A person centred care approach is key to offering outstanding activities in care and nursing homes.
Person-centred care means creating a picture of a resident’s past and present and, based on that information, providing them with meaningful choices as to the activities they wish to partake in. In an environment of great cost pressure, we understand this can be a challenge for care providers and we have taken this into consideration when planning our activities.
Here are five things we bear in mind to make our activities as person-centred as possible:
1. How to emphasise individual hobbies and interests
During an activity session, we actively encourage residents to contribute their favourite things, tastes and preferences. You can then use this information to theme subsequent activity sessions.
A one hour activity session may give you months of ideas to pursue individual or group interests. It may even inspire you to create further activity sessions for specific interests such as a ‘genealogy club’, a ‘knitting circle’ or a ‘painting group’. Listening out for residents’ hobbies and interests in conversation is therefore very important.
Examples of times we have encouraged older people in care and nursing homes to engage with their own hobbies and interests:
- Listening to a person with dementia play the piano for staff and the other residents present during an activity session
- Looking at embroidery with a 100-year-old lady and her daughter who both shared a love of the craft
- Playing James Bond theme music through the speaker system whilst looking at imagery from James Bond films through the ages, (can be used where a resident expresses any film preference)
- Looking through old football cards and programmes with an avid fan
- Providing a bird feeder for a man who loved bird watching
- Sourcing a bridal dress from a charity shop for a lady who loved to talk about weddings. (We were able to hire one for a day for a small donation.)
- Playing JS Bach for a lady who loved classical music.
Seeking to understand residents’ hobbies and interests can also serve the important purpose of discovering common ground between residents that would not otherwise have been known to them.
2. How to include relatives
Involving relatives and fostering a positive relationship between the resident’s family and the care home is central to person-centred care. Relatives should be given the opportunity to communicate the resident’s life history, their hobbies and interests to the care home or Activity Co-ordinator
The wife of a man in care with dementia was visiting and joined in with him during an activity session. We were talking about ‘things we did in the past’ using photos and artefacts. Unexpectedly, he began to relay stories from World War II, during which he served for the Allied forces in a
submarine. We were surprised at the detail of his memories. Afterwards, she rushed towards us just as we were leaving the care home and exclaimed, ‘You brought my husband back to me this afternoon!’
She had not had a conversation with him for many years and could not quite believe that her husband was regaling everyone with stories she thought were long lost to dementia.
Creating moments like this is the true reward for person-centred activity sessions. Always remember that the person responsible for choosing the care home is often a relative and that outstanding activities are a major factor when selecting a care home.
Relatives are often interviewed as part of an inspection of the care provider and their views documented in the inspection report. A glowing appraisal from visiting relatives of the activities offered by the care provider goes a long way in helping to improve goodwill and inspection results in this area. Also bear in mind that a good activity witnessed by relatives helps spread an important ‘word of mouth’ marketing message to promote the business of the care provider in the local community.
3. Promote independence and decision making
Here are a few ways in which to promote independence and decision making in relation to activity sessions:
- Do residents determine the overall direction and content of activities through interactive sessions and vocal contributions?
- Can residents make decisions about where they want to spend their time within the care or nursing home e.g. Which room do they want to be in? Where do they want to sit?
- Are residents aware of and regularly reminded of activity sessions that your care home is offering? Ensure people are reminded in conversations and sign posting.
- Are members of staff available to help residents get to and from activity sessions?
- Are adequate staff on hand to allow residents to leave mid-session should they wish to do so?
- Does the care provider offer a broad spectrum of activity sessions to address differing hobbies and interests?
If you would like some help getting started with discussing hobbies and interests, our DVD provides approximately 8 hours of activity material.
4. Use of names
Simply using people’s names correctly is the first important step in taking activity session from generic to person-centred.
It is important from the outset to refer to people by their preferred names. Treating residents in a person-centred manner and with respect involves remembering their wishes when calling them by their name. Some people like the use of Mr. or Mrs., whereas others are happy to be called by their name or even nicknames.
As activity leaders build stronger relationship with residents, more familiar or informal names may be introduced. Using personalised or informal names can create an immediate sense of rapport and familiarity.
One example that stands out from our experience is a lady called Sandy who we now affectionately refer to as ‘Sandy from Swan Street’. This is a very effective example because it draws on a piece of early personal biographical information (Swan Street being the lady’s birthplace in Winchester) and also has a rhythmic, alliterative sound.
Other examples we have used to fantastic effect include: ‘Colin from Cricklewood’, ‘Beryl our Ballerina’, ‘Sylvia our Storyteller’, ‘Rodeo Bob’ and ‘Barbara Belle’. For some people the closer the link to the resident’s own life story, the better.
5. Note taking
It may sound obvious but record keeping is key for effective activities. An aspect of good practice that care inspectors consistently remark on is the extent to which a care provider maintains an accurate and complete record of the individual circumstances of their residents. In the UK, records
are typically retained in a document called a ‘Care Plan’.
This document should contain sufficiently detailed information to allow activity personnel to tailor activities to that individual. It should include at least the following in relation to each resident:
A summary of key biographical information including at least the following: (i) former occupation; (ii) hometown; (iii) family (living and deceased)
A summary of the resident’s hobbies and interests including, for example, sports, pastimes, music, film, animals and cooking – see ‘ Hobbies and Interests’ below for further information
A log of the activities that the resident has particularly enjoyed in the past to make sure the activities or themes are repeated and explored in greater depth (ideally based on the preferences directly expressed by the resident)
Key pieces of biographical information noted by relatives at any time to care staff (such as, for example, ‘June drove ambulances during the Blitz’ or ‘Dorothy was a florist on her high street’ are incredibly useful topics for an activity leader to weave into an activity session but may not have been personally volunteered by the resident, especially if they are living with dementia.
Preferences expressed by relatives from time to time and a record of discussions with relatives
In conclusion, irrespective of the specific activity at hand, a person-centred approach should permeate every aspect of activities.