Wednesday, 30 November 2016

Care Partner Wednesday--Flowers and Kittens and Little Kids

Hannah during a 2009 visit

"Grandma, can I go to your work? I really like dressing up in a party dress and talking with everyone."

Since Hannah was six months old, trips to Christie Gardens have been part of her life. When she learned to walk, she would toddle, and then run, down the long corridors. Equipment such as walkers and wheelchairs didn't phase her a bit. She searched for the chocolate eggs residents left for her at Easter and carved a pumpkin with them at Hallowe'en. Mostly, she talked and talked with them, and they were delighted with the conversations. School and distance have made visits more difficult, but we are planning a trip over Christmas this year. After all, she asked.

The Eden Alternative second principle states:
"An Elder-centred community commits to creating a Human Habitat where life revolves around close and continuing contact with people of all ages and abilities, as well as plants and animals. It is these relationships that provide the young and old alike with a pathway to a life worth living."1

It just makes sense, doesn't it?

Then why don't we do it?

We create sterile, "safe" environments for our elders which resemble hospitals more than homes. They may be beautifully decorated, but the essential elements mentioned here are not only missing, but in some cases, forbidden. Animals in long term care? But what about, and what if, and maybe... 

And then there are children. Not every child has the advantage, like Hannah, of having a grandma who lives and breathes eldercare.
 Because we are a mobile society, grandparents may live far away, and many children aren't familiar or comfortable in the presence of older people. Where I work,  school groups are welcome. We have an ongoing relationship with a neighbourhood school, and over the years, many different classes have come to visit on a monthly basis. Those children grow up with visits to the elders as a fun part of each month. At the moment, we have a Kindergarten class of cherubs and a Montessori school of even younger cherubs who visit, show us their work, sing and talk with the residents. Last year, a grade 1/2 class became comfortable enough to teach our residents how to make a craft.

Having children visit brightens the day of the elders, makes them smile and laugh and produces interesting conversation.

What does it do for the children? The equipment of the elderly, such as walker, wheelchairs, portable lifts and oxygen tanks, can be frightening to a small child. With regular visits, these fade in importance, and the children see only their friends. They learn to talk with people who don't hear or see well and may seem unusual to them. They discover the elders are people with wonderful stories. They are enriched.

What about plants? Even if you were never a gardener, most people love growing things. My sister hates gardening, but every year she spends a fortune at the garden centre. Why? Because she loves flowers. She buys beautiful hanging baskets and positions them around her gazebo. Her garden is full of flowering perennials, and she lies in her hammock with a book and enjoys them all summer. 

                                               Our patio garden

Beside adding oxygen to the atmosphere, plants, and especially flowering plants, nourish our souls. We have many outdoor spaces at work, including a lovely Courtyard garden, but my favourite is the patio area in our neighbourhood. Here we gather to watch the community walk by, and smile and wave to them. We eat ice cream, watch the birds and chat. 

One of the plants on our patio blooms just once a year, but the brilliant, orange blooms last for about a month. Many residents go to the garden just to admire it. 
I see moods lighten, anxieties lessen and days fulfilled as elders spend time in the garden. Now that it's winter in Canada, our pots of plants have come inside, and fill four tables in a lounge and dining room. 
They continue to nourish, until they and we can enjoy the garden again.

And animals? That's a subject near to my heart that deserves a blog post all of its own. Stay tuned...



Wednesday, 23 November 2016

Care Partner Wednesday--The Plague of Boredom

Dull. Repetitious. Tedious. Boring.

Do you feel like yawning? I lay my head back and close my eyes when I hear the words. Or, I jump up and find something to do. Boredom, especially if it lasts for more than a few hours, causes me to slide into a dull stupor. My thinking goes on autopilot and my eyes

Boredom plagues many of elders, who are isolated by physical limitations. Many think the best situation for an elder is to live out their lives in their home, bringing in supports such as help with bathing, meals and housekeeping. This has its advantages, but isolation is a huge downside. These elders don't have the strength or ability to get out, so their only company is the television, the caregivers who visit them and occasional family. Those who choose to live in long-term-care aren't isolated, but can also face boredom if the activities offered are sparse or not geared to their interests.

The key to dealing with the plague of boredom is found in the first domain of well-being, identity.       If I know an elder well, I know what lights up her eyes, animates his speech and makes her face glow. If I can tap into that, no elder will ever be bored.

