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