Ageing By Caring

Every time you smile at someone, it is an action of love, a gift to that person, a beautiful thing. ~Mother Teresa

A smile seems a most appropriate place to start in how to influence the environments within which we work.

I was reminded of the importance of humour from attending a presentation of Dr Peter Spitzer of the Clown Doctors the other evening. http://clowndoctors.org.au

The Clown doctors are most well known for their work in the area of children and hospitals. More recently they are applying that knowledge and background to the care of people who are living with dementia in residential care environments and this work is currently being rigorously researched and evaluated.

Now I have to say, despite being a great fan, I admit to being somewhat sceptical about the application of “slapstick” humour in people living with advanced dementia. I had a little discomfort about this and wondered if it could be considered to be patronising or infantilising in some way.  Seeing the application of this work in action though clearly dismissed any misgivings I may have had. To see the captivating, engaging and genuine smiles in people living with a mass of tangles and plaques was infectious (in the nicest possible way).

There is no question that the environments within which we work are often difficult. The aged care industry is often filled with frustrations, numerous and quite pervasive inequities and underlying sadness’s, much of which can actually be mitigated with the introduction or perpetuation of humour.

As a consequence of the presentation I was forced to reflect on the impact of humour in my own life. Laughter is a joy to me and a solid foundation of my life. Humour though does sometimes act as both a friend and a foe. Sometimes it is undertaken to make others feel better, sometimes used to hide more lurking and evasive feelings behind.

Never the less the presentation also prompted me to reflect on the final days of relationship with my Dad. Despite him being in an obvious and heartbreakingly painful dying process, humour and laughter continued to pervade our interactions.

A note from my diary reads….

Watching us gather around you ….depending on you to make us laugh…Depending on you to take our pain away…And you do…As you have always done. You make us laugh out loud.

The boys share a beer with you – propped up in your hospital bed…waiting for the important pain numbing drugs to take effect …the drugs that will nurse you to your now expected death. I look around and see joy, laughter and appreciation for all that you have been to us.

You have your beer through a straw…and continue to tell jokes …to be the iconic Aussie lad that you are …..and then you sing to us “close your eyes and I will kiss you” with Adam your  beloved grandson , (representing all the grandbabies) laughing out loud…But taking that bottle and saving it for an eternity….knowing it was the last beer shared with his beloved pa.

This was his gift to us and our reciprocal gift to him…laughter humour and joy. This was a humour demonstrated love. A powerful love that could transcend the pain and the hurt because it was such an important part of the relationship we had always had with him. A reminder yet again that humour should never be withdrawn, even in times of such pain and hurt.

So thank you Clown Doctors for reminding me of these things

So how can you use this information to influence the environments within which you work?

The Mantra for you and for me this week:

• This week I will smile more (and as the Dalai Lama says – keep smiling and others will come to you)
• This week I will influence the smiles of others and on a daily basis do something with intention that brings a smile to another’s face.
• Every day I will reflect on the impact of laughter and joy in my day

And how will you know you have succeeded

• You will feel more love
• You will be surrounded by more love

For an additional slant on the power (and potential spirituality) of laughter have a look at ; http://www.youtube.com/watch?v=we_iR9BWBcw&feature=player_embedded#t=166s

Ahhhhhhh the joy of laughter….xx

You cannot open a book without learning something. (Confucius)

Importantly you have to have a belief that things can be better. When you are convinced of that,  you need to do your research and find evidence to underpin those beliefs.  Information is everywhere. At no other time in life have we been more exposed to the capacity to seek guidance and information from so many sources. But you have to be thirsty – do your research find your resources. Then share them …even with people, who may not want to share them….and you will make them thirsty also.

So what are some of the things that may influence the care of people in the aged care environment in a more person centred way ?

Obviously information about Person centred Care is the place to start. Read and gather resources to share with others. You might like to start with the “Father” of person centred care” Professor Tom Kittwood and move on from there. His book “Dementia Reconsidered: The Person Comes First ” is a place to start.

You may like to look at this PowerPoint slide presentation as an introduction:www.groups.psychology.org.au/Assets/…/conf05_pape_Woods2.pdf

or some work put together in Australia:

nursing.flinders.edu.au/comeintomyworld/

But also be thirsty for information around change management (and that is really what we need to do) and communication and leadership. You might like to consider setting up a research group in your work environment – where different people research different things and share it with colleagues in some formal or informal way. You might like to look for resources to share on change management and managing change in challenging (aged care) environments??

So ….the Mantra for you and me this week is:

• Every day this week I will search for an answer to something which will enhance my professional environment
• Every day this week I will share this information with others

And how will you know you have succeeded

• You will be enriched by new learning’s
• Your environment will be enriched by new learning’s
• You will have an increased passion for your work

Everyone thinks of changing the world…but no one thinks of changing themselves (Leo Tolstoy)

I am going to have some regular short sharp blogs over the next few months …to reflect on some of the things each and every one of us working in aged care can do to increase person centeredness in the environments within which we work.

