliance (DAA) and the Borough's Dementia Strategy group which supports the council's desire to make Sefton a 'Dementia Friendly borough'
Lost voices is a project that gives people in the early stages of memory loss the chance to record their own oral histories. These memories can then be used by the person living with memory loss to help recall key moments and facts from their lives. The library service receives a copy of these recordings which are added to its oral history collection. One copy is gifted to the interviewee which may be used to stimulate memories or as a reminiscence tool.
The project is based on a treatment of dementia called cognitive stimulation therapy4, where a structured programme of stimulation to the brains memory functions is thought to slow down, but not stop, the speed of memory loss.
Sefton Libraries had already been working with local care homes to produce 'memory boxes'; boxes of materials and artefacts on a particular recent historical themes such as football in the 1970's or school life in the 1950's. Such boxes have items like school caps, text books from the 1950's, pencil cases, protractors, board rubbers, football programmes, music from the 1950's etc. The boxes are loaned out to care homes who use them to stimulate reminiscence sessions for their residents.
The idea came during a regular service planning meeting when the two librarians were discussing ideas on how to extend the provision of the libraries memory boxes. Memory boxes had proved to be very good at stimulating reminiscence in groups of care home residents but the boxes stimulated collective memories, not individual ones. Ideas were floated as to how the memory boxes could be more personised to make them more effective as a stimulation tool. In other words, using your own personal memories to stimulate your own personal memories would be much more powerful than using collective or generic memories that everyone has. It was a lightbulb moment and the two librarians abandoned the memory box concept and began to focus on how individual memories could be recorded for use in cognitive stimulation. The library service had already carried out an oral history project many years ago where unemployed people were recruited as part of a job creation scheme to record the memories of local residents. These intimate memories were used to create an oral history collection of detailed, personal memories of local events and happenings. Their importance as a social history of the area is significant as the recordings provide details of history not recorded elsewhere.
Recording the memories of residents with early onset of memory loss was the obvious next step for the project: delivering a workable project model that didn't impact heavily on library resources took more thought. It soon became apparent that there were several key areas where the library service would need support from partners to make the project feasible. Not least of these was how would the people with early onset memory loss be referred to the project for recording, and how would the library service record the participants but for it to have minimal impact on staff time?
With minimal financial resources available to support the project, designing the delivery model required some creative thinking and support from partners. Key amongst these were Sefton's Alzheimer's Society, Age Concern and Age UK - all groups on the Sefton Dementia Alliance group. When the library service approached them with the concept, they were keen to get involved. They proved key to connecting with residents with early onset dementia and other forms of memory loss.
The library service put together a project plan which addressed the key issues of how the project would be funded and managed, who would carry out the recordings, how participants would be recruited and how would the project be promoted to a wider audience.
A low cost, low maintenance method of delivery was needed. Funds were found to purchase dictaphones and writable CD's which would be used to record and store the reminiscences. The delivery model had to require minimal staff time. It was decided that a library officer would act co-ordinate the project, but community volunteers would be used to carry out the recordings at the recipients' homes. The Alzheimer's Society encouraged its members to volunteer to help the project and initially 12 volunteers came forward who would carry out the recordings. The library service then engaged a sound recording specialist who trained the volunteers in the use of the equipment and gave tips on how to interview people to get the best recordings.
Once everything was in place, it was time to promote the project and engage with participants and their family. The library service wanted to start small scale so that they could refine the modus operandi if required. They asked for participants from the local memory loss groups, and 5 people initially came forward. These people weren't only interviewed, but with their permission, were also filmed. These films were then edited into short 2 minute promotional films which were used on social media and in promotional presentations by the library service5.
The working group looked at how the initial pilot had gone and made some refinements to the process, to improve on the quality of the recordings. With a working method in place, more widespread promotion took place.
Disappointingly, approaches to health centres to support referrals to the project from doctors brought little fruit. Some health centres displayed a poster but took little active part. Fortunately referrals of participants to the project were covered by the voluntary sector with the Alzheimer's Society playing an active role in referring its members to the project for recording. Most of our interviewees have led incredible lives; they have lived through war, food shortages, depression and the swinging sixties, so have fascinating tales to tell. A large percentage of the recordings offer a unique insight into the local community, not found in local history books. With permission we are able to keep these recordings for our archives, where they are available for the community to use. In the future it is hoped that the recordings will be uploaded on the libraries digital archive6. This will make them an easily accessible resource of community history.
