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Latest blog from our CEO: Planning makes a real difference

It’s that time of the year when people start to think of books for the summer holidays. Every year I go through a ritual of picking three or four books, take them with me and return with most unread!

In recent weeks one of the books that has dominated the non-fiction bestsellers lists on both sides of the Atlantic has been ‘Option B: Facing Adversity, Building Resilience, and Finding Joy.’

After the sudden death of her husband, Sheryl Sandberg became something of an internet celebrity with her heart-wrenching open letter to her late husband. Her voice had been previously prominent enough as Chief Operating Officer of Facebook but now she had a whole new audience as she spoke about the total overwhelming shock of sudden death.

She felt certain that she and her children would never feel pure joy again. “I was in ‘the void,’” she writes, “a vast emptiness that fills your heart and lungs and restricts your ability to think or even breathe.” Her friend Adam Grant, a psychologist, told her there are concrete steps people can take to recover and rebound from life-shattering experiences. We are not born with a fixed amount of resilience.

Option B combines Sheryl’s personal insights with Grant’s research on finding strength in the face of adversity. Option B goes beyond Sheryl’s loss to explore how people have overcome hardships including illness, job loss, sexual assault, natural disasters, and the violence of war.

It is a strangely life affirming book and surprisingly uplifting.

One of the constant themes in Sandberg’s writing is how important it is that we should be as prepared as possible for life-changing events. Had she and her husband talked and planned about things then she suggests life might have been so much easier.

It is often hard to talk about declining health and to have the discussions with family and friends that ensures that our wishes and feelings are taken into account when we might not be able to make our views known. But planning and letting others know what we want can make a real difference to those who love us.

A couple of weeks ago Scotland’s national ‘Anticipatory Care Plan’ was launched. Developed by a range of stakeholders through Health Improvement Scotland this resource includes an App, guidance notes and a pack to help individuals and those who support them be better prepared for palliative and end of life support.

Have a look at it, as it is a tremendously practical and useful resource. The hope is that as many people as possible have the conversations that matter.

Conversations and making plans of course involves people. We know at Scottish Care that care at home and care home staff are often the folks who people talk to and with whom conversations around care are being held every day. We equally know that in order for the ambitions of the Anticipatory Care Planning programme to be achieved we need as a society to give workers ‘time to talk.’ Put simply amongst other things that means changing the way we develop and monitor contracts to make them time flexible and sensitive. Proper planning around illness and palliative care has to become centre stage to the way we commission services and procure care. Unless that happens the conversations will not have the space to take place.

There are two events later in the year that will provide an opportunity to explore planning as well as other palliative and end of life issues. The first is the Scottish Partnership for Palliative Care Annual Conference on 20th September. The second event is Scottish Care’s Palliative and End of Life Care event on the 12th October.

Dr Donald Macaskill

@DrDMacaskill

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Guest post from Local Integration Lead, Robert Telfer

“We’re all going on a Summer Holiday…..”

Or so Cliff Richard sang, as some of you of a certain vintage might remember. It’s fast approaching the time when many of us turn our thoughts to our own summer breaks and, indeed, I may well be off on my own travels as you read this. For those of you who don’t know me that well, I have confession to make – there must be some nomadic blood in me, as my idea of a holiday is to hitch up my caravan to the car and head off to, hopefully, sunnier climes. For about the last seventeen years my wife and I have spent our summer break travelling down through France and venturing into Northern Spain on a couple of occasions. We tend to go early in the summer because it is both quieter and cheaper – yes, I’m miserable and tight-fisted, that’s now three things you didn’t know (well, maybe you did!).

Something I have noticed every summer while in France is the number of, shall we say, more mature, UK citizens who also take advantage of the off season prices and the lull before the high season rush. People, well into their 60s, 70s and quite a few into their 80s travelling around the villages and scenic areas of France in their motorhomes or with their caravans in tow all enjoying the relaxing lifestyle. When you have worked for many years in caring for older people settings it can become easy to forget that growing old does not necessarily mean admission to a care home, package of care in your own home or even just severely curtailing your style of life. There are many, many older people now enjoying life to the full as those folk I have met on my travels demonstrate. Most, if not all, of the Scottish Care Integration and Improvement Leads will work alongside other partners in workgroups looking at ways of promoting health and enabling us all to enjoy our lives to the maximum potential for as long as it is possible. The Falls Prevention groups, the ongoing work in promoting good nutrition, encouraging active lifestyles, stroke prevention etc. When you see these older people enjoying an active, healthy lifestyle it does reinforce how important the health promotion work is and the very obvious gains that are potentially to be had.

