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Valuing residents' stories. Weaving stronger and deeper care relationships
- 1. Valuing residents’ stories - weaving deeper and wider care relationships Elizabeth Knox Home & Hospital Nena Delos Santos (RN at EKHH) and Nick Moore (The Literacy Professionals)
- 2. Close, meaningful, continuing relationships and growth are the key to eliminating 3 plagues of loneliness, helplessness and boredom. How well do we as an Eden Alternative home understand and know our residents’ stories? Margaret Brown (Special Projects)30/08/2013 2
- 3. Putting the person at the centre of care
- 4. “Well the war came and my friends who were at the shop – one went into the army, one went navy, the other went to a dehydration factory and I thought “Blow I’m not staying here. I’m getting out of this!’ So I applied to be a land girl. But I was too young!” Peggy “I’ve never been married and had a lot of time on my hands. I mean if you work eight hours in a day, that leaves you with a lot of time. I wanted to know how my mind worked. So I read psychology and philosophy books. I never did a course – if you do a course you start thinking you’re an expert!” Gerald We decided to focus on stories
- 5. Engagement with the whole Knox community Training workshops The evolving story Infrastructure
- 6. • For the whole team (carers, RNs, OT, admin, the accountant, residents, families). Sessions repeated on two days and one night shift. • Focused on speaking strategies to elicit a narrative and writing strategies to record and share it. Workshops • Close link with literacy skills training that has been running for 3 years at Knox (Nick)
- 7. - Unlearn “medical” practices so that stories did not become another exercise in “diagnosis”. - Encourage and develop literacy skills in some cases. - Keep the focus on snapshots of peoples’ lives. Challenges
- 8. “As we were talking I could feel the relationship between us growing – every time I visited I heard a little more.” Nena, RN. Early outcomes
- 9. “And I never knew any of this from reading her care notes.” John, RN. “Now I understand why she is as she is.” Jill, RN Early outcomes
- 10. “I’ve enjoyed this – thinking of things I haven’t thought about in years!” Olga (resident) Early outcomes
- 11. “He told me how he used to wash and turtle wax his tractor!” Kristen (Volunteer coordinator) Early outcomes
- 12. “As carers, this is what we do with residents. It's just that when they first come I make a real effort to get to know them but if they have been here for a while, I just assume that's all been done.” Maria (HCA) Early outcomes
- 13. 1. Investigate the impact of the books. Have they helped make connections / start conversations? 2. Research into how narratives are helping to build meaningful care relationships at Knox. 3. Further support / encouragement and literacy skills development for staff, volunteers. Business as usual! 4. Stories send a challenge to society’s perceptions of elders and views of ageing as a process of decline. Next steps
- 14. -Residents who have given their input: Peggy, Gerald, Frances, Sarah and James. - The care staff at Elizabeth Knox Home & Hospital particularly carers Maria and Langi. - The management team – Jill, Janan, Charlene and Margaret for driving this one. - The Board at Knox for backing it. - Photographer Gareth Morgan for use of your beautiful woven flax photo. Acknowledgements
Editor's Notes
- Nick: I’m Nick Moore from The Literacy Professionals. We’re a workplace literacy training provider and have been working with Knox for 3 years.Nena: I’m Nena, I’m an RN. I’ve been working at Knox for 7 years. We’re going to tell you the story of a training initiative designed to weave close and continuing relationships at Elizabeth Knox Home and Hospital.
- Nena: Knox is an Eden Alternative Registered Home. Nick: We needed to understand our residents to eliminate the three plagues of loneliness, helplessness and boredom. We knew a lot about our residents’ medical care needs but we asked ourselves “what do we know of our residents’ stories”? We needed to capture their experiences and know them as people.
- Nick: So, we set about trying to put the relationship with the resident back into the centre of the assessment process and value the stories of residents as they emerged over time.
- Nena: We decided to focus on the stories of residents. To value them as people, you value their stories. We filmed carers talking to our residents. Look quickly at the quotes. Isn’t it amazing how much you learn about a person just from these few words?
- Nick: Jill, Margaret, the management team and the Board fully backed the initiative. We decided to run face to face workshops. Ketesand books were purchased for residents’ rooms to honour the evolving stories. The symbolism was important – Ketesare containers of wisdom and important things. A link from the past to the present and growth for the future. Ketesstretch and grow when you put more stories in them – have you noticed that?
- Nick: So in all, 100+ people were involved. We trained the care team, admin and management staff – and most importantly residents and families. We ran workshops at night so night shift people could participate.We used the videos we had made and focused on the skills that carers used.Nena:We practised getting each others’ stories and reflected on the experiences of getting residents’ stories. We focused on recording stories authentically using “first person” and trying to use the resident’s voice.
- Nick:From discussion of the videos, it quickly became apparent that we needed to focus on snapshots that residents were happy to talk about - not their whole life story.For some nursing staff it was about putting down the pencil, unlearning medical training and listening. Some care staff needed permission to go and spend time getting to know residents and encouragement. For carers, it was affirming that the business valued this.
- Nena: OK. Some early outcomes.I talked to Freda. It’s helping to build relationships between care staff and residents.
- Nick: It’s helping staff know residents better and gain a better understanding of them as people. Maybe it’s helping to even up the power relationships between carer / cared? And reduce dependency?
- Nena: Residents have been very willing and active participants.
- Nick: Unlocking the amazing lives of the residents. This is about personal growth for all of us.The role of the volunteer network is going to be critical in how this initiative continues.
- Nena: It’s about valuing the work of carers and bringing care relationships into focus. We want relationships to be driving care. Not the other way round.
- Nick: So, it’s time to take stock. The next steps are investigating the impact of the narratives on care relationships.Staff and volunteers will need further literacy upskilling. Knox is becoming an education centre – not just a rest home.Also – we need to champion the stories of elders – these elders have a voice and their stories challenge western perceptions of ageing as decline.