Dora's happiest memories center around her family's cottage. If you ask her about it, she will talk with animation for hours.  Melissa loves Gilbert and Sullivan music. Even though a stroke has stolen her right side and many of her abilities, the songs thrill her as she sings along. George reads train magazines, and his passion is locomotives. He loves to have someone talk trains with him. Jean likes to knit, and chats about various topics as she visits with the other ladies. None of these elders are bored, because they are known, and this knowledge leads to activities which feed their passions.

It's important to know what boredom is not.

  • Boredom is not necessarily being alone. Some people enjoy, and even need time alone to recharge.
  • Elders who frequently fall asleep aren't necessarily bored. Some elders have limited strength, and need several periods of rest each day.
  • Being busy isn't the cure for boredom. I can be busy cleaning toilets, but it certainly doesn't excite me.
One of the greatest challenges is the frail elder who has had many losses and is nearing the end of her journey. Josephine was one of these. She no longer talked, and her face had little expression. I would talk to her while I helped her to eat lunch, but she never indicated she understood. Was she bored?  I didn't know, but I continued to reach out to her.

For birthdays, the staff gathers around the resident, presents them with a gift bag and sings, "Happy Birthday." I expected no response from Josephine, as was normal for her, so I was delighted when her sagging head raised and her eyes opened wide. She stared at me through the whole song, and although she was no longer able to smile, I connected with those shining eyes. It was if she said to me, "I'm still in here. Thank you." It was her last birthday.

When we make the effort to truly know who our elders were and who they are today, and explore their dreams and passions, we can use this information to combat the plague of boredom.


Care Partner Wednesday--The Plague of Boredom

Wednesday, 16 November 2016

Care Partner Wednesday--The Plague of Helplessness

"Can I help you?"
"How can I help you?"
"Let me do that for you."

These well-meaning words can be exactly what's needed in the situation, or they can be the first, crippling step toward helplessness.

"The three plagues of loneliness, helplessness and boredom account for the bulk of suffering among our elders." 1

The elderly deal with losses in their bodies on a regular basis. Today, they walk with a sure step. Tomorrow their gait is faltering, and they need a walker. One day, they might not be able to walk at all. Today, they can feed themselves salads and drink tea with enjoyment. Tomorrow, they might need assistance to eat their meal and need their food minced to prevent choking. Because their bodies are slowing down, they aren't able to do what they once could. They need help.

This isn't what I mean by helplessness.

The plague of helplessness is when an elder can do some things, and isn't allowed to. Perhaps he can put on his shirt but has trouble with the buttons. Rather than wait until he gets on his shirt, the care partner takes over the whole operation. They are quicker and more efficient. Soon, he doesn't try any more. Eventually, he can't.


Helplessness strips elders of dignity. It sends a clear message: your value is diminishing.

Many elders need care. How do we combat the plague of helplessness and still provide care?

Emphasize independence
When providing care, look at what the elder can do, and give them the time and encouragement to do it. The loss of abilities can be frustrating and depressing, so it is important to look at what can be done.

The other day, a resident came to me with a piece of mail that had been delivered to her in error. I was in the middle of something, and almost asked her to leave it on my desk and I would deliver it to reception later. I stopped myself, realizing that she was capable of taking the mail to reception. Her steps were slow, but she would get there. I caught myself in time and directed her to where to take her mail. She did it herself.

Emphasize choice
Allowing an elder to make a choice, even if it isn't the choice I would make, combats helplessness. Choosing not to eat lunch, choosing two desserts instead of lunch, choosing to wear three shirts, choosing to stay in bed until noon or later, are all choices I have seen in the last few days. I know some of these choices bother those who are caring for the people who made them, but they are choices the elder can make and feel that they have autonomy. They are not helpless. In the end, does it matter if I miss a meal or wear three shirts or sleep until noon? Sometimes the "what matters" is only in the mind of the person providing the care.

Emphasize giving
Nothing causes tears to spring to my eyes sooner than to see an elder giving to another elder. An encouraging smile, a squeeze of the hand, a word. The opportunity to go beyond ourselves and our own struggles and encourage another is what makes us human. When an elder does that, their inabilities are minimized.

There have been many days when a comment from an elder made my day, and I told them so. When I open myself to receive while caring, the elder I am caring for is no longer helpless. We are in a reciprocal relationship.  I receive as much as I give.

