Washington DC - A Fitting Finish

Washington DC

Jenny comes to the end of her Travelling Fellowship adventure

So this is it, my final blog. Having never written blogs before I think I’m finally getting used to documenting my life just as my fellowship comes to an end! It’s been an amazing 6 weeks but I’m definitely looking forward to getting back home. 

So what have I been doing in Washington DC? After a brutal 1:30am wake up call to catch the flight from Boston I arrived in a somewhat confused state, but an early night set me to rights for the first visit on Monday morning. I spent most of the week with Iona Senior Services whose primary aim is to help people ‘age well and live well’. Within their building, they have Iona's Weinberg Wellness & Arts Center, a day centre offering support for individuals with memory loss and other conditions as well as a gallery space that rotates exhibitions 3 or 4 times a year. The artists in residence who are chosen must be 60+ years young (love that phrase!) and have the capacity to provide 75 to 100 pieces, depending on size. The size and significance of the show really encourages artists to push themselves, particularly if they haven’t made a big collection for a while. During the exhibition time, each artist also facilitates three key events:

1. Meet the Artist Reception: this is an introduction to their life and work. Anyone can attend and food and drinks are provided, similar to a gallery opening.
2. Lunch and Learn: over lunch there is a tour of the artwork and lecture from the artist about the pieces and process. Both the public and staff members are encouraged to attend.
3. Workshop: a workshop is facilitated by the artist for service users from Iona’s own Wellness and Arts Centre.

Once their exhibition is completed, artists in residence become an ambassador for the centre and usually donate a piece to the permanent collection, including a self-portrait box that they make for Iona to keep. On my first day, after spending the morning with Patricia Dubroof, Gallery Director for IONA Senior Services, I accompanied her to a home visit for a potential future artist in residence. Jim’s collection was absolutely fabulous and it was amazing to see the transitions between different mediums and styles throughout his life as an artist. Patricia explained more about what was involved, including training for the artist to enable them to work effectively with service users in workshops and preferred delivery methods for the lunch and learn sessions.

Jenny and a 107 yr old lady at the Veterans Affairs Medical Centre

Over the next few days Patricia and I visited two other facilities in which she worked. The first was the DC Veterans Affairs Medical Center, which offers long term palliative care, hospice and rehabilitation for veterans. Although the settings feel quite clinical, as part of the main hospital, they have done great things with the space. Patricia has developed an art gallery throughout the center with art work from local veteran artists and individuals within the center itself, transitioning every 3-4 months. Their creativity and healing programmes also include music, tai chi, visual art classes and museum partnerships. I observed an art session and then sat in on a team planning meeting to discuss exhibition schedules and the ongoing projects. The next morning we also visited the second Iona site at St Albans Church, who had a group of corporate volunteers from AARP in to help for the day. One of the service users, Barbara, was particularly inspirational. Having participated in many initiatives, she had recently started her own - ‘Introduction to Quilt Making with Barbara’. Participants can either work on their own projects or help make baby quilts for the St Albans Outreach Ministries and the session has been extremely popular.

My next visit was to the National Center for Creative Aging (NCCA). When I first started contacting organisations in the area and receiving times and locations I began to get slightly confused. Three out of the four people I contacted all gave the same address and I felt that there was some kind of conspiracy going on! As it turns out, there are a number of other likeminded organisations that share Iona’s workspace, including the NCCA. I met with Dorothy Wohlslagel, Director of Education Services, and Gay Hanna, Executive Director, to talk about the organisation’s primary services. Dorothy took me through their Online Artist Training in Arts and Aging, an e-learning training package that teaches artists how to lead lifelong learning arts programmes that engage older people. While not an ideal method, the organisation has successfully provided flexible training for large numbers of professionals within tight budget constraints. They are also aiming to develop it by adding more media forms, for example video clips, to help increase interaction and engagement.

National Museum of American History

On my final day in Washington I was back with Iona’s Wellness & Arts Center under the guidance of Jackie Sargent, the centre’s art therapist. After accompanying an outing to the National Museum of American History in the morning, I had an opportunity in observe a group art therapy session and then talk through staff training with Jackie in more detail. One of the key things she highlighted as important for staff to understand is the boundary between art making and art therapy. Knowing how to interact and react to art work appropriately, so that the process and product is validated is important for the individuals involved. One of the ways that this understanding is developed is through group art sessions for staff. Creativity evenings, where staff make art work together, are held in the studio once a month. They have a different theme each year and the resulting work is displayed in a yearly exhibition in Iona alongside the resident’s pieces. This focus on staff self-care is extremely important and also offers them first-hand experience of the process that the individuals they support go through. It was lovely to see how Iona use art for the benefit of staff, helping to develop empathy and respect for service users and what they do when at the centre.

And that was my last visit! I think that I have developed a clear vision for the key points I’m going to talk about in my report, but a bit anxious about the write up! I have three months so once it’s done I’ll keep you posted. I think I’m going to have a few weeks off and then come back to everything I have learnt with a fresh pair of eyes… Wish me luck!

"A note from Insight - thank you for reading Jenny's blog, she had an inspirational time, but we did miss her and we're keen to see how she incorporates her experiences into Leadership and Management Training."