It is so easy to put out there …in so many ways…that the issues that arise and that we are often forced to face in the aged care setting are because of “the thems” . “The thems” might be the government, the bureaucrats, the funders, the owners, the managers, the colleagues, the families or even the clients ….but seldom do we explore the “us” in that equation. The reality of course in life…is that it is only the “ us” that we can influence or change.

But in doing so – we have an opportunity to influence others by demonstrating another way … a way that is valued and respected and appreciated …a way that others want to follow…a way that improves the quality of life of those we choose to serve.

You might like to look a bit further at a model called the integral model (Ken Wilbur) which provides an increased academic understanding of some of these principles of change.

You might like to understand this further :

http://www.google.com.au/url?sa=t&source=web&cd=1&ved=0CCQQFjAA&url=http%3A%2F%2Fen.wikipedia.org%2Fwiki%2FKen_Wilber&ei=AyJ4Tu64OurEmAW7y5jVDQ&usg=AFQjCNHkZR8IBbhP9yvARI0-ej90_m5AxQ

or see the potential of its application:

http://www.aubynhoward.com/Pdfs/IntegralModelIntro.pdf

The broader application of the integral model reiterates that there is an interior and an exterior world that we can influence. The interior world is that which influences people and culture, whilst the exterior world influences performance and systems.

There are also potential interferences which may compromise the integral approach. Things such as self talk, or behaviour or culture and systems.  This series of blogs will attempt to provide some strategies in all of these areas…particularly as it relates to creating more person centred environments for older people.

Each of these blogs will have a format of an introduction to the subject material – a set of tasks for us to undertake – appropriate resources to assist – and some guidance as to how to measure whether you have made a difference.

I look forward to your contribution also and hope that we will be able to mutually share strategies and resources in the quest to create increasingly positive environments for older people.

After all ….each of us can make a difference

“We must not, in trying to think about how we can make a big difference, ignore the small daily differences that we can make which, over time, add up to big differences that we often cannot foresee.” – Marian Wright Edelman,

One person can make a difference, and everyone should try.
(John Fitzgerald Kennedy)

This suddenly feels like such a responsibility…and yet one which I have wanted to pursue for quite a while. Firstly though let me be clear about the purpose of this blog and the opportunity to be more interactive with all of you.

I am aware that setting up a blog has a certain expectation attached to it. After all – what is it that I know that I assume I can share with others??? Or dare I even assume that others would be interested in sharing??? Please allow me to be clear about my expectations and limitations in this area.

I know a lot about ageing, aged care and living with dementia. This has, after all been my life for almost 40 years. Interestingly though the other thing that has occurred over time is my own ageing, my own maturation and at times my own seeking (and sometimes finding) of life wisdom’s. I am an observer of people, of circumstance and a seeker of truths. I like most, have experienced life events which have informed me, changed me, impacted upon me deeply and fuelled a need for further understanding.

I am so sensitive to the inequities, the injustices that often underpin the care of older people but I am also painfully sensitive to many of the pervasive injustices of life in general. To some degree that marks the foundation of this blog…this alignment (or collision) of the planets of these two aspects of my life……and a desire to share these observations to make a difference. I am now in a relatively peaceful part of my life. In a joyous relationship with a loving partner, choosing work that makes my heart sing…(although too much of it at times) continuing to work on my own personal and spiritual growth , seeking inspiration and mentorship from others whilst still working with acceptance of some of the challenges in my life.

I have stood in front of classrooms for many years now sharing my thoughts, my observations my dreams for the future of aged care but change has been so slow, painfully at times.  I am challenged regularly in these settings by how we can truly change things. Despite surrounding myself with likeminded people and people who believe all things are possible, we struggle regularly to impact on rigid and insensitive systems and often archaic, primitive thinking. Well this is putting my money where my mouth is…..literally.

Last year I lost my adored father and mother in law in circumstances which could readily be considered “aged care disasters”. The additional pain of being an aged care professional, having worked in the industry for forty years…who could not even guarantee her father or her mother in law a gentle final journey – was devastating. I actually lost my voice after these incidents. I could not recall their stories, as the pain was too pervasive, the regret, the remorse and the anger too overwhelming.

Now though is the time. These stories have become an impetus for working harder to make a pervasive difference. I understand that there would be two views about this, both of which were outlined in evaluations of a workshop I facilitated the other day. On one hand participants congratulated me on being brave enough to share my life and my stories…in the pursuit of outlining fully the impact of “person centred care” whilst others said there was little to be gained by presenting negative stories and that positive examples of care practices are what influences people . I would like to think though – that there is benefit in doing both ….although ultimately you now become the judge of that over time.

With great humility I share and seek answers to making a difference …in aged care and in the broader arena of life. I will make a commitment though, if using an example of poor practice to ensure I provide a counter balance of a positive one …or at least offer some contributions to what could make a positive difference in the future. My blog therefore aims to contribute to that….nothing more …nothing less…welcome to the ride.