As Holy Week and Easter are the most important events in the Christian Liturgical Calendar Year, I wish to join with our Prior General, Brother Jesus Etayo, to wish all of the members of our Hospitaller Family of Saint John of God peace and joy.

Furthermore, I wish to thank everybody for the daily commitment in continuing the work of Saint John of God in the manner that he would approve of. It is true that we face many challenges in the day to day management and administration of our services for a variety of reasons, but we must not be discouraged.

The message of Easter is one of hope and courage. Brother Jesus tells us in his Easter message ‘not to be afraid for the Lord is Risen’. Yes, the Lord is truly Risen and He is with us as He promised He would be. ( Matthew 28:20) It is this conviction and the total trust in Him that this gives rise to in our lives that enables us to face the future with hope.

I will let Our Father, Saint John of God, conclude this short message: “I have nothing else to say to you, except to express the wish that God may save and keep you and lead you and everybody in his holy service.” (Letter to Luis Bautista)

United with you all in the joy and the hope that this Holy Season brings us.

Brother Donatus Forkan OH


Butterfly Model med

Director of Nursing at Saint Josephs' Centre, Norma Sheehan, presents the Butterfly Model

“Creating a family like atmosphere and sharing closeness, matters in dementia care”.

It was with this simple concept that David Sheard founded the ’Feelings Matter Most’ –  ‘Butterfly Model of Care’ for people living with dementia in 1995.

It was started at Merevale House in Atherstone, England – a care home for 36 people living with Dementia – since then the approach has spread across the UK and Ireland.

Known as Butterfly Service Homes, there are currently 60 project homes adopting this model in England, Wales and Ireland.  There are 5 nursing homes in Ireland; St. Joseph’s Centre would be the 6th.   Beginning with Tom Kitwood’s original theory of person centredness, the model also draws on ideas from neuro linguistic programming about personal congruence in leadership (Kitwood, 2007, Goleman, 1999, Dilts, 1990).

It emphasises the need to embed dementia care training in the development of staff’s emotional connection and emotional intelligence.

The Butterfly Model is about staff ‘being’ rather than ‘doing’. The traditional way of care is focused on staff moving from task to task with a sense of ‘doing to’ rather than ‘being with’.   Relationships between staff and people are shaped by: out of bed – wash, dress, - feed - toilet, - back to bed, with over 78% interactions being task based (Ward and Vass, 2005).

In order to achieve this change of staff ‘being rather than ‘doing’ a culture change process which frees the whole staff team up to ‘be’ rather than ’do’ more has to happen.

The ‘Butterfly Model’ centres on eight key components.

Being – person centred care - involves helping staff to shift their focus from only doing ‘tasks’, to being able to reach people on the inside (Sheard, 2007).

Enabling – quality of life starts with really seeing, hearing, and feeling the lived experience of people.  This also involves measuring the minute-by-minute experiences of people, and being determined to improve the moment (Sheard, 2008).

Inspiring – leadership this means guiding people away from detached management to a new professionalism of attached leadership.  Attached leadership is where people lead from the heart-not just by the hand (Sheard, 2008).

Nurturing – staff’s emotions-in dementia care, there is a need to foster positive team relationships, whilst requiring the development of an emotion led organizational strategy (Sheard, 2009).

Growing – training that works moves away from tick-box courses and awareness level competency training.  The focus should be on the development of people’s emotional intelligence-through reflection, modelling and coaching (Sheard, 2008).

Achieving real outcomes – this is all about focusing on policies, procedures and systems as secondary.  Instead, balancing, measuring quality of service and quality of life, become the focus (Sheard, 2011).

Supporting nurses in dementia care – to modernise and to restore compassionate cultures of care – is critical.  This involves nurses being developed to merge clinical best practice with the new focus of nurses knowing how to lead and personally model person centred care and relationship focused support (Sheard, 2013).

Mattering in a dementia care home centres on the core skills in staff of Feel, Look, Connect and Occupy whilst creating culture change through developing a community based on Share, Reach, Relax and Matter (Sheard, 2012, 2013).

Norma Sheehan
Director of Nursing
Saint Joseph’s Centre Hands image
Pastoral Care is central to the mission and core values of Saint John of God Menni Services.  There is a pastoral dimension to all our activities in addition to the specialist services provided through our Chaplaincy Department. 

