Sylvie Silver • Executive Director • National Activity Providers Association
If I ask my family and friends how they would like to die, they will say things like ‘in my sleep’ or ‘a massive heart attack’. In other words, they want a sudden death. They will want to be doing things that make them smile and things that have meaning and purpose to them, right up until the point of death.
People who live in care settings are no different. Commonly, they will be coping with disability or frailty as a consequence of ageing. Their quality of life may vary. However, in my experience, they have the same desire for a sudden death as everyone else. Nobody has ever told me that they want a long slow decline.
Care providers are responsible for ensuring the good general health of people. They are responsible for activity provision too, although it rarely gets the same attention. If we are to achieve the death that most people seem to want, then we need skilled activity specialists to work alongside clinicians to support the care team in order to achieve this. Even those cared for in bed can enjoy a contented and happy life, if we take the time and trouble to establish what makes them happy.
For example, a care home in Cardiff arranged for a small horse to visit a lady in her room as she had a lifelong love of horses. Her wonderful reaction was captured on video, so that she could relive the visit too.
A presentation that I attended in Australia – thanks to a Winston Churchill Travelling Fellowship – crystallised my thinking around maintaining and regaining skills for those who are frail and living in care. Our aim should be to promote healthy, active ageing. Providing physical activity and exercise, along with meaningful and purposeful engagement, is vital. We must also value social connections and the relationships that motivate people to engage more, if we are to aspire to a sudden death for all.
I recently had the pleasure of setting up a care home tour for one of the Australian care home managers that I had met. We were standing together in a care home, when a nurse told us that the resident we had just spoken to was recovering from a stroke. My Australian colleague asked how often the gentleman had physiotherapy and was shocked by the response that his treatment had stopped on discharge from hospital back to the care home. She couldn’t understand why we did not focus on regaining his mobility, not just for his own sake but the impact on the staff team too.
I frequently hear stories from activity co-ordinators who have managed to motivate a resident to get involved in something which has promoted not only physical activity, but social engagement too. Their sadness comes when these achievements are not recognised, not recorded, not added to the care plan. In brief, not valued as contributing to the health and wellbeing of the resident.
Having said that, I have been involved with activity provision for more than two decades and we have come a very long way in that time. Many care settings now have a named activity provider or specialist on the team. The regulator is looking for the holistic approach that puts the individual at the heart of the care and we have qualifications to support staff in this vital area.
Many of the major influencers in care recognise that we need a bit of a culture shift to ensure that we move the focus from meeting personal and clinical care needs to include social, emotional, intellectual and cultural needs too.
At NAPA, we encourage activity providers to see themselves as leaders, who can help to achieve this cultural shift. Our challenge now is to support managers and care teams to do this effectively, so that we can celebrate sudden deaths for all.
Sylvie Silver is Executive Director of National Activity Providers Association. Twitter: @activitiesNAPA