Still on the holiday theme, when I worked in Care Homes it was very common that when you entered a resident’s room you would notice family photographs displayed, either on the wall or on a dressing table. Often these would be holiday snaps from trips taken many years past, small faded black and white snaps or perhaps even some colour photos but with that peculiar tinge to them that old colour snaps seem to take on. A closer look at these photos would often show that the young woman in the frame was recognisable as the older person currently sitting in the bed, that perhaps those young children around her are those 50 something year old adults who come and visit at the weekend now and that young man standing beside her is a husband now sadly no longer with us. These photos would normally be a good way to initiate conversation with most residents. The question of “ Where was this taken?” would often prompt a detailed reply of where, when, who was there, where they stayed and other details. As the residents spoke about their holidays of long ago, their eyes would light up and it would be evident that enjoyment and pleasure was being gained from just thinking and talking about those days. Not only had enjoyment and pleasure been achieved during the actual holiday but many years later those memories were still giving happiness.

So, to anyone reading this, where ever you go on holiday this year I hope you have a great break and, remember to make as many wonderful memories as you can.

Where ever you are going — May the Sun Shine Upon You – unless of course you happen to be going on a skiing holiday, that might not be so good!

 

 

Robert Telfer, Local Integration and Improvement Lead, West Lothian and Renfrewshire.

 

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Care Home Week 17: Guest blog from Iriss

Care Homes and Community

Scotland’s shift towards delivering more support for older people in a community setting has led to lengthy debate and discussion on the future role of residential care. There has been a national push to ensure that care homes don’t become ‘islands of the old’, but are seen as community assets integrated into daily life.

The future of residential care report highlighted the importance of community involvement to encourage more volunteering in care homes. It also placed emphasis on the importance of flexibility from the Care Inspectorate when it came to registered care homes providing an outreach service to non-residents in the local community.

As it’s Care Home Week, we thought it was a good opportunity to flag our 2014 project with Ardenlee care home and Scottish Care, and to highlight the learning and tools that could be used by other care homes around similar initiatives.

Sunday lunch club

The idea for Ardenlee was simply to invite isolated older people in the community to attend a Sunday lunch and afternoon of activities at the care home. At the time of the project, Ardenlee was experiencing lower occupancy, which prompted management to reflect on the role of the care home going forward. Aware that the landscape of care was changing, they wanted to start exploring other ways they could be using the space they had available.

The work aimed to:

  • Dispel myths associated with care homes: that they are just places people go to die
  • Support older isolated people in the community to access social/peer support in a safe setting
  • Raise the profile of the care home’s respite service among the community as a place where people can maintain their independence
  • Explore alternative uses of long-term residential care homes to begin to plan for the future

Eligibility criteria was developed for the Sunday lunch club to ensure that they were able to meet the outcomes of guests without compromising the quality of care for their residents.

What worked?

  • Engaging early with residents, families and staff about the idea to understand their hopes and fears as well as give them some ownership of the process.
  • Engaging with the community (including the befrienders, Crossroad Carers and various care at home providers) to understand what was available and where the gaps were.
  • Building a robust business case with associated risk assessments. This included looking at all the policies in the home and considering how they may be impacted by the lunch club. This supported the case for the Care Inspectorate and helped management understand impact.
  • Identifying a geographical catchment which was enough to include some very rural areas, but still manageable in terms of transport.
  • Meeting with the local care inspector to pitch the idea and work together to make sure the service could work in a way that meets care standards.

Are you interested in opening up more in the community? The full project story provides further learning, details of the outcomes for the residents / guests, and helpful tips.

You may also be interested in our Outcomes in a care home setting cards to support delivering outcomes-focused care.

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Dreaming: Wishing Well

On the final day of #carehomeweek17 our theme is #dreaming. Below we learn more about Kingdom Homes Wishing Well initiative.

Kingdom Homes has 10 care homes located throughout Fife each home dedicated to either nursing care, residential care or specialist dementia care. Within each of our care homes we ask residents to let us know if they have a dream to take part in an activity or a special day out by posting a “wish” in the Wishing Well. The Wishing Well is located in the Reception area of each home.

