Dementia Care: Thinking Creatively About Each and Every One of Us

Over 70 million people worldwide will have dementia by 2030.

One current approach to caring for older people with dementia is person-centred care – an approach that recognizes the uniqueness and understanding of the world from the perspective of the older person with dementia. Carers practice a range of person-centred care techniques, from reminiscing together with an older person in order to understand their life, to experiencing the world from each older person’s unique perspective.

Creative problem solving can fulfil important roles in person-centred care. Applied successfully, it can produce new and valuable outcomes, i.e. care activities that both recognize a sense of uniqueness and are new to the care of an older person with dementia.

However, so far, creative problem solving has not been very widely applied to support person-centred care.

To explore the potential of creative problem solving in person-centred care, we previously encouraged carers to experiment with different creativity techniques. For example, residential carers used the What-if technique to challenge existing barriers to understanding the resident from different perspectives, then generate new care ideas in response to these barriers. They used the Brain Writing technique to combine and evolve ideas generated with other techniques. And they used the Other Worlds technique to generate ideas to manage behaviours that are challenging in different, less constrained domains such as social lives and different cultures. The carers singled out this Other Worlds technique because, unlike the others, it purposefully transferred knowledge and ideas from sources outside of their immediate knowledge and understanding.

However, to support creative thinking in person-centred care more effectively, we have also developed a new software application called Care’N’Share to support creative collaborations between carers to improve the person-centred care of older people beyond each carer’s own current knowledge and understanding. The software application was developed to enable carers to share good care practices and, more importantly, to think creatively about practices in order to apply them individually to residents during person-centred care.

To use the application, a carer simply enters an unstructured natural language description of a care situation in which an older person is having trouble eating, often drops food on the floor and is unable to maintain a balanced diet. The application then invokes creative search software to retrieve good care practices from the application’s case base that have different forms of similarity to the entered care situation.Screen

For example, one case that might be retrieved describes a resident not eating the food in front of him, which is presented to carers in 5 parts. The first part describes the original care situation – the person not eating his food. The second describes how different people – care staff, family members and the resident – reacted to the situation, and presented to encourage the users to reflect and learn from the situation. The third describes the different care activities that were implemented to resolve the care situation, for example a physical health check-up and changing the colours of the plates. The fourth part presents automatically generated nudges to the users to think creatively using information about the retrieved case in order to resolve the original situation. These creative nudges are generated by the application from the retrieved case content, for example the carers spoke to their manager, who got advice from an occupational therapist (OT), as the carers knew the problem was not with swallowing or the type of foods because the carers ‘d seen John eat and enjoy the food without problems with prompting. Can you adapt this action plan to your situation? At any point, the users can request the application to generate new creative nudges to trigger creative thinking to resolve the current care situation. The fifth presents a set of links to external training resources relevant to the case, such as SCIE guidance about nutritional care and older people.

Care’N’Share offers a new way to learn about older people with dementia – with creative problem solving in response to situations that are encountered during everyday care. Explore it and its creative guidance at http://carenshare.city.ac.uk. You can also learning about the creativity techniques mentioned in this blog at http://becreative.city.ac.uk.

 

The Creative A-Team

Ever wished that you had the creative A-Team on your project? Top architects, artists, designers and other creatives? Well, now, at the click of a button, you can.

Screenshot of the Bright Sparks website

The Bright Sparks app showing one creative persona

Well, sort of. A creative A-Team populated by digital versions of these great people.

Our new BrightSparks app builds on Michalko’s Hall of Fame creativity technique. The technique allows problem solvers to explore how famous people will help solve their challenge by using the unique knowledge and practices of these people. The BrightSparks app supports use of the technique without the need for human facilitation – you can use it alone, in groups, or workshop settings. We have added creative clues, which when applied to the personas, guide users to think creatively about designs.

The technique is simple to use:

  1. Identify a challenge that you or your project team would like to solve;
  2. Use BrightSparks to find insights from the profiled personas and by applying the creative clues;
  3. Write down your ideas on paper or capture them electronically by using the link to the MindMup visual mind mapping tool, available with BrightSparks;
  4. Explore the set of clues until the creative potential of the persona has been exhausted.
  5. Repeat the exercise with new personas to ensure that new and creative ideas are generated.