Boston Beautiful

Alzheimer Care in Boston

by Jenny Garratt

It’s been an interesting week in Boston. I decided to rent a car as my visits were so dispersed that public transport didn’t seem to be a viable option.  Having never driven outside of the UK, by the time I reached the rental desk at the airport I was decidedly nervous. After navigating through what is apparently one of the worst cities in the US to drive around I was relieved to finally reach my accommodation with only a minor curb bump! However, the excitement of my first day in Boston wasn’t over yet. After unpacking I came downstairs to find my hostess had left the house without giving me the code to the front door, effectively locking me in. Before you imagine my annoyance, let me first describe her... A single mum with triplet 8 year old boys (I repeat, TRIPLETS) who has a full time job, hosts 4 guests through airbnb, writes books in her spare time and is about to start a PhD. When she got back a few hours later I decided to let the front door situation go. She had enough on her plate.

My primary contact for the week was Hearthstone Alzheimer Care who kindly organised my entire Boston itinerary and even contacted other groups for me to visit. The Hearthstone approach aims to create a life worth living by enriching lives and offering hope. Support and care focuses on creating meaningful, positive and fulfilling experiences through the effective use of programming and environments that support independence and choice. Alongside their six facilities, Hearthstone also offers education for other organisations and initiates research into non-pharmacological interventions. They are closely linked to the I’m Still Here Foundation, which aims to develop and evaluate innovative non-pharmacological approaches for people with cognitive challenges and also creates and implements inclusive, community-based arts and culture programming.

My first morning was spent observing an Artists for Alzheimer’s (ARTZ) programme. ARTZ is one of the initiatives developed and maintained by the I’m Still Here Foundation and is made up of a collaboration of artists and cultural institutions which aim to educate and inspire individuals with memory problems, their care givers, family members and friends. The day’s programme was part of the Meet Me at the Museum initiative and involved an interactive tour around Harvard's Peabody Museum of Ethnology & Archaeology. It’s a free weekly program and each event is facilitated by trained ARTZ staff. Today’s group was split into two and facilitated by Dee Brenner, Programme Co-ordinator, and Dr Christina Smiraglia. The sessions were very engaging and aimed to have a ‘fail-free’ approach, encouraging interaction with the exhibits through questions such as “how does this make you feel?” rather than focusing on factual content. Afterwards, I headed to the Hearthstone office to participate in an awareness session for organisations thinking about bringing groups to ARTZ sessions. It was very informal and questions were encouraged, of which I had many! Content included practicalities of what happens throughout the session, understanding person centred approaches and tip sheets for accompanying care partners, who don’t get a formal training session, called “Tips for a Successful Museum Tour”.

On Wednesday I spent the entire day with Learning for Life, which is an educational programme specifically designed for individuals with dementia that uses Montessori methodology and the I’m Still Here approach. Learners select their own subjects to add to the curriculum and are supported to engage in creative activities, cultural experiences and cognitive stimulation throughout the day. The basic daily framework of the curriculum is constant but the context is continuously created, giving opportunities for novelty and new learning in a safe environment. The day started with a famous event in history that happened on the day’s date and then a photo of the day to discuss. There was then individual study options for the rest of the morning, including the life story corner (today's question is where do you go to feel inspired), reading centre (article of the day that is discussed, today's is about the life of Victor Hugo), art centre (draw a place that inspires you) and the cooking centre (today is making chocolate chip biscuits). There are clear signs for each activity and it was nice to see lots of choice, giving learners the opportunity to move between them if they finish or get bored of one.

Sean Caulfield and Dr John Zeisel

After going out with the learners for lunch, the afternoon was then spent discussing the article on Victor Hugo. Throughout the article there are questions for participants such as Guernsey was a place of inspiration for Hugo, where do you feel inspired? All questions aimed to promote engagement from the learners without the stress and frustration of focusing on specific facts that would need to be recalled. The discussion was extremely interesting and allowing leaners to choose the content of their curriculum ensures that they are always talking about topics that are both relevant and interesting to them. 

I had the pleasure of meeting  Dr John Zeisel at the Hearthstone Office, president and co-founder of Hearthstone Alzheimer Care, who took me out for dinner. One of the key points I took away from this meeting was an emphasis on transformation. Both Hearthstone and the I’m Still Here Foundation aim to transform the way that people think about dementia, not only through training but also through research. The use of creativity and artistic skills are integral to this transformation at a community level, helping to develop the mentality needed to act as a catalyst for change.

The morning of my third day was spent visiting Melody Bushmich, Early Stage Programme Coordinator for the Alzheimer’s Association, who gave me lots of information about upcoming programmes. It was interesting to see yet another organisation moving individuals from the traditional role as receiver of support towards playing a more active part in service provision. This reminded me of the Brooklyn Public Library and their transition from giving stories to teaching people to capture their own. The Alzheimer’s Association offer lots of services including care consultation programmes, legal and financial services, support groups and training. However, what really interested me were the new programmes currently in development for those with early stage dementia. The aim of one of the new programmes, an intensive course lasting 4 weeks, is to provide individuals with education, support groups and training on how to engage with other groups through volunteer opportunities. The programme aims be a launching platform from which people with dementia can become advocates for the Association and active volunteers within their own community. There is also a peer to peer element to link individuals with others that are experiencing the same thing, not for professional advice as such but more for support, understanding and friendship.

