Graham Galloway and Dawn Irvine from Meeting Centres Scotland came to Haddington to start a conversation about a Meeting Centre in the Haddington and Lammermuirs area. Graham spoke at a recent workshop run by members from the Musselburgh Meeting Centre, explaining the benefits and experience of the Musselburgh Meeting Centre – from the inside. Several people got in touch wanting to find out more…
Introducing the Meeting Centre Approach
Graham introduced the Meeting Centre Model. Meeting Centres are social clubs which offer on-going warm and friendly expert support to improve the quality of life for people with mild to moderate dementia, families and friends. They help people adjust to living with the symptoms and changes that dementia brings. Meeting Centres are a resource, providing support for people with early to mid-stage dementia and care-partners, based on evidence of what works. Originally developed in the Netherlands, Meeting Centres are now growing around the world.
Meeting Centres are social clubs based on the social model of dementia rather than a medical model, and focus on social connection and maintaining abilities. All Meeting Centres share 11 essential features that experience and research show work, including a regular weekly session, a trained team and promoting peer support, social connections, cognitive stimulation and psychomotor therapy. Volunteer and community involvement is crucial. The Meeting Centre approach is a flexible model that can be adapted to local needs and resources. Centres typically run 1-3 days per week in a community venue. What happens in a Centre, the activities and support, is determined by members’ interests and needs.
The Musseburgh Meeting Centre
In 2018, work started to set up the Musselburgh Meeting Centre. We set up a development project group including the Musselburgh Health and Well Being Group, DFEL and East Lothian Health and Social Care Partnership (ELHSCP). Those first years were supported by Meeting Centre Workshops led by Shirley Evans from the Association of Dementia Studies, Worcester University and Graham Galloway, then CEO of Kirrie Connections. Funding for the Musselburgh Centre was agreed by ELHSCP in December 2019 and the first members came through the doors on 3rd April 2023.
The Musselburgh Centre is a development project, set up to explore how the model works in Musselburgh and how the approach might work across East Lothian. Including if there are community groups who want to take the approach forward.
Around 13 people with dementia come to the Centre, most come two mornings a week. Carers are members and can pop in, come for activities, on days out – whatever works for them. There’s a regular Carers Space on a Friday. Members set the agenda and there are always choices. Activities have included a range of arts and crafts, gardening, visits to the local museum and library, walks and days out. Pupils from Musselburgh Grammar School also come regularly to the Centre and have become firm friends. Last year Members and young people enjoyed a joint Christmas party. In April, members participated in a Co Production Workshop on the future of the Musselburgh Meeting Centre.
Members tell us how much they enjoy coming along to the Centre. They have fun, feel comfortable, build confidence and are socially connected. We can see how people grow in confidence and ‘feel like me again.’ We’re also alongside people when times get tough. Carers also enjoy the trips out and events and benefit from peer support, support from the team and respite. The Centre has grown strong community roots, supporting a Friendship Group for people across the area, participating in the Musselburgh Community Day and partnerships with local businesses and organisations.
The East Lothian Dementia Strategy
The East Lothian Dementia Strategy was designed with people with lived experience and focusses on promoting rights and helping people remain as independent as possible for as long as possible.
“To enjoy daily life, activities and connections as we all do, and for their worth and value as individuals to be recognised and supported at each step of the dementia journey.”
The ELHSCP dementia strategy is a commitment to enable this to happen. The strategy sets out the needs and intended actions to help support people living with dementia and their families. It covers access to information, diagnosis and post diagnostic support, dedicated support for carers, expanding community connections, maintaining independence, transport, housing, staying safe and understood as well as care services and end-of-life care.
Social and community supports are a vital component in helping to maintain people with dementia at home for longer and to enable them to be active, healthy and engaged. The East Lothian dementia strategy brings opportunities for innovation, and a joined up holistic approach to supporting people with dementia and carers and challenging stigma.
The Musselburgh Meeting Centre and the extension of the Meeting Centre Approach across East Lothian are developing community capacity and increasing awareness of dementia. ELHSCP sees the Musselburgh Meeting Centre approach as an excellent example of partnership working between the community, third sector and formal HSCP services.
A Meeting Centre for Haddington?
We talked in groups and together about the Haddington Area and the needs, gaps and opportunities that a Meeting Centre might fill. Local carers said there is a need for community-based support for people living with dementia when generic services and community groups are no longer suitable or safe. Carers told us people living with dementia often need a more balanced and designed social and sensory environment, based around dementia friendly design principles, and more personalised working. Meeting Centres do just this. They are designed to be more than just dementia friendly, they are designed to be theraputic. The team adopt a person centred approach, with a focus on each person and what they need as well as on the group as a whole. Carers are also supported. Meeting centre sessions are planned to tailor personal experience so people can maintain and develop confidence, skills and competence.
Meeting Centres are set up using a community development process that brings together experts by experience, communities, services and professionals to create and run a Meeting Centre. The process focusses on key questions to create a business case, including: who comes, how do they come, what happens there and what resources are needed. We made a start on some of these questions at the workshop.
Who would come to the Meeting Centre?
Where people live The Haddington and Lammermuir Ward has a population of 20,079 and 11,354 people (56%) live in Haddington. Between 2014 – 2022, 134 people in the Haddington and Lammermuir Ward were registered with dementia. 107 people (80%) live in Haddington and 10% in Gifford (see above). Across the county, 5% of people registered live in rural settings, the highest proportion of these residents are within the Haddington and Lammermuir, and Dunbar and East Linton wards. These include the rural towns of Garvald, Gifford, Morham, Humbie and Bolton.