Now it’s time to collect your own Creative A-Team. Go to http://brightsparks.city.ac.uk/. We love it when a plan comes together.

James Lockerbie and Neil Maiden

The Creative Citizen

I recently joined my local Town Team, a collection of residents, business owners and others seeking to improve their neighbourhood in north London. At our inaugural meeting, we were presented data about how people use the high street – footfall, purchases, preferences etc. Whilst interesting, this data was limited – it didn’t tell us what these people really needed and wanted from the high street.

What to do?

I proposed to run a co-creation exercise with my fellow citizens to discover needs and create ideas to re-imagine the neighbourhood. After all, after air traffic control and Europe-wide food traceability systems, how hard can it be?

The Town Team agreed. We ran short creativity workshops with different groups of people who produced simple mood boards, removed constraints to open up spaces of new ideas, and generated concepts to increase the convenience of the town centre, and people’s connections with and participation in it. We also undertook table-top walkthroughs allowing people to describe how they used the high street, problems they’ve experienced and ideas that they have. We even set up a web-based tool to encourage asynchronous idea generation.

Fortunately for us, people engaged in the co-creation process, and exploited a chance for proper consultation.

But what took me so by surprise was the range and novelty of the ideas that all of these people generated using just a few simple creativity techniques. Ideas about the architecture and the street layout, about the amenities and their information needs, and about all forms of new service that they needed.

I was struck. Empowering citizens with even simple techniques and tools seemed to lead to a step increase in creative outcomes.

And whilst I’m under no illusions about some of the challenges ahead to innovate and implement these ideas, the potential to be creative during this innovation process is clear.

All of this got me thinking. What could the creative citizen achieve more widely if empowered with just a few, simple creativity techniques? Why should these techniques be the preserve of designers and consultants? And how could everyone learn and adopt a few techniques?

I wonder if what we need is Martini-creativity? Creativity that is anytime, anyplace, anywhere – made possible through simple to learn, quick to use techniques and tools, available to all?

Imagine if everyone can use simple creative techniques to resolve everyday issues. Now that really is something worth pursuing.Image

Building Better Roads

Sfalassa BridgeAs my Twitter followers will know, I’ve been traveling through Sicily, returning to some places for the first time in a decade. One change that really stands out over this period is the investment in the road system. A great new network of tunnels, bridges and motorways has spread out across the island from Palermo, making it quicker and safer to get from place to place.

One can only wonder at the cost of these engineering feats. Most were completed before 2008. Alas, I fear that solving our everyday travel problems with such large infrastructure solutions will not be possible in the austerity-ridden Europe of 2012.

Which got me thinking, as I glided across another beautiful new bridge: how will Europe be able to solve its future problems in our new, more constrained world? What do these Sicilian motorists need to do to continue to ensure economic growth on their island?

One answer is challenge assumptions about how things are done. New economic realities mean that many of these assumptions are out-dated.

However, most people have yet to realise this. Clearly, just telling people that they’ve living in the past is not a good idea.

So what to do? One option is to help people to think more creatively about what can be done if we simply challenge the old ways of doing things. Now, this is easier send than done. Our assumptions about how things are done are often deep-rooted. They are rarely talked about because, well, they simply describe how things have been done for a long time.

Build a bridge to cross a valley, use the car to get to work, use established forms of labour to earn a living. Challenging such assumptions can be difficult.

But I think that people are more likely to challenge such assumptions if they can glimpse a more positive future. Empowering people to think creatively in order to generate and own that future can overcome natural reticence to change.

There is an important role for creative facilitators here. Europe, more than ever, needs our skills in order to challenge out-dated assumptions in creative ways. The stakes are high. And the time is now.

Inevitably Biasing Creativity Outcomes

When we facilitate, we often think of ourselves as opening up new spaces of ideas. We empower people to think divergently, then only converge when the time is right. Our creativity techniques only raise horizons, blow away constraints, remove barriers.

Or do they?

