Let me out! No, Let me in!
Residents in care homes are frequently heard pleading, ‘Let me out’! As this usually isn’t safe or practical I am suggesting that instead relatives start asking, ‘Let me in’! Relatives can be a wonderful resource for care homes, not to mention for their own loved ones. They know better than anyone their loved ones personal preferences and it is likely they will be asked to provide this information on admission so that it can be included in their loved one’s records. However, handing over power to a care home does not exclude relatives. I am suggesting that closer cooperation between care homes and relatives would be a win, win situation and a gift for everyone, including the loved ones. So what can relatives do and how might they do it?
Outings: Let’s start with the obvious. In the summer when the weather is fine relatives can take their loved ones out. This might be as simple as exploring the grounds of the care home. Alternatively it might be a walk or wheelchair ride to somewhere in the local vicinity or a short trip to a special place that holds fond memories. Being in nature has beneficial healing effects for everyone so is always a good choice if available. It doesn’t need to be a grand outing – just ambling along and taking time to engage and observe things and people can be a lovely experience. The outing might involve just family or friends or be part of a larger group.
Note: Outings must be authorised by the care home in advance and any limitations fully understood and adhered to for the safety and wellbeing of your loved one and you.
Outings are stimulating and have many of benefits. They provide:
– Special time to be together.
– Time away from the noise and routines of the care home.
– Much needed fresh air after the hot and stuffy atmosphere of the care home.
– an opportunity to reconnect with special places from the past.
– a way of connecting with the outside world: watching and engaging with people, children, dogs etc.
– time in the tranquillity of nature, viewing distant horizons, watching the clouds go by and birds etc.
These are but a few of the benefits of outings. People with dementia may not remember the outing they have just had but that doesn’t invalidate it in any way. It is being in the moment that matters and our loved ones with dementia can teach us about that.
‘In-ings’ – What can relatives do in the care home. This is an area that is less well defined but I would like to open it up. There is lots of scope for relatives to become involved in doing things in care homes and I believe they are a huge untapped resource. So how then might a relative approach this? Here are my suggestions:
– Let your loved one settle in and you get to know with the staff, environment and routines of the care home. Visit as frequently as feels right for you.
– Develop a friendly relationship with the manager, staff and residents.
– Ask if they have an activities organiser and if they do, find out what activities they have and when and offer to join in any that interest you.
– Once you have established a relationship with the manager or activities organiser think about what you might want to offer. Do you like gardening, cooking, craftwork, singing, playing keyboard, poetry etc.? If you enjoy any of these activities tell the activities organiser you would like to be involved. If there is something you would like to do that is not in their programme, speak to the organiser and ask if she or he would support you in setting up a little group on a trial basis.
Always be supportive rather than confrontational unless there are grounds for concern about the safety and wellbeing of residents. Staff and management are often overstretched and have an extremely difficult job. They need all the assistance they can get so once they have got to know you and are aware of your desire to help they are likely to welcome you with open arms.
End-stage dementia – Individual personal caring:
In end-stage dementia, when the person is nearing the end of his or her life and is immobile, the type of care needed changes from activity based to one of individual personal care. In fact, everyone at this terminal stage should be getting the equivalent of hospice care. This takes care not only of physical needs, but social, emotional and spiritual needs as well. Relatives can play a very important role at this time and here are some of the things they can do.
They can offer gentle hand massage, foot massage, personal grooming, play special music, read short poems and other things.
There is a wonderful programme called Namaste Care created Joyce Simard. Her book Namaste Care tells you all you need to know about the programme – what to do and how to do it. Although written primarily for care homes, relatives can engage informally in the ways suggested even if the programme hasn’t been formally implemented by the care home.
These videos show some of the benefits of Namaste Care in practice.
If the care home is unfamiliar with this programme you might, once you have gained their confidence, talk to them about it.
May you be open to, and create wonderful new opportunities and gifts for your loved ones and yourself.