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.

Reminiscence work

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!

Jeannette Larsen
librarian
Gentofte Public Libraries

jeal@gentofte.bibnet.dk

Translated by Vibeke Cranfield