As you would expect many of the recordings are about life during World War Two. They can be quite harrowing, talking about fathers going off to war and never returning, dashing to the bomb shelters, as the planes flew over to bomb Liverpool docks. Quite a few recordings were about being evacuated; children bereft at being sent away, and some feeling distraught at coming back to a family they hadn't seen for many years. Staff have listened to tales of going to school and seeing children barefoot because they couldn't afford shoes, and many stories about first meetings between husbands and wives.
Families have reported back about the value of the recordings, and how much they have enjoyed listening to their relative's memories. We have heard from the daughter of a lady, now in her 80s, who worked as a neurological nurse. She shared her recording with her grandsons, who had no idea their grandmother had done such valuable work. They took copies of the recording to share with their children, who can now ask their great granny about her nursing career.
The project cost £2300 to deliver which included the cost of dictaphones, promotion and publicity, and training. The memories of almost 100 local residents have been recorded so far, the people range in age from 53, right through to 101. However, the value of the project has had much more wide ranging effect, over and above the number of recordings taken place.
The work of Sefton's Lost voices has demonstrated the key role that the library service has in collecting and preserving the memories of residents for community use. In a time of austerity, it has shown key decision makers that the public library service isn't just about books; it's about the community it serves. It demonstrates the flexability of libraries in their ability to adjust their offer to reflect pressing need in the community. Crucially, it shows how librarians can deliver a low cost, effective project that not only improves the quality of life for residents living with memory loss but also addresses the issues of social isolation and family resilience.
Delivering such an innovative project that meets such a key strategic need in the borough has raised the visibility of Sefton Library Service with partners. At a time when budget pressures are extreme, demonstrating that the service is flexible, responsive and able to evolve to meet a local need in such a cost effective way has opened the eyes of some decision makers on what a valuable asset the library service actually is. So internally the project has had an entirely positive effect.
Raising the profile of the library service further, the project received an internal Sefton Council award for excellence in meeting council priorities and team performance. It was also shortlisted for the prestigious CILIP7 Libraries change lives award in 2016.
On the back of the project, Sefton Library Service has been approached by members of the voluntary sector and other local charities to participate in some of their key initiatives to improve mental health in the borough. For the local Public Health Service, the library service is now considered key in delivering some of their initiatives to improve health related early intervention and prevention, which is hoped will alleviate demand for some of their high cost, intensive services. Success breeds success!
For all involved this is such a rewarding project. We currently have six active volunteers, who go out and conduct the interviews. We have a volunteer who comes in weekly to download and create the CDs which are then posted out. One of our library apprentices works half a day a week on the admin and co-ordination of the project, this has added to her skills set and has given her a insight into the extended roles libraries can play in the community. The volunteers have commented on how enriched their lives have been in being involved in such a project, by meeting the local residents and having an insight into their lives. It has helped bring families together at a difficult time in their lives and helped us preserve the collective memories of the local communities. Crucially, at a time of austerity, it demonstrates the value of library services in meeting community need in an efficient and low cost way. It's an example of community groups working in true partnership with the library service to deliver shared objectives at very little cost. What's not to like.
Ai fini della citazione, utilizzare esclusivamente il testo in lingua italiana, che presenta il DOI, la paginazione, l'abstract e gli altri dati ufficiali.
When citing, please always refer to the Italian translation only, complete with DOI, page numbers, abstract and other data.
[Andrew Farthing, Lesley Davies, Lost voices: un'iniziativa bibliotecaria a basso costo per sostenere la dementia strategy. AIB studi, vol. 57 n. 3 (settembre/dicembre 2017), p. 512-521. DOI 10.2426/aibstudi-11710]
 Living well with dementia: a strategy for Sefton: consultation report, 2014-2019, strategy author June McGill. Version 0.3 - 12.05.15, http://modgov.sefton.gov.uk/moderngov/documents/s62564/DementiaStrategy2014ConsultationreportMay2015.pdf.
 Office of National Statistics, Census. 2012.
 June McGill, Living well with dementia cit., p. 7.
 Martin Orrell [et al.], A pilot study examining the effectiveness of maintenance cognitive stimulation therapy (MCST) for people with dementia, «International journal of geriatric psychiatry», 20 (2005), n. 5, p. 446-451.
 Chartered Institutes of Library and Information Professionals: https://www.cilip.org.uk/cilip/cilip-libraries-change-lives-award.