I am increasingly convinced that the creativity techniques and artefacts that we give to people to use bias the creative outcomes that they produce in significant ways – sometimes very significantly.

Now I am not saying that this is a bad thing. But we need to be honest and recognize biases.

This semester I am teaching creativity in service design thinking. The students are combining different creativity techniques and design artefacts. Watching them, it is clear that their ideas and designs are heavily influenced by what they’re given to work with. For example:

  • Giving them creativity triggers from James Robertson [http://www.systemsguild.com/jsr.htm] led to them to design new touchpoints with the qualities that each trigger seeks
  • Giving them an analogy leads them to focus on solution ideas that can be transferred from the analogical domain, at the expense of those that cannot
  • And giving them physical artefacts during desktop walkthroughs led to more physical rather than logical touchpoints.

None of this might be a surprise to you, but the extent to which these biases occur might be.

Some students reflected that a desktop walkthrough for a dementia care service constructed from Lego was influenced by the availability and shape of the bricks – indeed larger bricks led to more abstraction whilst moulding more literal representations from Plasticine led them to be more concrete.

Creative biases provide us with opportunities and risks. If we can deal with the risks, we can enhance our creative capabilities.

Anatomy of a Creativity Technique

Image by Simon James - Menage a Moi

Why are Jokes Funny?

I’ve always been fascinated by why some jokes are funny, and others are not. Great jokes are deceptively simple. They are often just one or two sentences long. And yet, a simple joke can have multiple layers of humour and truth.

Whilst most of us are able to tell a joke to elicit a reaction, we find it more difficult to explain why the joke works. Comedy writer Jan McInnis thinks that a good joke involves a set-up with the subject and facts, and a punch line that highlights the irony, twists the joke in another direction, or gives an outrageous result (http://www.absolutewrite.com/specialty_writing/anatomy_of_joke.htm).

But this description does not necessarily explain why some jokes work better than others, why some are regarded as classics, while others are forgotten immediately. We seem happy to tell jokes and laugh at them, but not to dissect them and understand their inner workings.

I think that it is similar with creativity techniques. Some work well, others do not. Great creativity techniques are also deceptively simple. They often involve just one or two steps, and yet can unleash considerable creative power. And whilst I know how to make it happen, I do not always understand how or why it happens. And I’m not alone in this.

This gap in our knowledge bothers me. I think that we could deliver creativity support more effectively if we understood how different techniques work. So what to do?

My proposal is to investigate the inner workings of different creativity techniques – theoretically, logically and empirically. I am sure what we learn about the anatomies of creativity techniques will be fascinating.

Who wants to join us in this creativity dissection?

Creativity on a Shoestring

Ever wondered how to do more for less? Most of us have. Indeed, in the current economic climate, you cannot just throw resources at problems. Smarter is the new smart. And many commentators have argued that creativity is key to being smarter.

However, these same commentators often ignore that creativity is not free. Indeed, many reported creative processes and techniques themselves consume resources – resources that organizations just don’t have. This poses a challenge – how to be creative with less. We need creativity on a shoestring.

I’ve been working with City graduate Bianca Hollis of BBC worldwide to design and evaluate creativity on a shoestring. Bianca is a user experience designer developing digital products such as web sites and software apps. Like many working in digital media, she uses agile methods to design these products. Agile methods encourage the iterative development of working software, often in two-week cycles. This leaves little time for creative thinking – who really wants to think divergently when the next software release is expected in 10 working days?

So our challenge was to fit creativity techniques into agile in creativity workshops that rarely last more than 45 minutes in agile projects at BBC Worldwide. We gave stakeholders techniques such as hall of fame, constraint removal and back to the future to generate ideas for new BBC products. Moreover, I think that we succeeded. The workshops generated lots of ideas that were rated significantly more novel than existing ideas in the project backlog.

We were sufficiently excited by these successes to take the shoestring creativity techniques on the road. This week we ran a tutorial at OOP2012 in Munich, teaching quick creativity techniques to agile software developers. The techniques were a success. People’s reactions revealed that we’ve hit a nerve. Creativity on a shoestring is needed more than ever.

So let’s be smart. Create more from less.