My next call of the day was Goddard House, an assisted living complex that also has a memory support facility attached to it called Olmsted Place. It was in Olmstead that I observed an excellent music therapy group session facilitated by Angela Schroedar-Dill. 

From the outset the use of names on an extremely regular basis solicited a positive reaction and ensured all residents were continuously engaged, felt welcome and included. Song choice was clearly important, with the theme for the day being hopes and dreams, and the songs were interspersed with questions like ‘what would you wish for if you threw a penny into a fountain’? After the session I met with Ginny Mazur, the Community Partnership Director, and Cindy Allard, the Programme Director. 

There was a clear emphasis on staff engagement and the promotion of continuous learning for all. Cindy explained that each staff member was very unique, with different passions and skills that they were encouraged to share. One staff designed jewellery, another played the flute and another was interested in technology. Ginny and Cindy aimed to encourage staff to use their interests and skills to provide the residents (and other staff members!) with new learning opportunities.

Day Programme at Hearthstone

On my last day with Hearthstone I visited one of their own sites in Woburn to meet with Stephanie Faulkner, Program Director. A huge amount of thought had gone in to the individual programming on offer, with so many activities and experiences available that it was impossible for someone to do everything! There were multiple programmes every hour, in stark contrast to the one activity in the morning and one in the afternoon schedule that you often see in other care facilities. It was a truly excellent example of how much really can be offered with the right attitude and training. The use of parallel programming, where individuals have choices that are tailored to their varying abilities, also ensured that all residents participating in experiences were being set up to succeed. The notion of ‘failure-free’ programming is essential when trying to avoid feelings of frustration that can occur when given challenging tasks that may lead to failure. Wording is also extremely important, with the different levels being called discovery, vitality and serenity. 

Resident companions, or care workers as they are known elsewhere, also do programming and there is a real emphasis on having a team approach, all working towards the common aim of giving residents excellent care, support and a life worth living. What I also found interesting was seeing improvisation skills acknowledged as a key component in the successful facilitation of resident experiences, a theme that has been touched on in other visits throughout my travels. Stephanie’s background in drama helps her continue the flow of conversation with residents in a natural, carefree way. Threading is the term used to describe the method of connecting conversation and topics together, a key component in good improvisation. 

My time with Hearthstone has been extremely inspirational and has helped highlight the difference between good person-centred care and great person-centred care.

Two Tribes...?

Two Tribes? by John Dennis 

NHS and Local Authority Social Care Provision

An interesting article appeared on the BBC website last week.  It reported that the Baker Commission (Set up by The Kings Fund to look at Health and Social Care provision), had recommended the NHS and Local Authority Social Care Provision should be merged.

http://www.bbc.co.uk/news/health-29047190

This is not really remarkable!  This is after all Labour Party policy and the present Government, whilst making no such commitment has established a direction of travel which brings services from both the NHS and Local Authorities into ever closer alignment.

What is remarkable is how slowly this process is moving despite a sense of crisis in Social Care resources and provision. Labour’s commitment does not extend to any detail about how the merger would work and the Coalition seems to prefer small steps rather than any bold resolution.

Could the answer be an unresolved turf war? How would the Department of Health respond if Local Authorities were given the role and resources to deliver all Social Care? How would Council Leaders respond if the NHS were given the role of providing all Social Care?

When “Frankie Goes to Hollywood” recorded the song “Two Tribes” in 1983, they asked “what happens when two tribes go to war?”  In this case the answer seems to be “virtual stalemate!’

New York, New York - WCMT

Jenny travels to the Big Apple

I have finally finished my first week in the USA and it feels like it has gone on forever! In a good way, I’d like to add. I had a four day working week and then had a few days break from visits, to take in some of the New York sights. I was getting a little worn out so I think that it came at the perfect time in my trip! But first let’s talk about my visits before discussing play. When I arrived in New York I got a bus from the airport to my accommodation in Brooklyn (I used airbnb, so I was staying with locals) which seemed to take the better part of forever. When they asked how I had travelled from the airport, my hosts were horrified to learn of my mode of transport and questioned how I had survived with all limbs and bags accounted for - “I don’t want to tell you not to get the bus… But don’t get the bus”. So I spent the rest of the week cycling around Brooklyn, which admittedly was a much more pleasant way of seeing the area.

 My first port of call was Gary Glazner, Founder of the Alzheimer’s Poetry Project (APP). On the day I spent with him, I observed a poetry session and was amazed by the reactions the ‘call and response’ method evoked. Gary, as the group leader, recited lines from well-known poems which the group then echoed back to him. In the second half of the session this was then used as inspiration to create their own poem as a group, although any topic can be picked. Once the poem was finished it was then recited by the group as a final product. All the participants clearly felt comfortable in the environment, giving them a space in which they could safely express emotions and feelings, with everyone’s point being valid no matter how many times they repeated it. Conversation and songs naturally flowed if participants felt they wanted to say something, with impromptu songs and comments springing from nowhere and being draw into the mix. After having agreed that the theme of the song was ‘making money, honey’, my favourite response to Gary’s question “so what could we do make some money?” was from a particularly mischievous lady who replied “sell our bodies”! The morning was filled with laughter and jokes, making the whole experience enjoyable to both participate in and observe.

