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Thinking like Tolstoy

Updated: Jan 24, 2023

By Isobel Sibley



As Business Development Manager for ‘Extra Care’ within Safe As Houses, myself and my fellow team members spent invaluable time in Birmingham attending the Dementia, Care & Nursing Home Expo on the 15th and 16th September.

Throughout the two days, I attended many extremely thought-provoking seminars covering several topics. These ranged from developing supported living services to the digital transformation of the care industry, but a theme that was consistent throughout both days was an ongoing discussion surrounding Equality and Diversity.

This is a massive topic within the social care sector nowadays, and because of its increased acknowledgement in society, it’s a subject I wanted to share my views on following the event.


Equality is about ensuring everybody has an equal opportunity and is not treated differently or discriminated against because of individual characteristics.

Equality is about ensuring everybody has an equal opportunity and is not treated differently or discriminated against because of individual characteristics. Diversity is about taking account of the differences between people and groups of people and subsequently placing a positive value on those differences.

Sadly, we live in a society where older people can often be overlooked and the tremendous value that they bring to society is often neglected and sometimes even lost altogether.

It goes without saying that the elderly bring a wealth of knowledge, experience and wisdom. Their life experiences can be a tremendous asset to all of us.

In many cultures across the world, the older people become, the bigger the celebrations get and the root of this thought is something we need to embrace and acknowledge across social care. We need to focus on the positives that older people bring to us as a society and as individuals.


An interesting cultural reference was brought up during one lecture and it really struck a chord with me. ‘The Death of Ivan Ilyich’ by Leo Tolstoy is only around fifty pages long but packs a punchy story about ageism that is well worth a read. The book touches on the important issues of getting older and serves as a lesson from the past that is relevant in today’s present and hopefully, well into the future.

In the book, renowned judge, Ivan Ilyich is taken ill and cannot get out of bed. Tolstoy tells us how the people around him purely focus on looking for the next judge and not the fact that poor Ivan has become unwell. This is highly relatable when we look at some of the disappointing family situations we have all come across when working within the care sector. The Person-Centred care approach of the late 1980s is, of course, widely attributed to Professor Thomas Kitwood. Person-Centred care is a way of providing care to people by focusing on the person's uniqueness and preferences, instead of the disease, its expected symptoms and challenges and the person's lost abilities.


Person-Centred care is a way of providing care to people by focusing on the person's uniqueness and preferences, instead of the disease, its expected symptoms and challenges and the person's lost abilities.

Looking specifically at Dementia, Person-Centred care recognises that dementia is only a diagnosis and that there is much more to the person than merely a diagnosis. A Person-Centred approach changes how we understand and respond to challenging behaviours. For a person with Dementia, we can look at their behaviours as a way of how they are trying to communicate their needs - their way of reaching out and trying to communicate with us.

The Person–Centred care approach encourages and empowers the caregiver to understand the person with Dementia as having remaining abilities, life experiences, personal beliefs and human relationships that are hugely important to them as a person and contribute to who they are as a unique individual.

On a moment-by-moment basis, Person-Centred care allows us to see the world through the eyes of the vulnerable and enables older people to become part of overseeing their care plan. This is an incredible lesson and as a society, as organisations and as individuals, this is how I believe we should all operate.

As an analogy – think about the body. Your hands would not work if they weren’t attached to your wrist, and your wrist would be useless if it was not attached to your arms. Everything is connected.

We all play a significant part in creating a better, independent and happy life for vulnerable individuals, so we all need to work together to create a positive change within the Social Care sector.

I greatly enjoyed my two days in Birmingham and look forward to taking everything that I learnt far beyond the B40 postcode in my on-going career. I hope you have enjoyed this first short blog of mine. Myself and the team look forward to bringing you more in the coming weeks and months.

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