We have granted many wishes over the years including –

  • Taken a gentleman who for many years was manager of a cinema to a modern day cinema to see behind the scenes, how films are shown today. His wife and son were able to accompany him on the visit too.
  • The honour of taking a gentleman, the last remaining member of his Black Watch regiment, to the Black watch Museum in Perth to see the Weeping Window poppy display.
  • Taken several gentlemen to Ibrox football stadium to see their favourite football team’s ground.
  • Taking a gentleman to the paper mill where he worked all his adult life to see how the modern day mill operates. To his delight, when he was presented with a hardback copy of the firm’s history book, he discovered a photograph of himself in his apprentice days was published in it.
  • Several ladies have been taken on special shopping trips.
  • A retired bus driver gentleman went to Stonehaven for the day, his favourite destination when he used to drive coach loads of day trippers during his working life. Kingdom Homes’ minibus was at his disposal for the day and he was able to plan the route with our driver. He enjoyed lunch in one of Stonehaven’s pubs before returning home.
  • Another lady wanted to go for a drive into the Scottish countryside so she and a couple of other lady residents that she is very friendly with went to Pitlochry for the day, enjoying the beautiful scenery on the journey.
  • A wish was granted to take a lady and some of her family, back to Craigtoun Caravan Park near St Andrews where she and her husband first set up home together.

 

At Kingdom Homes we are delighted to be able to grant these wishes – the smiles on the faces of our residents and their families who accompany them are worth every bit of work that goes into organising the trips. We are humble to make their dreams come true, making new memories and stimulating old ones for very special people.

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Latest blog from our CEO: the Power to Dream

Rituals and routines are important and one of mine is that as I get my 2 and ¾ year old daughter up in the morning (the ¾ is important in nursery politics) I ask her did she have any dreams. She usually – unless grumpiness is present due to the early rise – says ‘Yes.’ When then asked ‘What about?’ She replies, ‘Monkeys and crocodiles’. Never ‘Crocodiles and monkeys.’

I am one of these folks who has never been able, with the odd exception, to remember my dreams but I know that the world of dreams is a very important part of our health and wellbeing. Yet despite years of analysis and debate from Jung to Wallace, why we dream remains one of the great mysteries of psychology. Some say its to do with consolidating our memories, others that dreams provide an enactment of threats to prepare response, and yet others that they are to do with regulating our emotions. Hundreds upon hundreds of books have been written about dreaming not least around the belief that dreams are a gate to greater insight, and in some cultures that they provide insight into the future in the nature of being premonitions.

Not surprisingly I am not going to discern that mystery today – give me some more sleep and I will try.

But there is another sense in which we talk about dreaming and that is the imagining of a world or a reality which is different to the one we are currently experiencing. Perhaps this sense was best encapsulated by Martin Luther King whose immortal speech, ‘I have a dream’ led a people to struggle and gain freedom from discriminatory law and behaviour in the 1960s Civil Rights movement.

Today is the last day of the inaugural Care Home Week and it is about ‘dreaming…’ It is a day where you are invited to dream with your imagination firmly rooted in reality about a new future and about different possibilities for the shape and life of care homes in Scotland.

We know the challenges that we face with an ageing population and reducing resources. We know the need to attract more and more committed individuals to work in our care homes and to properly reward and respect those who dedicate their lives to the work of care. But we also have, in the midst of challenge, to give space to be able to dream. We have to have the power to imagine better.

What do we want care homes to be and to look like?

Might we dream of a time when the old are not just considered as recipients of care and support but are recognised as contributors and valued citizens with still much to give?

Might we dream of a time when the physical care home building was a place at the heart of our community with doors open in safety to a neighbourhood which saw it as a place of happiness and enjoyment; of value and worth; of insight and surprise?

Might we dream of care as being seen as a critical role for our society intrinsic to making us a human community, well-valued, with good status and appropriate remuneration? A role held equally by men as by women, by the young as well as those not so young.

Might we dream of care homes being sufficiently resourced that they are able to be properly staffed so as to offer excellence in the care and support of conditions as diverse as dementia or multiple sclerosis or cancer?

Might we dream of care homes as places where poets and painters, musicians and politicians, dancers and dreamers live and spend their time? Places where death sits as comfortably as life, where honesty abounds and risks are entertained?