After the session had finished Gary and I had some time to talk about the training he does for groups in the aged care sector to help them connect with people living with dementia, including family caregivers, healthcare workers and artists. The focus is on engagement, using simple techniques to elicit positive responses and techniques to create new poems. The APP also has a teaching manual "Sparking Memories: The Alzheimer's Poetry Project Anthology" which has information about the techniques and the medical implications of using poetry. Training can be done face to face, but Gary also offers virtual training, consisting of hour long skype sessions each week with time in between to use learning and report back. This blended approach is crucial in ensuring that practices become ingrained in people’s behaviour, rather than an individual simply learning skills and not having any practical experience before training ends. Once again, the best case studies Gary spoke about were those that had the backing of upper management (yes I am starting to sound like a broken record – leadership and management)! After doing training sessions in one facility, he returned a few years later to find that, although all the original frontline staff members had changed, the knowledge and understanding had been passed on and poetry sessions were still taking place. The fact that management understood and valued the APP ensured that new members of staff were encouraged and supported throughout the learning process.

A day with Christopher Nadeau, Executive Director at The New York Memory Centre (NYMC), was next on my agenda. The NYMC offers many different services including adult day care that focuses on non-pharmaceutical interventions, care giver support services, computer cognitive training for those with memory problems and staff and care giver educational training. I observed a percussion session with artist in residence David Azarch and a music session with artist in residence Ismail Butera. Seeing the different styles of artists made me appreciate how individual each form is and also highlighted the variation for participants. The day care service also offers a huge range of other creative programmes such as poetry, theatre, painting, sculpting, multimedia expression, dance and yoga. There was something for everyone!

I was particularly interested in the relationship between the staff and artists in residence. Staff members took an active role in facilitation, both within sessions and between them, and I asked Christopher more about what training they have in the creative arts. He explained that they have knowledge assessed training in areas such as dementia, but the learning process for artistic initiatives was less formal, with much of their understanding being gained through shadowing artists during sessions. During the induction phase for new starters, underpinning knowledge is also developed by a training package about the philosophy of the centre. Once again, the focus is on increasing understanding of the value of artistic and creative initiatives and, from this basis, building practical knowledge through hands on learning.

My last two days were spent with Judy Kamilhor, Brooklyn Public Library’s Coordinator of Older Adult Services, who creates and maintains a huge range of services that stretch across the 58 neighbourhood branches. The department’s main services that go out into the community are ‘Books by Mail’, library books sent out through the mail for older people who are homebound, and ‘Books to Go’, that offer a kind of mobile library for groups in communal settings such as care homes. Inside the libraries themselves, the Creative Ageing initiative runs regular programmes, each one usually spanning over 8 weeks and consisting of a minimum of 16 learning hours. These programmes are facilitated by professional artists and Judy had kindly arranged for a session to coincide with my visit; ‘Room for Everyone: An Afternoon with Poems’ by Jess Greenbaum. This was a three hour poetry taster session and I was extremely impressed with the intellectual and thought provoking content, which managed to keep me fully engaged for the whole three hours even though I wasn’t even taking an active role in the session! Judy herself sat in, which is something she tries to do regularly not only to ensure quality control, but also as both personal and professional development.

I was also lucky enough to catch an ‘Exergamers’ session, an activity that is new to the programme and sees older adults using the Xbox™ bowling game. Different library locations throughout New York compete in virtual bowling competitions, helping to develop social networks not only in their own location but also with older adults throughout the whole area.  Another Creative Ageing programme that I found particularly interesting was ‘Our Streets, Our Stories’, that focussed on capturing and documenting the diverse stories from older people in the area (many of whom emigrated to the country) through in depth interviews. Training on interviewing techniques and how to use technical recording equipment was not only for staff but for people in the community – teaching older adults to capture the stories of older adults! Now that is a creative concept. What is happening here is a crucial development in the relationship that the library has with its surrounding community; a shift from sending out stories and telling people what to read to a focus on providing people with the tools to collect and create their own stories.

So how are these innovative ideas and the culture shift that comes with them cultivated? The library has a comprehensive training package ‘Everyone Serves Seniors’ that includes a series of sessions and publications. Judy is also currently updating it to cover even more ground in the arts and creativity field, with the finished product hopefully also including sessions with guest artist speakers around specific topics. The overriding aim of the training is to ensure that everyone understands how to give all older people great service. I can’t wait to see the new package and, from what I have seen, I am sure that it will lead the way in arts and creativity within the library system.

Once my working week was over, I had a few days down time with my partner Sam, who came over from England for the weekend. Most of the photos this week are from touristy things as there weren’t many opportunities in the visits for snaps, but hopefully they have brightened up your reading. Some of the main events included; 

• going up the Rockefeller building at sunset 
• a boat trip to see the Statue of Liberty
• a musical lunch on Broadway
• walks through Central Park 
• a trip to the Sea, Air and Space museum 

We definitely packed lots in to just a few days! Well that’s all for now and I’ll catch up with you next week!

Smiles in Sydney - WCMT Fellowship

Smiling in Sydney 

by Jenny Garratt

I have finally finished the Australia leg of my travels, bringing it to a close with an excellent week in Sydney! This week started with a visit to the War Memorial Hospital Day Centre where I spent time talking to Rod Escobar, the lead Diversional Therapist, and participating in some of the activities with clients. I was very impressed by what he told me about the training staff in the facility receive. 

