Sarah Crockett, author of Activities for Older People in Care Homes, writes about how, with the right attitude, activities co-ordinators can turn any situation (even an outbreak of illness) into an opportunity for positive interaction.
Being an Activity Co-ordinator means different things to different people – and it often means different things depending on what day, or time of day it is. But what is at the core of the role? If you got down to the bare essentials what would it look like?
Activities for Older People in Care Homes
In a community of people who are particularly vulnerable, an outbreak (lit. more than 7 people ill at once) means that everyone is barrier nursed, everyone is confined to their room, seeing one or two people in the day, and in the worst case restricted to bread and water as well. But the thing about sickness from an activities point of view is that it reduces everybody’s complex needs to just one. I am bored and miserable, make me feel better! And in this setting, what makes almost everyone feel better is a smiling face, a cup of tea (or hot beverage of choice), and a good chat. Sure, what the chat is about is different for everyone – although most people will start off from much the same topic – I hate being stuck in here on my own. And yes, the theme that develops will be very personal, but its people being people at grass roots level. Being an activity person suddenly ceases to be about complex needs, reams of paperwork, trying to make life better in a big way for everyone, trying to manage a budget (or lack of one), trying to create a press release worthy event every single week, forward planning, all the myriad things that go on day to day. Suddenly it’s about one human being sitting with another human being and just being! It’s the most person centred activity I’ve done in a long time, and the one that’s met the most needs. I have to admit it’s exhausting and exhilarating in about equal measures; the day seems endless with none of the usual structure built in, but the quality of the interactions rockets. There is nothing else to do, no desperate pressing of time, no secret conviction that one’s time could be better spent in doing this differently. There is just the person in front of you – oh, and the cup of tea. It can be daunting – going in to visit someone that you don’t usually sit and chat to, wondering if there will be enough to say, wondering if you are the right person to be doing this. But ultimately you are the right person, because you are the person that is there.
I’d like to introduce you to Edward. He’s been with us four and a bit months. I’ve been in and chatted to him a little, and enjoyed it, I’ve done an assessment of his needs – he’s nursed in bed palliatively, he loves classical music, and his personal radio needs to be in the bed with him, he is a practising Christian who will take communion whenever offered, and he doesn’t want a glass of beer – he’d rather have apple juice or tea. But with 61 other people, that’s about as far as I’ve got so far. Earlier this week I was part of a conversation that talked about him giving up, being very depressed, being very weak, saying that actually his death is very near. He spent most of this week asleep, or violently angry at the world. Wednesday morning after I cancel all the activities planned for the day I walk past his room. A carer coming out says that he is calm this morning, and awake. So I go in. He’s just got a cup of tea, so I sit and help him drink it, and listen to him talk – mostly he just needs an audience. I don’t necessarily agree with some of his opinions, but I’m here to boost him, not me, so I make the right noises in the right places, and gradually the conversation starts to shift. Half an hour later I offer him another cup of tea, which he accepts. And half an hour after that, another one. By now we’ve talked about his career as an engineer and draftsman, my garden and first potato harvest of the year, the fact that whoever stuck the roof on the building opposite didn’t have the first idea of coherent design, he just wanted to tart the place up to sell, and money as the root of all evil. Oh and steak – the joy of a good steak dinner, possibly involving potato salad. Edward has also asked me to pass him the model buses from the desk where they are half hidden in the 90th birthday cards. He’s shown them to me with the pride of a creator. He made them himself in his shed. He would go and look at the real things, make notes, then create them from the blue prints in his head. We discuss the idea that it’s the same with me and making clothes – seeing how a thing ought to go, and making it so. He shows me the tricks, where they come apart, his favourite views. He tells me how he made them. He also tells me that his sister used to design clothes, but couldn’t draw – she’d describe them to him, and he would draw them. He tells me that his hobby was always woodwork, it lit him up.
At the end of an hour and a half he decides he shouldn’t hold me up, and dismisses me to ‘go and get on with some jobs’. I assume he’s tired, so do as I’m bid. If Edward is tired, it’s with the status quo. When the carer comes to help him with his lunch – he is too weak to manage to feed himself, or to chew very much – he tells her in no uncertain terms that she’s not to mush it all up like that, and she’s to sit over there in that chair whilst he gets on with his lunch thank you very much. By the end of lunch time everyone is talking about how Edward ate his own lunch, and the carer who was made to sit in the corner is wearing it like a badge of honour. That afternoon Edward demands paper and pencil, and sits drawing the view from his bedroom window. The following morning he demands bacon and eggs for breakfast. When I arrive he not only remembers me, he wants to know what took me so long, and is thrilled that I’ve made him some potato salad fresh from the garden! Two days later Edward (who suffers from acute postural hypotension) is sitting on the side of his bed, trying to get up.
I’m not saying this is all down to me, to the feeling of being actively listened to, there are other contributory factors – for example he has come off his medication this week as well. But I do know that this was an hour and a half of my time very, very well spent.
Activities for Older People In Care Homes is now available from Jessica Kingsley Publishers.