Communication, Life Story Work and Supporting Identity in Older People’s Services
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Loss of identity is one of the most significant yet least visible risks facing older people in care settings. When services focus solely on tasks, routines and safety, people can quickly become defined by their needs rather than who they are. Communication and life story work play a critical role in maintaining identity, dignity and emotional wellbeing.
This approach aligns closely with person-centred planning and safeguarding expectations, including Person-Centred Planning in Social Care and Safeguarding in Social Care. This article focuses on how identity can be actively supported through daily communication practice.
Why identity matters in older people’s services
Identity is expressed through language, relationships, routines, roles and personal history. When communication ignores these elements, older people may experience:
- Reduced confidence and self-esteem
- Withdrawal from activities and relationships
- Increased distress or resistance to care
- Loss of motivation and engagement
Supporting identity is therefore a core quality and safeguarding issue, not an optional enhancement.
Operational example 1: Preserving professional identity in homecare
Context: An older person receiving homecare repeatedly rejected support, describing staff as “treating me like a patient”.
Support approach: Life story work identified that the individual strongly identified with their former professional role and independence.
Day-to-day delivery detail: Staff adapted communication to be collaborative rather than directive, asking for preferences and opinions before tasks. Language shifted from “care tasks” to “support with daily routines”. Staff acknowledged expertise and past achievements during conversation.
How effectiveness is evidenced: Reduced refusals were recorded, daily notes showed improved engagement, and supervision records confirmed consistent language use across the team.
Operational example 2: Supporting cultural and personal identity in extra care
Context: An older person from a minority cultural background became increasingly isolated after moving into extra care housing.
Support approach: Life story work highlighted the importance of cultural traditions, language and food.
Day-to-day delivery detail: Staff incorporated culturally familiar greetings, supported access to preferred foods, and encouraged involvement in culturally relevant activities. Communication avoided assumptions and prioritised listening.
How effectiveness is evidenced: Participation in communal spaces increased, emotional wellbeing scores improved, and family feedback was positive.
Operational example 3: Maintaining identity during physical decline
Context: An older adult experienced rapid physical decline, leading to frustration and anger during personal care.
Support approach: Life story work identified strong values around privacy and self-reliance.
Day-to-day delivery detail: Staff offered choices at every stage, explained actions clearly, and allowed time for the person to do what they could independently. Communication reinforced respect and partnership.
How effectiveness is evidenced: Incidents of distress reduced, care plans were updated to reflect identity-focused approaches, and audits confirmed consistent practice.
Commissioner expectation (explicit)
Commissioner expectation: Commissioners expect services to demonstrate how they protect dignity, identity and wellbeing, particularly where people experience loss or transition. Evidence should show reduced distress, improved engagement and personalised communication strategies.
Regulator / Inspector expectation (explicit)
Regulator / Inspector expectation (CQC): Inspectors expect providers to treat people as individuals, respecting identity and life history. They will look for alignment between care plans, staff language and people’s lived experience.
Governance and assurance
Strong governance includes regular review of life story information, observation of staff communication, supervision discussions focused on identity, and analysis of complaints or incidents linked to dignity and respect.
Key takeaway
When communication actively supports identity, older people feel seen, respected and engaged. This strengthens outcomes, reduces distress and provides clear, defensible evidence of high-quality care.
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