Everyone who works in the day centre, from  the manager to the bus driver, attends many of the same workshops and training sessions. This ensures that each individual’s actions are underpinned by knowledge and understanding to promote positive interactions with clients at all points in their day centre experience. What it also does is increase the value of each individual and promotes the development of a connected team mentality rather than artificially pigeon-holing people into conforming to simply their ‘job description’. An example; last year all members of staff were involved in an art therapy workshop, led by a professional Art Therapist that sometimes works within the service with clients. Although not necessarily a skill that would be used by a bus driver, what is important is their understanding of the underlying concepts and why these kinds of interventions have value.

War Memorial Hospital Day Centre

I firmly believe that this encouragement of understanding at all levels is fundamental to decreasing the focus on task orientation often seen in social care organisations, and promoting the development of creative, person centred approaches. Support with ongoing training was also a key management quality exhibited in the organisation, and Rod made it clear that having the time to pursue professional development opportunities made a huge difference to staff morale and understanding. Unfortunately I was so absorbed by our conversation that I didn’t finish the painting I had started with the clients by the time I had to leave! But they assured me that if I left it with them they would complete it after they had finished their own.

My next stop of the day was at the Diversional Therapy Australia (DTA) head office, where I met with Margie Kennard, the Office Manager. She gave me an excellent insight into the range of organisations that DTA connect with and also took me through the structure of the workshops and conferences they provide. I particularly liked the ‘Takeaway Café’ concept used in the workshops because of its emphasis on sharing practical knowledge, which is often something missing from these kinds of learning initiatives. Any member of DTA can apply to present at a workshop and this is a great opportunity to develop personal skills as well as share best practice. Margie also discussed the work of the Humour Foundation, the Arts Health Institute and the Dementia Collaborative Research Centre, all great organisations working towards common goals.

I then spent the next three days with the Aged Care Channel (ACC), who took me around the local area to meet some of their member organisations. ACC provide live broadcasting and a variety of learning resources to members, with about two thirds of all aged care facilities in the whole of Australia using their services. On Tuesday I spent the day with Bente Ryan, Senior Support Manager at ACCTV, and we visited the Play Up Programme (an initiative developed by the Arts Health Institute), in which trained performers, called ‘valets’, use humour therapy in health and aged care environments to bring joy and happiness to people. The programme was developed on the findings of the SMILE study, which found that using humour therapy in residential care could reduce agitation by 20% and should therefore be considered as a viable psycho-social intervention before medication is used.

We observed one of the valets, Maurie, in action and the genuine connection he developed with the residents was a joy to behold. Staff members are also included, with a small number in each facility being trained as ‘Play Up Partners’ who carry on the work in between visits from the valets and after formal programmes have been completed. Through mentoring from the valets, they are encouraged to find their own style and play to their strengths to reinforce the feeling of fun in their facility. It was evident that picking the right Play Up Partners can have a huge impact on the effectiveness of culture change. They are the role models for other staff members and need to be willing to share ideas and information with their team. The whole experience was extremely moving for me personally and I decided that it wasn't appropriate to take pictures of the Play Up Programme in action for a number of reasons. Not only were many of the people we visited receiving end of life care, but I also didn't want to distract them from the programme as it was clear that everyone who Maurie came into contact with had their day brightened and enriched.

Aged Care Channel Control Room

After this intense day with the Play Up Programme, I spent Wednesday at the central office for ACC and learnt more about the programmes they offer. Just as interesting but not as emotionally draining! They broadcast a new programme every month, each featuring pre-recorded content and a live introduction and Q&A session at the end, with anyone being able to call in and ask a question. The whole show usually lasting between 30-45mins. After the completion of a programme, a DVD is sent out to every single member facility with the broadcast, additional modules, learning outcomes, participant workbooks, facilitator guides and presentation slides. These extension assessments aim to ensure that learning is continued in the workplace and can be put into an action plan at service level. The topics they chose to run are directly determined by their members and other organisations in the sector that they collaborate with. Each year ACC conduct a member survey to influence the next year’s production, then have workshops to flesh out the content for each one. Due to their large presence in the sector, they have also been used as a platform to give aged care providers the chance to interact with high level influencers, e.g. when the Minister for Health and Ageing changed he came on for one of the Q&A sessions.

Sydney Tower

Having been given the opportunity to look through some of their training content, as well as observe the live broadcasting of ‘Clinical Skills: Recognising and Managing Sleep Disorders’ on the day, I came away extremely impressed by the quality of the subject matter and filming. A storytelling methodology is used throughout and reflection is encouraged, ensuring that viewers are engaged with the content. Using a variety of different viewpoints, including clients, family members and carers, gives viewers a clear progression through the logic behind decisions and promotes a deeper understanding of the topics. After the last broadcast had come to a close, Karen Martin, Strategic Development and Partnerships Manager for ACC, whisked me off into town for dinner in the Sydney Tower, a rotating restaurant with an amazing view of the city. A lovely treat!



Karen and I then spent Thursday visiting two Living Care facilities. What I found particularly interesting was the importance attached to transformational leadership as a key factor that has contributed to culture change within the two facilities. The leader’s role was not only to inspire, but to encourage a culture of continuous training in staff members. In the second complex we visited, the full time Diversional Therapist, Lindy Junkkari, explained how her role had developed within the last 5 years. She now manages 8 Recreational Activities Officers (RAOs) who provide a huge range of creative activities and events for the 150 residents. The diversity of what they offer was extremely impressive, with their repertoire including qualified puppeteers, beauty therapists, animal therapy, bus trips, community visitors scheme, volunteer groups, art therapy and the ‘grow and hatch’ programme which involves caring for chicken and duck eggs. 