As a care partner, I have the ability, with the purest of motives, to create helplessness in those I serve. All I need to do is--everything. I remove choice, because I make better choices and give without recognizing the ways in which I receive. I may feel I'm doing a good, or even an excellent job, but in creating helplessness I am causing suffering.

As a care partner
Care Partner Wednesday--The Plague of Helplessness

Wednesday, 9 November 2016

Care Partner Wednesday--The Plague of Loneliness

Loneliness, helplessness and boredom. If you've spent any time around those who espouse the Eden Alternative, the words roll off your tongue. The first principle states:

"The three plagues of loneliness, helplessness and boredom account for the bulk of suffering among our elders." 1

Loneliness doesn't need definition. We've all felt it. It's not necessarily about being alone, because I can be by myself and be content. Or, searing loneliness can rip me apart. I can be with a group of people and feel desolate and isolated. Or, I can experience acceptance and joy.

I have two friends who are important to me. We go out to dinner together, go to movies, and on one occasion, we helped one of the group clean her garage. We listen to each other and support each other. We laugh and cry and check up on each other. When I am hurting, I know these friends are just a call away.

What if they weren't?

What if, tomorrow, both my friends passed away?

I would experience the most profound loneliness, as if the supports had been knocked out from under me. I would flounder.

Many of our elders experience this on a regular basis. Their friends, those who they depended on and had fun with, are gone. Family cares for them and visits, but they have their own lives. Days stretch endlessly, and they begin to wonder why they are still here.

Remember when we discussed connectedness?
It's meaningful connections that dissipate loneliness.

Esther came from hospital to our neighbourhood. Cataracts clouded her vision, and she was almost totally deaf. This new world was frightening and lonely. At lunch, rather than take her to our dining room, I arranged for her to eat in the neighbourhood next door, where her friend of 60 years lived. She sat at the table, and a few minutes later her friend rounded the corner. When they recognized each other, their faces glowed. "I can't see much, but I can see you!" Esther's loneliness evaporated, and now she connects with her friend three times a day at meals.

Gina and Jane live across the hall from each other, and sit at the same table in the dining room. Although they've only known each other since they lived in the care section, they've become fast friends and look out for each other. Gina goes to Jane's door and picks her up for those events she might be to anxious to attend. Jane reads the newsletter to Gina, who can no longer make out the words. Their connection has made their lives rich and full.

Loneliness is a plague that comes from institutional living. The more we create "home," the more we are able to make loneliness evaporate.

Care Partner Wednesday--The Plague of Loneliness


Wednesday, 2 November 2016

Care Partner Wednesday--The Domain of Joy

"This is what makes us different." The wife of one of the residents stood by my desk with a glowing face. "You're not perfect. Nobody's perfect. But this..." she waved her hand, "this is wonderful. Special. This is what makes us different."

She was referring to the many staff in all departments who dressed in costume to make life fun for residents on Hallowe'en. Everywhere you turned there was something new and fun to see in the form of a staff member in costume. In our neighbourhood, Robin Hood gave you your pills, Waldo (as in "Where's Waldo?") helped you get ready to meet the day, Jack Sparrow fixed your toilet and Superwoman greeted you at the desk. Every time residents discovered a new costume, there was laughter, exclamations, and yes, joy.

Joy is at the pinnacle of the triangle of the seven domains. It can be elusive, and is dependent on the other domains being fulfilled. Unless I know you, we are connected, my life contains meaningful activities, I can make choices,  I feel secure and I have opportunities to grow, joy isn't possible.

"One of the best ways to understand“joy”and the role this emotion can play in our experience of well-being is to become aware of how often it sneaks up on us. Moments of joy often catch us by surprise. These joyful moments cannot be scheduled, structured, or commanded into existence. They can only emerge from the moment. No one can say “I’m going to experience joy at 2:30 this afternoon.”Efforts to intentionally create joy for others are doomed to failure. The best soil for joyful moments is always found in places where relationships are deep, rich, and intensely meaningful. It is through the relationships we have with one another that we can discover ways to recognize and celebrate moments of joy when they occur."

Have you ever noticed that media seldom depicts happy, laughing, joyful people who are also elderly? It's a subtle message, but it's clear. Joy is for the young. There is no denying aging brings incredible challenges. It does. However, it can also bring joy.

Just ask my friends.


Care Partner Wednesday--The Domain of Joy "This is why we are different."