Where’s the gap? People felt that Haddington has limited community facilities for its population size and that transport was a key issue, especially for the villages. There were mixed views on what the gap is and whether there was capacity to support another community led group.
We also discussed whether we should focus on supporting people with a diagnosis of dementia or keep a wide vision. Graham told us that Kirrie Connections supports people with signs of mild cognitive impairment (MCI – a risk factor for dementia) and there is no requirement that people have a diagnosis of dementia. He explained that people could wait a long time for a diagnosis and this was a time when Meeting Centres can play a key role and fill a significant gap. In East Lothian, there is no follow up for people with MCI by the Older Adult Mental Health Team unless they are isolated. We agreed this was an area where a Meeting Centre approach could make a significant difference.
How would people come to the Meeting Centre?
We talked about whether people should be ‘referred’ by a professional. In Musselburgh, Alzheimer Scotland Link Workers contact Fiona when they have someone who would benefit from the Musselburgh Meeting Centre. For MCI, people are diagnised by the Older Adult Mental Health Team. Carers of East Lothian also pass information on what support is available to care-partners. Graham told us that there are benefits of looking beyond a narrow diagnostic pathway to look at where we can fill a gap. explained it takes time for that wider awareness and role to grow and a lot of it happens as the Meeting Centre is becoming established. Fiona from the Musselburgh Meeting Centre told us how they built awareness and relationships by members being out and about in the community, the visibility of the Musselburgh Meeting Centre in the town and at community days and inviting community and professionals into the Centre. Sue explained that the new Brain Hub in Musselburgh was developed in partnership with the Hollies to develop this wider focus and support and reach more people.
Joining up
We talked about how people living with dementia and care-partners need to see a ‘pathway of support’ for different stages of living with dementia. A pathway, route or map for people with lived expereiunce rather than service providers can help people manage things today, plan for tomorrow and prepare for change. Problems arise when there is no ‘next step’ and carers can feel they are on the edge of a precipice and have to wait for a crisis for things to happen. Services and community support need to work together and ‘join up’ to stop that happening.
For example Fiona explained that as there is no Day Centre in Musselburgh, the Meeting Centre is supporting people with higher levels of disability and impairment. Meeting Centres do not provide personal care and do not register with the Care Inspectorate. Day Centres provide that essential and higher level of support so are an essential bridge into higher levels of care. There is a gap at a critical point. There are significant benefits all round of working together.
Graham told us how Kirrie Connections works with members and care-partners to help people manage and plan transitions into Day Centres and care homes when the Meeting Centre can no longer provide the support required. This support helps people living with dementia and care-partners manage a difficult and challenging transition into day care or a care home.
Where? When? What?
Key decisions we need to make
We talked about some of the decisons we need to make that affect what happens at the Centre.
Venue – where would the Meeting Centre be? Are there spaces that meet the criteria? Sue explained that in Musselburgh, Janice, Chair of the Health and Wellbeing Group, visited and ‘mapped’ all the community spaces in Musselburgh. The project team identified a short list and a group of people living with dementia and carers visited them and we agreed a venue. Graham told us that in Angus there are Meeting Centres in sports club and a carers centre and Kirrie Connections started in an unused council building provided for free, they now have their own building. Musselburgh Meeting Centre is in the church coffee lounge. Graham advised us to find a ‘good enough’ building and make a start, however small.
People – we need a trained and stable team of people to run the Centre, including a mix of employees and volunteers. This is the biggest cost round a Meeting Centre. Where would funding come from? What support might we get from Musselburgh? We agreed that we need support from ELHSCP for the costs of running the Centre.
Opening times – are often determined by the venue, the availability of the team and finances.
Resourcing – If the community is going to take on this role, there needs to be a partnership with ELHSCP and the Council. We need a mix of funding sources grants, donations, member contributions, in-kind support and we need to look at different approaches, including social enterprise models and income generation opportunities. We need to start small and build evidence of need/impact to make case for more resources.
What we decided
We agreed we’ve made a significant start in our conversation. There’s interest in exploring a Meeting Centre model further, but concerns about resources and sustainability.
We want to form a working group to take this conversation forward. A collaborative and equal partnership is essential from the start involving people living with dementia and carers as equal partners and local activists and groups, along with ELHSCP, Meeting Centres Scotland, Alzheimers Scotland, Volunteer Centre East Lothian and Carers of East Lothian.
DFEL is planning to employ a development worker for a year who will provide support to explore and support the development of the Meeting Centre approach in the Haddington Area.
What happens next?
We agreed to meet again on 16th January 10am – 12 noon in Haddington. Diann kindly agreed to find a venue. All are welcome. The next stage is to work through the Meeting Centre process to help us make a decision about if and how we want to proceed. We need to:
- set up an initial working group to take the conversation forward and guide the exploration/development process
- do a community mapping exercise to identify assets and gaps, including dementia specific and dementia inclusive options
- explore potential venues and partnership opportunities
- connect and learn from dementia-friendly community work already happening locally and wider
- involve the whole community to assess local interest and needs and raise awarness of dementia and the meeting centre approach, including social media and working with networks
- explore funding and resourcing options, including discussions with local businesses and the Area Partnership
- develop a business plan, including funding options and sustainability strategies
Finally!
Phew! A lot of work, thank you to everyone who came along and gave so freely of your time, experience and creativity.
Thank you for agreeing to explore this approach with us. The outcome may be a meeting centre, it might not be; but the process of coming together to look at how we can make life better is the worth its weight in gold.
We’ll share details about the meeting via the Health and Well Being Group and social media.
See you in January!
Take care
Sue