All RAOs have a Certificate Level 4 in Leisure and Lifestyle and have quarterly resident meetings to discuss the schedule as a collective and see if any changes need to be made. Lindy also told me about their annual Leisure and Lifestyle Forum that all the DTs and RAOs throughout the whole organisation (11 sites in Australia) attend. Its focus is on networking, sharing ideas and education, with previous sessions including dramatherapy, person centred care, modifying activities and animal therapy. I am particularly interested in finding out more about the Certificates in Leisure and Lifestyle and, although I did not get the opportunity to go in person, Karen has kindly offered to email me the details of the local college who developed the accredited framework. Watch this space!
On my last day I met with Joanna Jaaniste, principle of the Dramatherapy Centre in Sydney. Dramatherapy uses theatre techniques to facilitate personal growth and help individuals achieve therapeutic goals by providing them with context through which they can tell their stories and express feelings. The Dramatherapy Centre offers unaccredited training for professionals interested in developing their understanding of the practice and Joanna described how initiatives are often jointly owned by professionals and staff members. She particularly emphasised the importance of giving potential participants the opportunity to ask questions about the process beforehand as many can be put off by the word ‘therapy’, fearing they are going to be critically analysed. Training for staff and carers is crucial so they can explain the process, ensuring that everyone is aware of what happens and can support individuals outside of sessions.


And that was my week! Apologies that my blogs seem to be getting longer and longer. I think that, apart from anything else, this is a great way to record and distil my own thoughts. I’m sitting on yet another plane, on my way to New York, and will update you with my findings next week after seeing the Big Apple!

Making Music in Melbourne!

Making music in Melbourne 

by Jenny Garratt

Having just left Melbourne, it is safe to say that I have had yet another interesting week. However, before I regale you with stories from my visits, I first want to tackle a bigger issue. I feel that I have been conned. When I was planning for this trip, although I knew it would be winter in Australia, I was not prepared for lows of 2 degrees. Safe to say that my packing reflected my assumptions that the whole of the country would still be relatively warm no matter what the season. Luckily I have one pair of boots with me and a few hoodies, so I’ve survived! Now back to my adventures… This week has been split into two main visits to Emmy Monash Aged Care and the MAC.ART project. Emmy Monash is a Jewish aged care provider who cater for people with varying needs, from independent living to dementia care (they call their dementia wing ‘memory support’), and offer a range of creative and artistic initiatives.

I also want to quickly highlight another terminology difference. In Australia services for older people are divided into ‘high care’ and ‘low care’. Individuals assessed as requiring ‘high care’ need a lot of assistance with daily living activities, whereas those assessed as ‘low care’ usually need a lot less help. I spent my time at Emmy Monash under the guidance of Pamela Bruder, their Lifestyle and Life Enrichment Program Coordinator, who whisked me around the complex to observe a variety of activities including:

• Painting session in high care. What I particularly liked about this session was that the ‘painting of the week’ is framed and put on the wall. Staff stated that residents exhibit a lot of pride when chosen and feelings of satisfaction are evident.
• Creative word session. A member of staff initiates conversation through the use of a photograph and a story is developed around it. As residents talk, quotes are written down and repeated back to the group throughout the activity.
• Meaningful activity for individuals in need of memory support (based on Montessori methods). Residents are encouraged to participate in regular, day to day activities including making sandwiches and folding laundry.
• Resident skype with a local school to talk about the play they are developing as a joint venture. This is a year-long project and will include a performance at the end, which some of the residents will act in.
• Painting session in low care. Relaxation music, which is used in many activities, set the tone of the session and helped relax residents. Each resident who regularly participates in artistic activities has their own folder where their work is kept and added to each session.
• Choir with a mixture of high and low care, including residents from the memory support wing. I was extremely impressed by the diversity of languages, hearing songs in English, Yiddish, Hebrew and Russian in just one session. A focus on maintaining and preserving Jewish identity is a theme seen throughout many activities and heavily linked to emotion and memory for many residents.

Bearing in mind that I was only there for two days, the frequency of activities should be obvious! They are all part of a wider initiative developed by Pamela; the organisation’s award-winning Life Enrichment Project that uses a variety of creative and expressive arts-based activities. She also talked me through some of their projects that had already been completed, of which I will share one with you that I found particularly inspirational. ‘Footsteps to Friendships, Pathways to Peace’ was an inter-generational art collaboration between Emmy Monash residents and students from a local primary school and the groups worked together, mostly in pairs, to produce artwork that explored the theme of migration and resettlement. Many of the residents in Emmy Monash are holocaust survivors and the majority of students who participated in the project were refugees and immigrants, some of whom were also chosen as they were having trouble concentrating at school. The connections made between the two groups made a significant impact on both residents and students, with many of the friendships still being maintained today.

