Stories from member hospitals, told in the words of the staff involved:

Lurgan Hospital – Southern Health and Social Care Trust, Northern Ireland

We had an 85-year-old lady who at 4pm every day became very distressed. One of the domestics after reading her care sheet and speaking to her family, discovered that the lady’s husband gambled and in years gone by if he was not home at 4pm it had meant there was every chance he had lost all his wages. Using the Butterfly Scheme response to reduce anxiety, as a team and working with her family we were able to distract the lady to take her focus off the time and it really helped her. We passed this info over to the nursing home when she was going home, so they too could help her.


Shropshire Community Hospitals NHS Trust

Bob’s story:
Bob was admitted into hospital after a fall at home. He was very angry, his behaviour was aggressive, he was unhappy, frustrated and everyone found it difficult to communicate with him. Bob required 1-1 care (one member of staff with him at all times) as he was very restless and at risk of falling.

Whilst caring for Bob on a one to one basis I had a really good chat with him and filled in the patient information leaflet (using personalised information is part of the Butterfly Scheme’s care approach). WOW WHAT A STORY!!!

Bob worked in a cinema in Shrewsbury, we talked about the olden days and movies and what he did whilst he worked there. His eyes lit up with joy. They were very happy times for Bob. Bob loved movies especially cowboy films. He would talk and talk about them.

That evening I printed off some old photographs of the cinema he used to work at. At last Bob had something to talk about, staff would put on a film for him every afternoon and his eyes would light up as he looked at the photographs. The staff would talk to him about Shrewsbury Cinema. The photographs were left on his table in front of him.

Bob no longer needed 1-1 care; he became easier to communicate with.
He enjoyed his stay in hospital, watched lots of movies, and interacted with staff. Bob’s mood changed completely because he had something to look forward to and something to talk about. He became very popular with the staff and well-liked. Something as easy as a chat and filling in the leaflet benefited Bob’s well-being and his stay in hospital was pleasant.
Bob was discharged a happy man and walking well!


Lurgan Hospital – Southern Health and Social Care Trust, Northern Ireland

We admitted a 91-year-old lady who had been very distressed at home. On admission her family first of all apologised and said that she would hit out and would try and bite you; it was what she did at home and this had become her norm. Sure enough, for the first 3 days she was very distressed when staff were attending to her and was very unhappy being where she was, but her family had opted into the Butterfly Scheme and staff team used the Butterfly Scheme REACH response to reduce anxiety to the patient. From her carer sheet we found out that she had no children but had cared for her nieces, nephews, grand-nieces and -nephews and loved children. A baby doll dressed head to toe in pink was introduced to her, and within the day she was like a new lady. She had named the doll Jack herself and changed back into a softly-spoken lady who just doted on the baby. All care given to her was introduced through Jack and she for the most part complied and wasn’t distressed. There were no more biting incidents; her family were amazed and the lady herself was visibly less agitated.


The Shrewsbury and Telford Hospital NHS Trust

We have undertaken training with our SAU (surgical assessment unit) who have now as a ward developed a dementia cluster – a core group of staff to roll out and promote good practice. One of the things they have initiated is that they use the REACH response (the Butterfly Scheme’s set of skills-based care approaches) in their bed-based handover …. especially the parts based on making a strong connection with the person, bringing all the person’s support equipment into use and appropriately supporting hydration.


Shropshire Community Hospitals NHS Trust

Nancy’s Story:
Nancy was admitted to hospital with a diagnosis of dementia; she did not communicate through speech, but nodded her head. She was a very quiet lady who would nod if you asked her if she wanted cup of tea, coffee, juice etc. Over a small period of time we noticed her fluid intake was low and could be at risk of becoming dehydrated. Her family visited one weekend so I decided to fill in the leaflet with them. Nancy’s reason for not drinking was that she only drank hot water, she had never drank anything else. She began to drink.

This small task of filling in the leaflet using the Butterfly Scheme care approach made such a huge difference to Nancy’s health and wellbeing and she was no longer at risk of becoming dehydrated and was discharged from hospital some time later.


Lurgan Hospital – Southern Health and Social Care Trust, Northern Ireland

An 82-year-old gentleman with Alzheimer’s was admitted to hospital for rehab following a fall at home. He had decreased mobility on admission and a grade 2 pressure sore, which measured 2 cm x 2cm. The gentleman found personal care and dressing changes distressing and sometimes struck out at staff, so that it could take staff 1-2 hours to change his dressing. The family opted into Butterfly Scheme on admission and the staff team used the Butterfly scheme REACH response to reduce anxiety to the patient. The team used distraction therapy, noting from the gentleman’s personal information sheet that he’d been a postman; they made a post box and letters, giving the post box the name Hospital to orientate him and using the names of relatives and staff on letters, which he sorted out and posted. The post box was placed beside the gentleman when dressing change was being carried out.
Now that the patient was less anxious, staff were able to change the dressing when required and the wound improved. His distraction score had gone from 18/18 to 7/18, which meant staff could treat his pressure sore effectively; being less anxious, the gentleman no longer felt the need to physically assault staff.


Calderdale & Huddersfield Foundation Trust

A lady with advanced dementia, who had lost her sweetheart in WW2, believed that he had returned and they had a baby boy. She cuddled a doll and contentedly waited for her husband to return from work. The staff as a whole team knew not to reorientate her into the here and now, but met her in her reality, otherwise she became extremely distressed and agitated. By using the Butterfly Scheme principles, the staff team personalised their care. For example, the team member who cleaned the bathroom was happy to sing as she worked, because she understood that this was the only way the lady would allow her to enter her world.


Harrogate and District NHS Foundation Trust

A lady with dementia who needed a general anaesthetic was known to be unlikely to cope with the process. Using her Butterfly Scheme insights, the nurse worked in partnership with the lady’s daughter, who accompanied her for the anaesthetic. The whole team worked to the nurse’s personalised plan; the daughter held one hand and the nurse held the other (singing “I wanna hold your hand!”). The anaesthetic was delivered without distress and the nurse later said, “I was proud of the care we had given”.


Airedale NHS Foundation Trust

During the early stages of implementing the Butterfly Scheme, a dementia training facilitator who works in A & E was asked to try to stitch the head of a man with dementia who had fallen and had lacerations. Others (who had not yet had Butterfly Scheme training but who were due to have it) had tried, but felt that his distressed behaviour made it too dangerous for him and for the person stitching. The trainer successfully stitched the man’s head but felt that this success was directly due to the Butterfly Scheme training and use of the REACH response.


Calderdale & Huddersfield Foundation Trust

A very pleasant gentleman with dementia loved to talk about his holidays, but if the person he spoke to appeared disinterested, he could become anxious, which was often perceived as aggression. Because of the whole-team approach, all staff began each interaction in full knowledge of his needs and this promoted positive interactions, avoiding distress. The approach was also used on subsequent admissions and was found to have a positive effect on his potential for falls, his motivation and mood for eating and drinking and his length of stay.