James lives in supported living in South London. His self-contained flat is in a development which benefits from a shared living area and a team of Support Workers available 24 hours a day. James has a diagnosis of schizophrenia, one of the symptoms which adversely impacts on his quality of life often is neglecting his self-care. Until late 2017, James preferred to have an overgrown beard, making him look generally unkempt. He had also been declining dental check-ups for years.
James’ keyworker, who had developed a strong trusting relationship with him, as well as a great understanding of how schizophrenia was impacting on his quality of life worked with him to develop strategies to help increase his motivation and desire to care for himself better. This was much needed as James had a heavy cold, and his appearance had declined further.
James’ Keyworker encouraged James to focus on himself, motivating him to become clean-shaven and stay that way. Emphasis was placed on supporting James to increase his self-confidence, and motivation to care about his appearance again.
It was another two years before James could be persuaded to attend a dentist appointment for a check-up. In the meantime, his support team would often talk to him about teeth and oral health when he was in a receptive mood. They encouraged him to brush his teeth and explained how dental practices had changed in the years since his last visit, with treatment being a lot more modern and less painful. The team also continued to work in collaboration with James’ community psychiatric nurse.
Patience and persistence paid off, and James agreed to a dental appointment, only to change his mind as he left the house. Eventually, when he was ready, he sat in the dentist’s chair but again declined to have his teeth examined.
At this point, the local dentist had to refer James to a specialist dentist, and James agreed to attend a series of appointments to prepare him for the required treatments.
Preparing for surgery
The next step was a general anaesthetic in October 2021 to remove 20 teeth that were beyond repair due to extended neglect. By this time, his Keyworker had become the Home Manager. Still, she continued to work closely with James’ new Keyworker and other team members offering constant support to prepare James for his upcoming operation. Their positivity ensured he was informed and ready and would not have second thoughts about undergoing the day surgery.
To take his mind off the impending op, James went out a day trip to London and a meal out with his Keyworker.
James’ apprehension was all too evident when he asked the Home Manager for a hug as he left for the hospital in the early hours, saying, ‘I’m not sure if I’ll be coming back.’ In the event, James needed to stay overnight, and his dedicated Keyworker stayed with him throughout.
Within days of his mouth healing and no longer in pain from his decayed teeth, James made a new request. He wanted to go to McDonalds, something he had never asked for before. Team members soon noticed a notable change in his sociability and confidence, too – he has even started to visit the local snooker club with others in his house.
The process of fitting James with dentures began soon after his surgery, and six months later, in September 2022, they were ready. He is keen to wear them daily and is consistent in cleaning them, and is keeping up his personal grooming routine.
Home Manager, Cynthia Babundo, says: “We are delighted at the progress James has made and so pleased to see him taking an interest in new things. At Christmas, he joined the support team and other tenants for a meal out for the first time ever.
“He also recently announced that he would like to take a holiday to Hastings, which previously he has always declined to consider. He’s even talking about how he and his Keyworker will be able to cook in their caravan.”
Who knows what adventures await James in the future?