Might we dream together and make our dreams for care homes a reality for as John Lennon once said:

A dream you dream alone is only a dream. A dream you dream together is reality.

Happy care home dreaming.

Donald Macaskill

@DrDMacaskill

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Care Home Week 17: Guest blog from Alison McPherson

 

 End of life care does not stop when the heart stops beating.

As a home manager, the care home I manage provides care for 57 people; 28 people who are living with dementia, and 29 younger people who are living with alcohol related brain damage.

Some of the residents do not have family members, through estrangement or because they have outlived their relatives and for these residents, relationships with the staff members are the closest to family that they have.

When a resident died, he was a few hundred pounds short of paying his funeral.  As there was no family, there was no one to claim benefit or contribute to the cost and he ended up in a pauper’s grave with no marking to remind people of his life.

This was distressing for the care team.  We discussed this within the team and it was decided that the care home should purchase a plot in the local graveyard where we could respectfully lay our residents to rest, with dignity.

Since then, the staff have arranged funerals for a number of residents, working with a local humanist (Paul Harkin).  The service is planned and the memories of fellow residents and staff members are recorded, and form the basis of the memorial service.  Staff members volunteer to be cord bearers for the coffin.  By supporting staff and residents to remember their friend and to participate in the organisation of the service,  they are able to grieve.  It provides an outlet for their feelings and provides opportunities for other residents to think about their own funeral, how they would like to be laid to rest, what music they would like, etc.  For some of them, they had never considered this an option. 

Staff members select music to be played, and this is normally songs that held meaning for the resident.  For one man it was Status Quo, ‘Rocking All Over the World’.  For another it was Judy Garland, ‘Somewhere Over the Rainbow’, as this was from his favourite film.

The memorial service is then held in the care home. The staff members prepare the room and residents are supported to attend.  When Paul delivers his service, very often there are not many dry eyes in the room.  The hearse is brought to the care home and staff and residents follow to the graveside, where the committal takes place.

On the return to the care home, a purvey is provided and we sit together, as one, to talk about our memories of the person we have lost.

Life has many roads, and for some they get stuck on a path. This doesn't mean that a person should not be afforded dignity at the end of their lives.

 

 

The Dash - Linda Ellis 1996

 

I read of a man who stood to speak

at the funeral of a friend

He referred to the date on his tombstone

from the beginning to the end

 

He noted that first came the date of his birth

and spoke the following date with tears

But he said what matters most of all

was the dash between the years

 

For the dash represents all the time

that he spent alive on earth

and only those who loved him

know what that little line is worth

 

For it matters not how much we own

the cars, the house, the cash

What matters is how we live and love

and how we spend our dash.

 

I'm privileged to spend my dash looking after others, ensuring that every day on earth is a day worth living, is a day where they are afforded dignity and respect.  And when their life is coming to the end, they leave knowing that they are safe and that they will not face their final journey alone.

 Alison McPherson (Hillview Care Home)

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Friendship: Strachan House Care Home

Today, all day, during #carehomeweek17 we are celebrating #friendship. Scottish Care's Integration & Improvement Lead Rene Rigby describes how Strachan House Care Home helps to foster inter-generational friendships by linking up with pupils from the local primary school. 

"The care home itself is located between Craigcrook Castle and Blackhall Primary School in Edinburgh. It provides care and support for some eighty two residents.

 

"Pupils from Blackhall School are regular visitors to the home and their choir performs for the residents, who love to hear the young people singing.

 

"The school pupils also join with residents to participate in a ‘bridging the generation gap’ initiative, where the children write stories and then spend time with residents discussing their writings.

 

"This week, to celebrate the friendship between the community and those living and working at the care home, the residents and children were joined by relatives and staff and enjoyed an outdoor fair ground musical concert thanks to Dignity Charity. The music unlocked and evoked many memories. The sun was shining, the gardens were alive with the chatter of voices old and young, there was an enjoyable interlude when we all had an ice cream cone.

 

"The beauty of collaboration in this inter-generational event is that we combine strength with wisdom."

Rene Rigby

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Care Home Week 17: Guest blog from Margaret Mackie

Today's #carehomeweek17 theme is #friendship and Anderson's Care Home in Elgin benefits from enjoying numerous enduring friendships with organisations based in their community. Margaret Mackie's blog below provides more insight into the value of these relationships to residents at the care home. 

