Respect for each other’s work

I have been spending a lot of time recently in residential aged care homes sitting watching the people who live there and those who care for them.

It struck me as  I watched carers at work just how self-focused they had become. I watched a lifestyle staff member leading a group of people with dementia in an activity focused on Bastille Day and she was doing a good job of keeping people focused and enjoying it. However, as happens a few people became restless and began to walk away, one walking up close to someone else and causing some disturbance and another wanting to walk with a person who was listening. Someone else was snoring loudly and making it difficult for others to hear!

What is unusual about this was that there were two care staff nearby writing in files. This is a necessary part of the day but right at that moment they were treating their colleague as a “sitter”, someone to “mind” their people while they got on with their writing. This is not just a problem invovling care staff. It occurs with all staff groups.

What would have been more respectful of their colleague and more helpful in maintaining their residents in a good emotional state would be to assist their colleague by remaining engaged and attentive to what was happening in the group and intervening when needed.

Unfortunately this attentiveness can be rare, especially when staff are so focused on their own work that they lose sight of the bigger picture and the TEAM focus. Each different type of staff member contributes differently to the success of the day by assisting all others to achieve their own goals.

The consequence for the person in our care is they they are not the focus of our care attention – our job completion is. This becomes staff/organisation-centred care – not person-centred care. This is just one small way in which the institution and our work habits can get in the way of person-centred care.

What is your experience? Does this happen where you work? How can we organise our workplaces better so we have better cooperation among colleagues and more person-centred work practices?

Fiji Aged Care – Yvonne Jackson

Yvonne Jackson is a Australian aged care nurse living in Fiji where her husband is working for two years. She writes of aged care in Fiji:

Last week I was one of four women from the Corona Women’s Charity who visited the Father Law Home situated just outside Suva. We provided morning tea and $300 of groceries and donations from local companies which included adult diapers and frozen chickens. The Corona ladies try and visit every 3mths.

The reception was very welcoming with the residents and staff coming to say hello with their lovely big smiles. The morning tea was followed by Bob and other residents entertaining us with a few songs.

The elderly in Fiji are traditionally cared for by their families and the community, but like the Western world, people move leaving the elderly behind so care is needed. Suva has three age care facilities; the other two are ‘pay as you stay’. Father Law Home is free to residents therefore totally dependent on charities. This is typical of most health care facilities in Fiji, they are all trying to providing the best care they can with few resources they have.

We must accept that Fiji is a third world country, the elderly are not neglected but the money is just not there. Father Law Home was built in 1955. It is home for 25 men and women of mixed cultures who are cared for by 3 nuns and 8 paid staff, which include 2 cleaners and a cook.

We walked into an open covered area between the kitchen and the lounge/dinning, room where we were to have morning tea. Further along are the toilets, bathrooms and laundry. The bedrooms are 2 to 4 bedded and recently several of the small, men’s bedrooms, have been knocked onto one large shared room resulting in a reduction of privacy but let in a lot more light and air. Everyone agreed it is a great improvement.

Sister proudly showed me the lounge/dinning room. Her nephew came to stay with her and paid for the floor to be tiled (the torn lino and carpets removed), he painted the walls and replaced the 3 broken fans. A little goes a long way in Fiji.

The government provides free medical care, regular dental, eye checks and free burials. Father Law home has to pay their own electric, gas and water rates. They are dependant on grants, donations and charities. Residents do not pay but 3 families do donate approx. $200 a month. When I asked about their income I was given a long list of donations all small and all different but which together pay for the residents care. For example recently 2 local companies donated fish and chicken otherwise their diet is vegetarian (Father Law Home has a large chest freezer). Rotary are in the process of fitting water tanks (mains water supply is not dependable) and Corona want to replace the old broken toilets and showers but was told they work and we were asked if we could start with the fly screens which don’t work.

This is normal for most caring facilities in Fiji with little money available the needs are great. The list of organisations asking for help are endless, what we do is a drop in the ocean but we hope all those drops together make a difference.

Yvonne Jackson Fiji

If you can help with towels, sheets, pillow cases and light blankets etc., (even second hand) these items can be sent to Father Law Hom in Fiji. Contact the manager Veronica Mulu <veronicaflh@yahoo.com> to arrange it.

Can anyone fix dementia care?

Have a look at this video of Sir Gerry Robinson made by the BBC. He is a business man who specialises in turning around businesses from failure to success. He looks at what can be done in dementia care in two homes in the UK.

What he finds makes you want to throw your head back and wail in frustration and sadness.

Yet, he finds some signs of hope. The BBC series is broken up into several 15 minute pieces in these video clips telling the story of his journey.

This video is the first of several I will link to in a series of posts over next few days. This will be well worth your time just to see what is being done and what can be done.

Let me know what you think. What is happening in your place? What grabs your attention?

Merry Christmas and Happy New Year!

to all our readers and customers who have supported the work we do.

Our goal is to create opportunities for older people in care to experience wellbeing and to support those who care for them. You have contributed to that work and we thank you.

We look forward to working with you and stimulating reflection on the person-centred approach to care practice  in 2011.

Our office is closed from 24th December and reopening on Tuesday 4th January 2011.

For immediate response and for EAP enquiries we can be contacted on 0408 145 819

Best wishes

Bernie

Families in aged care

Families affect the wellbeing of the people you care for. Some are easy to have involved and others are difficult. Every one of them is doing the very best they can and in the only way they know how, to be involved in the care of their older relative.

Think about your family for a moment. It is the place where you attached to your mother and father and learned the ways of relationship and behaviour in society. How to function and feel, how to solve problems and make your way in the world. You also probably learned how to avoid some feelings. Its all part of your own attachment history with your caregivers.

Now come back to the families you have in your work. The older person is the attachment figure or caregiver for the younger people who visit them, their adult children. And you are now an attachment figure for the older person. How the wheel turns.

Some families do not cope well with being replaced by professional caregivers. They feel angry and guilty at the same time. They think they should still be the primary person to provide care for their mother or father. Some parents have instilled this guilty thinking into their children so they are caught. Others find themselves doing it naturally.

Caring for an elderly parent is not easy so we should be patient and understanding but also careful to maintain healthy boundaries for ourselves and them.

Next Thursday you may wish to come along to the latest public training day we are holding on “Working with families in aged care” at the Assisi Centre, Rosanna, Victoria on Thursday August 5th from 9.30am to 4pm.

Bookings limited by space so book soon on 03 9431 0311

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Aged Care and the Federal Election 2010

Aged care is rarely a sexy vote winner for political parties but as the population is ageing pollies are having to pay more attention to aged care as an important topic in the discussion.

Caregivers either at home or in paid roles are squeezed by expectations to provide high quality care with minimal support and in some cases inadequate support. Residential carers are expected to provide person-centred care when the staffing levels are clearly inadequate for them to do so. This is complicated by poor pay for nursing leaders encouraging good quality nurses to leave aged care and return to acute care where they can get more money. This leaves aged care with too few nurse leaders.

So can we get the pollies to acknowledge the need for more staff per person in residential care? Ask your local politician when next you email them!!