What does a meaningful and engaging programme of activity look like? To give ourselves some context, let’s try to remember five things that we have done over the past 24 hours; these may be both obscure and mundane, but try it anyway.
Personally, I have driven a good distance across the country to get to a meeting, bathed my baby and put her to bed, cooked dinner for myself and my wife and been for a short run. All of these things are rather unremarkable in themselves, but when brought together they become a set of activities that have stimulated me mentally, physically and emotionally.
By considering activities in this way, as the beings, doings and general goings-on of life, we can start to plan our activities accordingly, including ideas that stimulate wellbeing and celebrate the uniqueness of the residents we work for.
Putting activities at the centre of care
At Oomph! we work with staff from a wide range of care settings to develop the skills, strategies and confidence to ensure their activity programmes perform a central role in improving quality of life. This is vital, as when the full value of activities to address the health and wellbeing of residents is appreciated, it creates an atmosphere in which wider teams are more willing and interested to contribute. This invariably enriches what’s on offer and leads to wider participation.
The best strategies for success always involve looking at the care setting as a community in which everyone is a potential contributor. Creating this ‘activities’ culture will have the biggest impact on service users and care staff. Training and supporting someone as the activity lead and nurturing their skills in this way is essential for promoting and harnessing this shared responsibility. It is also statistically proven to increase job satisfaction and reduce staff attrition rates. All too often, we find that those taking on the mantle of activity co-ordinator are left to their own devices, often only finding success when they have the personal tenacity and talent to carve out a varied and creative programme for the home.
Create projects to bring people together
Creating projects that everyone in the home can contribute to, is a really positive way of building a community culture and is a great way to improve everyone’s job satisfaction. A home that we work closely with ran such a project with the objective of bringing the whole home closer together. They purchased an old doll’s house, which they then went on to decorate and refurbish as an extension of their care home. Residents worked together to design and furnish the house and each room represented a different decade. It is now proudly displayed in their reception area, so that everyone visiting the home can take a look. It stimulates great conversations between residents and staff as they reminisce about the homes they grew up in and how much they changed by the time they were bringing up their own children. When activities take on a life of their own, as this one did, the activity lead’s responsibility is to keep the plates spinning, enabling everyone to participate in a way that suits them and to support thorough inclusion throughout the home.
Another way to embed activities throughout a service is by providing self-service resources that anyone can access in order to run an activity. Over time, these resources will naturally accumulate and a ‘library of activity’ will develop. However, to ensure it is regularly engaged with, and added to, there does need to be an element of curation. To support this approach at homes Oomph! works with, we provide a daily international event calendar, weekly newspaper and radio show as inspiration. This means that anyone in the home can engage and add to the programme that is already on offer. Having such a broad selection of resources enables anyone to deliver an activity whether they have an hour to commit or just a spare five minutes.
Use life stories
Using life stories as a way to get to know a resident is not a revolutionary idea, but it can often be under-utilised as a tool for creating activities. Not only do they provide us with a way of seeing beyond the symptoms of a condition to the person beyond, but they also contribute rich material to the activity planning process. On our activity leadership training, we work with life stories to discover life goals that are yet to be achieved, help maintain highly valued skills and also uncover common interests between residents and staff. Such common interests can help to build relationships and develop the community in the care setting. Collating this information makes it far more possible to be responsive to the needs of an individual and is also a great way of integrating ‘interest-based activity’ into the care regime.
Having said all this, approaching somebody living in a care home and asking them whether they have an unfulfilled ambition, or if there is something that they would like to achieve, is a very difficult thing to do. If asked directly, it rarely yields an actionable response. If you think about the last time you were asked what you wanted as a birthday gift, your mind probably went blank. It is often far more satisfying when you are presented with something unexpectedly that you can see some generous thought has gone into. Gifts given like this bring about feelings of delight, self-worth, and that you are understood by those around you. We should endeavour to create activities in this way.
Connect to past and present passions
We worked with an activity co-ordinator who discovered, through a conversation, that a resident had been a lifelong Burnley Football Club fan. He had regularly visited the ground from a young age and the co-ordinator had found out that he had fears that he would never be able to go again. Unbeknownst, to the resident, she reached out to the club with this story and they responded with the offer of hosting him and his grandson for the day, so they could watch a game, have a tour of the ground and receive a meal in the hospitality suite. When the plans for the day were revealed, he was naturally taken aback; in his own words this was something ‘unexpected, out of the blue, and greatly appreciated’. He went on to say to the co-ordinator that, although he has had many good days throughout his life, this was a truly great day and a stand out occasion. It doesn’t take a great leap to see that the value of this day wasn’t only in the activities that were carried out, but that it was arranged by taking into account what was important to this man.
Another activity co-ordinator who trained with us used life story planning to unlock a lady’s passion for horses. When completing the lady’s life story, she discovered, through conversations with family members, that her client had been an avid horse rider from a young age. This wasn’t something that this lady could remember through conversation, but, with support and after a little time, they visited a local stable to spend some time with the horses there. As soon as she had stepped foot out of the car, she took her care worker’s arm and said, ‘I know that smell’. From that moment on, from seeing the horses, to being able to mount and ride on one, the whole experience became one of reconnecting with both emotional and physical memories. This experience has been repeated a number of times since as it has her boosted confidence and increased her social interaction. We hear of many similar successes, whereby activities have enabled residents to exercise control over their lives in this way, regaining a part of their identity and increasing feelings of self-worth.
We have also been inspired by the activity co-ordinators we have worked with that have discovered specialist skills held by residents, which are in danger of being forgotten. When these discoveries are made, often through life story work, we open up a new and therapeutic avenue of activity for the resident in question. Providing an opportunity to maintain skills, whatever they may be, allows the person practising it to be lifted into a position of authority, a feeling which can often be elusive when living in receipt of care.
Evaluating the impact
Over the past five years, we have delivered hundreds of courses to thousands of people. Time and again we have seen how activity programmes that are implemented with imagination, and integrated alongside other care pathways, bring immediate improvements to quality of life. We partner with 40 leading care home groups to put person-centred activities at the heart of their offering and ensure care home residents have something to look forward to every day of the year.
Intrinsic to our approach is the collection of impact data with the homes on the success of their activities. The methods of how to gather this evidence forms a key part of our training course. Care staff are used to recording care interventions as part of reporting procedures. By applying these procedures to the activity programme, we can obtain a measure of the benefits to both those living in or using the setting and also those working there. Having this information is essential when creating a responsive environment that is self-aware; we found that homes within pilots at two major care groups we have been working with saw an increase in their Activities Net Promoter Score – the measure of whether users would recommend a product or service to others – by residents, relatives and staff by 40 points over a three-month period. This was a strong indication that these homes had implemented successful changes and were reacting to the needs of those using their services.
Where in the past there has often been a general understanding of activities as a means of entertainment, we are now seeing a gentle shift in focus toward the therapeutic outcomes of activity provision. Success in this field requires strong leadership with a vision for inclusion so that a community culture can develop, but it also relies on all others in the care setting, contributing and sharing their skills and passions in a way that engenders continued personal growth. Personal care is no longer limited to maintaining bodily health, it is about nourishing the mind and reviving the spirit. Through the provision of vibrant and ambitious activity programmes, we can deliver truly three-dimensional care.
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