 

In Anderson's, we believe that people in residential care should be able to enjoy a quality of life equalling, even surpassing what can be available to older people in their own homes. Individuality is important and actively promoted. Each person brings his/her own personality and unique life experience. 

One of our residents who is well known in the community and especially to our local football club, continues to attend home matches so we invited the football players to join us for tea, fun and games. So lovely for our residents to meet the players, coaches and legends from Elgin City Football Club. We were also joined by VIP Childcare Moray with whom we have a wonderful intergenerational link. The youngsters visit us on a weekly basis and entertain us with singing, stories and cuddles. VIP Childcare have their own vegetable plot in our gardens and our residents love to watch them planting their vegetables and watching them grow. The horticultural students from Moray College UHI  visit each week and attend to our gardens.  This is something special for residents who were keen gardeners. They enjoy picking the fruit and vegetables at the end of summer. We have also welcomed their beauty therapy students who spend time pampering our residents who really enjoy the attention.

We were very fortunate to welcome “employee volunteering” Chivas volunteers to join us on a couple of occasions. The first visit, they painted our fences in the gardens with the residents providing the juice and sweeties during the day. Their second visit, the Chivas volunteers assisted carers to escort our residents to East end School, with whom we also enjoy fantastic intergenerational links to watch their nativity play.

We Love to celebrate special events in a big way, i.e. Easter, Halloween, Christmas, Queens birthday, Valentine’s Day, Robbie Burns Day etc. Our residents look forward to these special events and enjoy helping to make the decorations at the arts and crafts group each Friday.  Once a year, we host a “Wig Wednesday” fun day. This is in aid of Clic Sargent supporting children with cancer. Residents really loved making their own hats and wigs and we were delighted to raise £333 for the charity.

Each Christmas we receive a special invitation to attend a Christmas dinner at our RAF base in Lossiemouth.  Gordonstoun school also send out an invitation to us each Christmas to spend an afternoon with them and enjoy a lovely high tea and entertainment from the pupils. We are regularly attended by volunteers from the students and there has been a community link with the school for over 40 years.

One of the most revolutionary ways in which Anderson's communicates with our community is via our Facebook page which shows all the wonderful things our residents participate in and all the events which take place.  By engaging in the medium of social media we have opened up a whole new world of communication for both our residents and relatives alike as social media has helped to bridge the gap in generational participation.

This is particularly lovely for families who live a distance away, especially those living abroad, who are able to respond and leave their own comments.  Our Facebook page is very popular and we receive thousands of likes on some of our posts.

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Ordinary Living at Abbeyfield Kirkcaldy Society

It is Care Home Week 17 and today we have been focusing on Ordinary Living. 

The residents and volunteers at Abbeyfield Kirkcaldy Society have provided us a snapshot of their everyday lives and activities at the care home, providing wonderful insight into the friendships and joy fostered with care home living. 

Mary McKay

"I’m very happy and very comfortable here at Abbeyfield. In fact I’d be happy to spend the rest of my life here. I like the things we do, they are great fun and good. The food is good, there’s always something nice to eat. The staff always go out of their way to help."

Helen Key

"Life at Abbeyfield is very good. I find the staff exceptionally good. There’s always something interesting to do and I’m glad I came here to live. My husband came to visit but took unwell and he was allowed to move in here until he eventually went into hospital. I felt that was so very special and I’m grateful that it could be done. I have also been supported to achieve a life long ambition which was to go to see “Take That”. I was taken to their concert in Glasgow. I’ve got the tee shirt!"

Bill

"The family didn’t want me staying by myself due to my mental and physical state. And so the decision was made for me to move to Abbeyfield.

"Two of my biggest problems were anxiety and depression. Since coming here I’m feeling so much better, more confident and relaxed. Being here is helping me get back to a more normal lifestyle. There’s great support here from everyone. I’m allowed to help out in the kitchen set tables etc, things I once was able to do at home. I’ve established contacts at the local church where I’m going to begin volunteering and have been out with the walking group “bums off seats”. Having people around me has helped enormously, I’m much happier within myself and feel things are heading in the right direction."

