Thursday, 10 April 2014

Caregiver Wednesday-- Culture change part 2

My mind has been circling a quote for a few weeks.

"Often the best therapy is to provide opportunities for happiness and increased meaning in the lives of residents." 1

These words are the result of an experimental intergenerational program between school children and elders in Australia. It is quoted by Bill Thomas, founder of The Eden Alternative, in the forward of a book I am reading (and loving) called Dementia Beyond Drugs.

It's simple, but profound, and forms the basis of everything involving culture change.

Instead of looking for a medical intervention when people with dementia exhibit the behaviours that are common with the disease, look for non-medical answers. Why didn't we think of this before?

Many reasons.

Our generation has grown up in awe of the medical advances that have made living longer and healthier possible. And indeed, we have much to be thankful for. Vaccinations, antibiotics, insulin, and advances in the treatment of so many diseases. I am not anti-medication. Even anti-psychotic and anti-anxiety medications can be effective when given in low doses, closely monitored and given after all other non-medical interventions have been tried. Sometimes they calm the person just enough for other, non-medical choices to be effective. The problem comes when they are our first line of defence.

There are other reasons we don't easily default to a more social, holistic approach.

It's expensive.

It isn't an exact science, and often requires many attempts to find the right key. And each person's key is different.

It's difficult to measure results. How do you measure happiness, purpose, control, personal growth? There are some indicators, but it's more challenging.

Another discussion in the book which has had me mulling for weeks, is the difference between care and treatment. "Care means helping a person or relationship to grow." 2 This isn't how I normally think of care. Isn't care "looking after"? "Doing for"? Although there is an aspect of that in our caring, if I am able to shift my focus from what I am doing to what the other person needs, there can be growth.

Caring in culture change says, "It's not about me, and what I am doing for you, it's about you--who you are and what you need to grow."

Treatment is more medical in nature, and more measurable. I have a wound. You treat it. It gets better. Treatment is important, because those we serve are frail, with multiple illnesses. They need treatment every day. It needs to be administered and monitored. However, they are not their treatments ("the wound in room 3" rather than "Mrs. Jones with the wound in room 3") and their treatment isn't the most important thing about them.

We wouldn't put our medicine cabinet by the front door in our homes. It's hidden away in the bathroom. By the front door, we have a wreath, a welcome mat and a family picture. These are the things that define us, and this is what is prominent.

If we are looking for culture change, our homes need to look like home, our care needs to find ways to bring growth, and our treatment needs to be accomplished quickly, so that residents can get on with life.

Vibrant, growing, interesting life.

1. Dementia Beyond Drugs, pg. x.
2. Dementia Beyond Drugs, pg. ix

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