 When I asked Pamela what she thought were the most important factors behind the quality of initiatives offered the residents, she said that the support of the board of directors and CEO were integral in upholding the organisations philosophy, which is based on promoting innovation and continuous improvement. This focus on leadership was a theme also touched upon by my second visit of the week, to Dr. Julie Gross McAdam. Julie’s programme is called the McAdam Aged Care Art Recreation Therapy program (MAC.ART) and is designed to be an all facility project that includes residents, family members and care workers. Our first stop on Thursday was at the Alzheimer’s Australia office, where we met Phoebe Lindsay who is currently working on a number of new projects. These include a new dementia training experience, a simulated program that allows people to experience what it might be like to have dementia and promotes dementia friendly environments, and the Forest Project, a projected experience for people with dementia that allows them to interact with a virtual natural world. Alongside these new innovations in technology, the organisation also offers a wide range of training courses.

For the next few days we visited various homes around the Melbourne area in which MAC.ART projects had been completed. My personal favourite was the Nixon Hostel, a City of Kingston Council dementia care home. Here we were shown around by Colette Baya, Lifestyle Coordinator, who was an absolute delight. The whole home was just, well, ‘homely’ for want of a better word and when entering you would have no clue that every resident there had some form of dementia. For me, this is an excellent indicator of an environment that has great care. Colette uses a mixture of different approaches, including Montessori methods and Tom Kitwood’s petals, and has been trained in the Spark of Life philosophy that I talked about in my last blog. She also let me in on a little secret, what she called her bible, which is a book called ‘The Best Friends Approach to Alzheimer’s Care’ (Virginia Bell and David Troxel). I hadn't heard of this and it will definitely be on my reading list when I get home!

Spending time at Nixon Hostel really hit home the importance of making the most out of your resources. As a council funded home, budgets are tight but this does not mean that truly person centred care cannot be achieved. Staff are encouraged to be involved in all activities and include residents in as many everyday tasks as possible. Colette is always on site and mentors team members who need guidance. She also says that having backing from the manager, who is very supportive, has enabled her to have the freedom to do things differently. Colette, for me, optimised this not just in her words but also in her actions. Let me give you just one example… Colette has chickens at home and every day one of the residents cuts up the scraps left over from dinner into little pieces for Colette to take home and feed to them. In return, Colette cooks a boiled egg at home every Friday morning and brings it in, wrapped up and warm, for the resident to have with her breakfast. Such a simple act and yet it represents so many key qualities of excellent person centred care; meaningful activity, individuality and positive relationships to name but a few.

This week has been extremely interesting and I particularly enjoyed meeting so many residents that have directly benefited from artistic and creative services. Seeing the end result is extremely motivating and I can’t wait to find out what my next visits will teach me in Sydney. So enough for now and talk to you soon!

Perth - City of change and inspiration - WCMT fellowship

Jenny brings us her first Travelling Fellowship Blog from Perth

Today you find me sitting on a plane somewhere between Perth and Melbourne. With most of the contents of my vegetarian enchilada on my lap (why on earth they would choose a meal difficult to eat neatly on the ground let alone in the air is beyond me), I thought that this would be an ideal opportunity to note down some of my adventures from this amazing first week on my Winston Churchill Travelling Fellowship.
I arrived last Sunday and my first impression of Perth was a city of continuous construction. I have never seen so many buildings and roads being dug up, rebuilt and upgraded all at the same time. Safe to say that the local distributer of traffic cones probably never has to work another day in his life. However, apart from the jungle of scaffolding that appeared to envelope half the city, Perth seemed like a very agreeable place. My first meeting was on the Monday with Pilar Kasat, Director of the Community Arts Network Western Australia (CAN WA), and I arrived feeling decidedly underdressed after navigating through an area of town that appeared to include every designer shop known to man. Pilar was an excellent host (and by that I mean that she immediately offered me a cup English Breakfast tea) and was very happy to be used as a guinea pig for the questionnaire that I developed for my trip.

 The purpose of the meeting was to learn more about ‘Bush Babies’, one of a series of projects that CAN WA has run over the last 6 years as part of their wider strategy ‘Rekindling Stories from the Country’. The aim of Bush Babies is to capture stories from local aboriginal people and preserve their language and culture, with many of the aboriginal elders featured in it having been born at a time where they were not allowed to live in towns and were therefore born in the ‘bush’. The project has incorporated a number of artistic mediums throughout the years including storytelling, photography, intergenerational workshops and painting exhibitions. For me, the beauty of the project is the organic progression between the different forms, which was predominantly driven by the aboriginal community themselves, and really showcases the advantages of empowering a group that would traditionally be seen as the ‘subjects’ of art.

On Tuesday morning I visited the Bush Babies painting exhibition at the WA Museum and learnt more about the people involved and the process through which it has developed. In the afternoon I thought I would use my free half day to take in some of the sights. Having decided to visit a nearby island that I had been told had kangaroos on it, I set off from my hostel with high hopes. After a lovely walk down the river, I arrived to find an island that was slightly bigger than I had first thought. Kangaroos, while not the smallest of animals, are deceptively hard to spot in vegetation and if a small group of German tourists hadn’t been standing deadly still in the distance I doubt I would have found any of them. When I approached I was amazed at how tame they were and, after an affectionate rub of their heads, I decided my Australian experience had really begun.