Jeannie

"I’ve volunteered here for over eight years. I began shortly after my mum, who was a resident at Abbeyfield, had passed away. I feel me being here helps gives the care staff more time with the residents. I love all aspects of the work that I do. I have training when needed or wanted and the care staff are always supportive and great to work with. They have made me part of the team."

David

"My recent holiday to Pitlochry was first class in fact I would say it’s the best holiday I have ever had. The hotel was lovely, the food was terrific. I went in a Jacuzzi for the first time in my life. There were only a few others in the pool and the whole thing was marvellous. I loved the outing to the House of Bruar for a shopping trip, it was great fun – nice soup! It was so good I had two bowls of it. The visit to the new dam centre was really interesting, lots to do and see and the views were great. I liked the Heather Gems factory and shop and found gifts for my daughters. We went to the Black Watch museum but they took ages with the meals so we didn’t have much time to look around. The only two downfalls were the singer at the hotel who hadn’t a clue and the bank holiday traffic on the way up. It was a great crowd I was with and we had a great time. I’m happy living here at Abbeyfield, you couldn’t find a better place. This is my third holiday since I came here, last year was to the Trossachs, and every one has been special. Life here is great, good company, good food, great outings."

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Care Home Week 17: Guest blog from Jai Chohan

To complement our Ordinary Living theme today during Care Home Week 17, we are featuring a blog from Jai Chohan at Broxburn Care Home. Harry was a resident at the care home and this blog describes how the staff were able to meet Harry's needs during his time there. 

Harry first came to our attention last summer via social work. He was residing in a home in Edinburgh where they were struggling to manage his level of stress while maintaining his independence. As a result, Harry had become difficult to care for and refused all help.  He was also absconding from the home regularly and displaying distressed reactions towards staff and fellow service users. Harry had no awareness of his own wellbeing or safety and in his own words believed everyone was ‘out to get him’ he just wanted to go home to his flat in Edinburgh and to see his friends at his local pub.

Harry had a history of alcohol abuse and suffered from poor mental health as well as his dementia diagnosis. As a team at the home we reviewed his needs and visited him at the home in Edinburgh. From this we felt that if we planned his care prior to admission, included him in his care planning and let him set his own realistic goals we could meet Harry's needs and improve his quality of life.

When preparing for his admission we used the issues that arose in his current home to prepare a safe and comforting environment for him. We also made sure all staff members were aware of Harry, his needs and our plans to encourage self-help. All staff in all departments played a huge part in Harry's care and in the improvement of his mood, care and general quality of life.

To care for Harry we had to get to know Harry.  He was allocated a key worker and named nurse, however everyone helped to bring Harry out of his shell. We found out about his life, his jobs, what made him happy and eventually he opened up about what made him sad and we began to get to the route of his problems.

Kitchen staff worked hard to include him in his meal choices to promote a regular varied diet. We saw his weight increase and he began to come out of his room and socialise at meal times. Housekeepers included him in cleaning his room as he would often leave his room in a very poor state.  Over time he began to take pride in his room and environment. He became close with staff and as he saw it, we were now his friends. We assisted with all his care needs when he first arrived as he did not want to look after himself. After encouragement, prompting and TLC, Harry began to shave himself, then shower himself, he put clean clothes on himself and cleaned his teeth. Before Harry became unwell he was primarily self-caring.

Harry was a very happy, caring and empathetic man who had lost his way slightly. Harry's dementia, mental health and alcohol issues were being treated but Harry the person had been forgotten. Our main goal when caring for him was not only to ensure he was healthy and comfortable, but also to meet Harry's own goals and outcomes. He wanted a pint in the pub, a cigarette, a Mars bar and a glass of cola at night amongst other day-to-day basic items. With every positive step Harry made with us we would help him meet one of these goals. We discussed why there were limitations for him, helped him to understand and included him how we would work around these.

We understood what he missed from his life and tried to incorporate it into his new life. He looked at Broxburn Care Home as his home and staff as his family and friends. We endeavoured to meet his everyday relationship and home comforts that he clearly craved.

Harry sadly became unwell and passed away, however while he was at Broxburn we strived to give him a good quality of life and believed that we did. He had his good days and bad days as we all do but during his year here he went for pints with staff and his son, regularly walked with staff to the shops, had a visit to Edinburgh and attended church. He became self-aware, happy and valued that he had met a lot of his own goals and we all still miss his happy face and silly jokes.