Using Life Story Work to Reduce Distress and Improve Emotional Wellbeing in Older People
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Emotional distress in older people’s services is frequently recorded but poorly understood. Terms such as “agitated”, “withdrawn” or “anxious” are often used without analysis, leading to reactive responses rather than preventative care. Life story work offers a structured way to understand the meaning behind distress and to design support that promotes emotional wellbeing and stability.
This approach aligns closely with broader quality and safeguarding frameworks, including Quality Assurance in Social Care and Safeguarding in Social Care. This article focuses specifically on using life story work to reduce distress and improve emotional outcomes.
Understanding distress through life story work
Distress is rarely random. In older people it is often linked to:
- Loss of control or identity
- Unfamiliar routines or environments
- Communication breakdowns
- Past trauma or unresolved grief
- Physical discomfort that is poorly expressed
Life story work helps staff interpret behaviour as communication and respond appropriately.
Operational example 1: Reducing evening anxiety in supported living
Context: An older person became increasingly anxious in the evenings, repeatedly calling staff and expressing fear.
Support approach: Life story work identified that evenings had historically been family time and that silence triggered anxiety.
Day-to-day delivery detail: Staff introduced a consistent evening routine, including familiar music, a scheduled call with family twice a week, and staff checking in at predictable times. Staff used reassurance phrases taken directly from life story discussions.
How effectiveness is evidenced: Call-bell use reduced, mood notes improved, and the provider recorded reduced staff time spent on crisis reassurance. The intervention was reviewed monthly.
Operational example 2: Addressing withdrawal after bereavement
Context: Following bereavement, an older adult withdrew from activities and meals.
Support approach: Life story work highlighted the importance of social roles and routine to the person’s identity.
Day-to-day delivery detail: Staff reintroduced meaningful roles, such as helping with simple tasks linked to past interests. Conversations acknowledged loss rather than avoiding it. Support was paced and optional, not forced.
How effectiveness is evidenced: Engagement levels increased, nutritional intake stabilised, and family feedback confirmed improved emotional wellbeing.
Operational example 3: Preventing escalation through early distress indicators
Context: An older person experienced periodic emotional escalation resulting in incidents.
Support approach: Life story work identified early warning signs and effective reassurance strategies.
Day-to-day delivery detail: Staff monitored early indicators, used agreed calming techniques, and offered choice and control before escalation occurred. These strategies were built into daily support plans.
How effectiveness is evidenced: Incident frequency reduced, and staff confidence improved. Learning was captured through supervision and team meetings.
Commissioner expectation (explicit)
Commissioner expectation: Commissioners expect providers to demonstrate proactive approaches to emotional wellbeing, reducing crisis intervention and safeguarding risk. Life story work should be clearly linked to measurable outcomes such as reduced incidents and improved engagement.
Regulator / Inspector expectation (explicit)
Regulator / Inspector expectation (CQC): Inspectors expect services to recognise and respond to emotional needs, prevent avoidable distress, and demonstrate learning from incidents. Life story work should be visible in care plans, staff practice and review processes.
Governance and assurance
Effective governance includes routine review of life story information, supervision focused on emotional wellbeing, analysis of incident patterns, and audits of how distress is recorded and responded to.
Key takeaway
When life story work is used to understand and prevent distress, older people experience greater emotional stability and dignity. Providers gain clearer evidence of impact, stronger safeguarding practice and improved inspection outcomes.
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