On Wednesday I spent the day with Kate Campbell-Pope, an occupational therapist and professional artist who is a member of the Society for the Arts in Dementia Care and works for Disability in the Arts, Disadvantage in the Arts Australia (DADAA). She showed me many examples of creative projects that she had facilitated throughout her career. My personal favourite was the Hyperbolic Crochet Coral Reef Project which started after a scientist found it much easier to map hyperbolic expansion using crochet rather than computer technology! One of the key points that I took away from my meeting with Kate, apart from the diverse range of creative opportunities available to older people in the area, was a greater understanding of the importance of mentoring in Australia. Within her own organisation, DADAA, informal methods such as this are heavily supported and state funding is available specifically for mentoring opportunities. Mentoring is also not just something for the young. Professionals of every age are encouraged to use this method to learn more about areas that others specialise in, with the length of mentoring being indefinite. The opportunities for skills development and the view of learning as a continual process makes mentoring an interesting alternative to more traditional methods of knowledge acquisition and something that I definitely want to learn more about throughout my stay.

I spent the next two days with Sandy Crowe, a Dementia Care Consultant and Spark of Life Master Practitioner for Southern Cross Care, and Hilary Lee, the Founder and Director of Spark of Life and Chair of the Society for the Arts in Dementia Care. Spark of Life is a whole systems approach and aims to implement the essence of person centred care by igniting the ‘spark’ within all older people. What I found particularly interesting about the approach is that, before any culture enrichment initiatives are started within the organisation, all board members and higher management need to sign an agreement stating that they understand the approach and fully support it. Having this formalised backing is crucial in ensuring that creative programmes are seen as important and respected throughout the whole organisation.

Resident going to 'Sunshine Club'

The training and development process needed to achieve this culture change is extensive and clearly laid out by Spark of Life. Becoming a Master Practitioner is the highest level of training offered and is an intensive three week course, teaching individuals to be educators in Spark of Life. Potential Master Practitioners also go through an application process before the course, thereby ensuring that only people with the right attitude and value base are accepted. At the next level down there is the Spark of Life Certified Practitioner course, to give practitioners an understanding of the scientific basis on which the approach was developed, and the Club Facilitator training course, which trains individuals on the frontline to effectively facilitate the ‘Sunshine Club’ programmes with residents. I had the privilege of seeing a Sunshine Club in action on Thursday and observed the first programme in one of the Southern Cross Care homes. The aim of the Sunshine Club is make each ‘member’ feel unique and special as part of this exclusive club. The placement of individuals in certain groups is very careful and based on a three level system, with level 3 usually quite early stage dementia and levels 1 and 2 being later stage, thereby ensuring that groups merge well.

Jenny with SADC Board Members

On Saturday I was picked up by Maree, another board member of the Society for the Arts in Dementia Care, and attended a group learning session. Each session is based around a small number of specific subjects and activities. The focus of this session included practical elements on the use of sand in occupational therapy activities and a short training session on life story books. The majority of attendees were occupational therapy assistants and they were given time to experience the sand activity themselves, from a resident’s perspective. The importance of this cannot be understated, with the group making many practical observations as they explored the activity and understanding the sense of achievement from a first-hand perspective.

So that was my week! It was packed full of ideas, experiences and truly person centred people. I feel like I have already seen so much and I’m looking forward to the next stage in my adventure. Look out for my update about what’s going on in Melbourne next week, where I will be visiting Emmy Monash Aged Care and the MAC.ART Program.

Jenny

Winston Churchill Travelling Fellowship

Jenny Garratt our Social Care Specialist Training Associate and ILM Centre Manager, has been lucky enough to be selected for the Winston Churchill Travelling Fellowship under the category; The Arts and Older People. We are immensely proud this opportunity has been awarded to Jenny.  

What is the Winston Churchill Travelling Fellowship?

The  Winston Churchill Memorial Trust awards travelling fellowships to British Citizens to bring back knowledge and best practice for the benefit of others in their UK professions and communities.

A Fellow must travel overseas for between 4-8 weeks and gain a wide range of experience within their chosen category.  This year there were 1,182 applications and 137 Fellowships awarded, 9 of which are in the category 'Arts and Older People'.

Background to the Fellowship opportunity

Jenny's first placement under the National Skills Academy for Social Care Graduate Scheme was in a care home.  Here she witnessed such breadth in creativity and boundless enthusiasm from the staff for incorporating art into their lives.  From a learning and development perspective, understanding how such a positive mentality can be transferred to peers is a fascinating process. Perhaps even more fascinating is how organisations in other cultures facilitate art for older people.    

Aims and objectives

From this fantastic experience Jenny hopes to;

• Investigate projects on an international scale, with specific focus on the methods used to train staff and volunteers in organisations.
• Gain insights into the Learning and Development techniques used by other cultures and how they could be implemented in the UK.
• Identify best practice that can be build upon and replicated in our learning and development packages, which would have direct impact upon the staff and volunteers we train, and an even bigger impact on the Service Users.

From a personal perspective, this is an extremely fulfilling opportunity giving Jenny new perspectives on best practice and innovative solutions from a wealth of different cultures.  It will give her chance to grow her experiences and inspire her to think creatively about older people and how to improve their quality of life. 

"I believe that the effective use of the arts can facilitate a wider mentality shift that I would like to see happen in the Social Care Sector - from a task and process orientation towards innovation and creativity." Jenny Garratt

Jenny leaves for her Travelling Fellowship on the 1st August, returning on 22nd September - I'm sure you'll join us in wishing her the best of luck. Watch this space as Jenny will be blogging regularly on her travels, keeping us updated with her adventure.