As an occupational therapist at Brenthurst Residence over the last 3 years, I have seen some lovely interactions between staff and the Elders. My learning curve was challenged when I noted the difference between staff who had been here for many years and were totally passionate about their work and the newer generation of staff who were using the Carer role as a step up into their next job. Some people just naturally care, lend a hand and focus on the personhood, but others need to be guided in this process. Other times, the changes in attitude or how Elders were approached created issues between staff which needed a gentle approach to create the necessary changes in how residents were assisted through the various activities of the day. How to problem solve then fell on me in my role as Occupational Therapist as I work closely with all here. I was then officially asked to become the Resident and Staff Advocate as part of my work.
From a young age I was always drawn to the elderly, just having a soft spot for them and wanting to make them happy. My first experience working with elders who were diagnosed with cognitive impairments was when I started working at Brenthurst. I thus needed to establish good working relationships with the Carers and Residents. In the course of my introduction to care of the Elderly, I saw things that did not seem right to me – such as: if a person would be asleep in the lounge or in their room, I noticed that a Carer might not gently awaken them, but just get them up without any consideration for the fact they were still sleepy and not fully aware of what was happening. If you were fast asleep, and people you either didn’t know at all, or vaguely remembered were to be in your personal space and touching your body without your permission, how would you react? How would you feel? How would you feel if someone lifted you off your seat without knowing why you’re being lifted or where you were going to – If you were safe or being abducted?
Granted, I had a lot to learn about caring for folk challenged by Dementia, but humanely speaking, I was affronted by what could have been a gentle process. I tried to reason with myself, saying that it wasn’t as bad and that my own grannie would understand staff are busy. But surely what I saw could be addressed and not just left. I learnt that for a person who has Dementia of any kind, that “Behavior is their Language”. Thus, sometimes a resident would shout or lash out. This was not because they did not want help but because they were upset at being disturbed. Sometimes it appeared there was no reason for the outburst but their facial expression or body language was not read well enough to understand what the need might be.
Thus, started a journey of getting to know the staff, their experience and expectations of themselves and the work as well as getting to know the personhood of each resident. I had to look at strengths, weaknesses, opportunities and threats all round to present my concerns and plan for training the staff in what we call “handling skills”. To this end, I found like-minded leaders in the teams and worked on developing what we now call “Eden Eyes” to actually see why and what we can do to actively honor the wishes and preferences of our Elders. This also meant developing training materials and receiving support of the Matrons to introduce the concepts of there being someone to stand in the gap when things were not “right” or had to handle the “push-back” of staff to changes requested and had to demonstrate in practical ways the opportunities for doing things differently and to look at things differently to meet the needs not initially apparent. Sometimes it made me feel angry but, having been given the opportunity to create change by the CEO, staff training was initiated over a number of sessions during their monthly training so staff could grow in understanding the process of partnering with the elder in the support THEY wanted and needed. Sometimes staff would become frustrated because they were taking so long to “get the job done” and I would step in the gap to help them better understand their roles.
Being a Staff & Resident Advocate is not easy. To speak on behalf of the residents, at times, means speaking about the routines they are used to following. Their perception of me, as well as of Occupational Therapy principles in helping the Elderly requires patience and ongoing willingness to identify and address situations which could be done differently. Having good working relations between us is essential towards how residents are worked with. It is a work in progress, getting minds to shift from “us” and “them” rather to “WE”. I believe that by building healthy relationships between us, allows for a happier work environment as well as a happy home environment for the Elders. We have just embarked on establishing “The Eden Alternative” as a way of life here and I am looking forward to shifting the Paradigms that are not yet in line with this amazing way of life.
Imaan Abdurahman, Occupational Therapist