One focus area for our Pastoral Care Department is End of Life Care and issues. “How we deal with death and dying has been described as a measure of our humanity. We should treat our going out with the same respect and awe that we attach to our coming in, our birth. Both occasions are momentous-both are part of the life cycle” (Perspectives on End of Life Report, 2009, Irish Hospice Foundation)

The above quote comes from the Irish Hospice Foundation who have been doing a lot of work in promoting End of Life Care. As part of End of Life Care the Department of Health has just published a draft general scheme for Advance Healthcare Directives which will be included in the Assisted Decision-Making (Capacity) Bill 2013. This means that Advance Healthcare Directives are currently recognised under common law. So if you prepare one, they are recognised by the courts. But there was no legislation governing them. Until now. The government proposes to bring in a law to govern Advance Healthcare Directive. It will be introduced in the Assisted Decision-Making (Capacity) Bill 2013. (more information on this can be found at,

This move will promote the autonomy of a person to have their wished noted. As part of this the area of End of Life Care will also be noted if the person wishes.  In line with all these developments here in Menni the Chaplain and the Speech and Language department have developed an End of Life Form where the men and women attending our service can have their wishes for End of Life noted if they wish to. 

The Irish Hospice Foundation has developed a form called “Think Ahead” which deals with Advanced Care Directives and the Chaplain has linked in with them in relation to their form and how it can be adapted for the Intellectual Disability Sector. This is in conjunction with the Dublin Mid-Lenister group working on an End of Life Care Pathway for the Intellectual Disability Sector.

The Chaplain in Menni meets with anyone expressing a wish to fill out the form and supports them in doing this. Going forward the Chaplain will run groups on this topic and from this the men and women can make an informed choice around the form (weather to fill out one or not) and also work in liaison with families and key workers.

Staff will be supported in the area of End of Life by taking part in the Final Journeys Programme (a programme developed by the Irish Hospice Foundation).  To date the men and women who have been supported in filling out this form have found it very helpful.


The findings of a three year study exploring the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in Ireland were released at a conference held in Lucena Clinic Services recently. They suggest that improved planning, delivery and quality of effective transition between CAMHS and AMHS are necessary to improve the process and outcomes for young people with mental health service needs.

Funded by the Health Research Board and completed in partnership with University College Dublin, the ITRACK study examined mental health service organisation, policies, processes and user and carer perspectives. Pictured are (from left) research collaborator Dr Barbara Dooley of UCD, Principal Investigator Professor Fiona McNicholas of Lucena Clinic Services and UCD, lead researcher Dr Niamh McNamara (University of Bedfordshire) and conference speaker, Dr Zoebia Islam of University of Warwick and DeMontfort University.

While the transfer of written information between services was perceived to be very good, there was clear evidence that the process of transition between CAMHS and AMHS was poorly managed, with little direct face-to-face or telephone communication between services. Data analysis is currently underway and comprehensive findings will be available in the coming months. For more information see McNamara, N. et al (2013) ‘Transition from child and adolescent to adult mental health services in the Republic of Ireland: An investigation of process and operational practice’, Early Intervention in Psychiatry (doi: 10.1111/eip.12073) PMID: 23826636 [Epub ahead of print].

Research Assistants were Mr Michael Adamson (University College Dublin) and Dr Lesley O’Hara (Lucena Clinic). Collaborators included Dr Blanaid Gavin, Dr Siobhan Barry and Dr Karen O’Connor from Saint John of God Hospitaller Services Group, along with collaborators from Trinity College Dublin (Prof Imelda Coyne), University of Limerick (Prof Walter Cullen), University College Dublin (Dr Barbara Dooley) and University of Warwick (Prof Swaran Singh, Dr Moli Paul).

The ITRACK project was carried out with an award of €198,973.80.

The conference held at Lucena Clinic Services on 11th February was called Mind the Gap: Transition from CAMHS to AMHS in Ireland. Speakers were Dr Zoebia Islam (De Montfort University / University of Warwick), Dr Niamh McNamara (University of Bedfordshire) and Ciaran Cobbe (PROTECT Wicklow).

The conference was well attended by interested parties from Saint John of God Hospitaller Services Group, Crumlin Children’s Hospital, ISPCC, Barnardos, Headstrong, HADD, the National Service Users Executive, Mental Health Ireland, the Mental Health Commission, Mental Health Reform, University of Ulster, University College Dublin, University of Limerick, University of Bedfordshire and University of Warwick.

For further information contact:

Michael Adamson

Research Assistant

Lucena Clinic

59 Orwell Road


Dublin 6

01-4999739 / This email address is being protected from spambots. You need JavaScript enabled to view it.

Additional information