My Stories are My Identity Sarah Reed Many Happy Returns 51 Fitzjames Avenue London W14 0RR +44(0)20 7603 2786 sarah.reed@manyhappyreturns.org ABSTRACT This paper describes workshop contents conducted using Many 3. CONTEXT AND EVIDENCE OF NEED Happy Returns cards with residents and staff from two care homes and children and teachers from two schools, around reminiscence. Reminiscence plays a part in all our lives, and while older people enjoy remembering and may sometimes share their stories with one another, connecting with younger generations can be as – or 1. BACKGROUND more meaningful, revealing and satisfying for them as it provides Lead organisation: Many Happy Returns for Generations evidence of their self-worth not only to themselves, but also their Partner organisations: Queens Court Care Home Wimbledon families and friends and society in general. (Barchester) and Randell House Farnborough (Independent Age); There are substantial benefits for younger people and children in Guillemont Junior School and Wimbledon Chase School. learning about life and living social history through sharing and Date of the project: March – May 2009 exchange of views and ideas, and by comparing and contrasting their experiences. Participants: Care home residents and staff, Year 5/6 school children and teachers; age range: 10 – 99 years.; approximately 50 For carers, reminiscence can connect them better to those in their residents, 16 care staff, 60 children, 5 teachers care and this helps to improve their performance as well as enhancing their teamwork, job motivation and job satisfaction. However, one of the central issues for care homes nowadays is 2. INTRODUCTION that staff team are often mostly task-focused. This means that Many Happy Returns 1940s is a box of 24 large reminiscence interaction between them and residents may be limited at best and cards, researched among over 120 people 75 years and older and sometimes cursory. Many residents in care homes can be isolated designed for high appeal and usability to help people to re-find and lonely despite being surrounded by people (and the same is forgotten, happy memories and prompt conversations across the true for those living alone in receipt of Social Care, of course.) generations. Reminiscence is a powerful way to engage with residents during On one side, a variety of images of everyday subjects from the even incidental or personal care, which may typically be carried 1940s act as visual reminders to those who were young during the out in near silence. There is currently little formal training period. On the other side, background information, questions and available for carers in reminiscence, and less still in enquiry, conversational prompts provide younger people with enough active listening and conversation – skills that are so essential for historical knowledge to have rich conversations. They can be used meaningful relationships with and the well-being of older people. by anyone aged 10 and over, without training. They help people This work is being developed further by Many Happy Returns. over 75 years old to reveal their life experiences and histories for their own benefit whilst also helping to develop more meaningful relationships with younger people in general – and their carers in 4. WORKSHOPS OVERVIEW particular. 4.1 Stage One: Children’s Workshops We wanted to introduce the product to all the groups and help carers to understand better the power and therapeutic value of The card subjects are matched to the National Curriculum at Key reminiscence and how using it on a regular basis can help them to Stage Two in History and PSHE. Firstly, a total of seven separate provide better person-centred care and get more from their peer Children’s Workshops were run for two hours each at both homes, group relationships as well. with local primary school children at Key Stage Two (10 – 11 year-olds). Many of the residents in both homes have varying degrees of dementia but they were able to converse with the children using the Many Happy Returns cards. 4.2 Stage Two: REAL Communication Workshops Three, two-hour REAL Communication workshops in reminiscence, enquiry and active listening were then conducted 28 with care staff in both homes, each one being held ten days apart. experience of being moved into a care home was discussed, which The workshops involved learning games, experiential activities, exposed staff to some surprising revelations about their own sharing acquired knowledge and discussion. perceptions of those in their care. Additional information was provided for each workshop and simple homework tasks were also set. 7.2 Workshop Two In order to allow staff to settle in to the new ways of engaging Active listening, enquiry and questioning techniques were with the residents, a two-hour feedback session was held one demonstrated to show the importance of real engagement between month later. people. Participants played ‘question-and-answer-scramble’ word games to show how the structure of conversations work. Body At Queens Court, an observation session prior to the REAL language and tone-of-voice issues were also explored. Communications workshops was also conducted, to note how the staff used the cards to trigger memories and inter-relate with the 7.3 Workshop Three residents. Ten staff members attended the workshops. At Randell The third workshop focused on reminiscence and the importance House, five staff members and the Home’s Manager participated. of allowing people to be heard. The staff did their own reminiscing to understand better that triggers for reminiscence can come from a wide variety of objects – even ostensibly ‘abstract’ 5. AIMS AND OBJECTIVES things. One exercise showed how to be alert to those who may The aim of the children’s workshops was to introduce them to ‘drown out’ the voices of more reticent personalities. people who in most cases, are a full generation older than their 7.4 Final discussion group own grandparents and to give the residents the chance to interact with very young people – who are mostly absent from care home Approximately one month later the groups came together again to life. It was hoped that these workshops would lead to deeper and discuss the workshops, their evaluations and the learning continuing relationships between the homes and the schools. outcomes; and to consider how/if their behaviours had altered. All participants had completed questionnaires after each workshop, The three, two-hour interactive, experiential workshops for staff and also a detailed survey of the learning outcomes at the end. focussed on three issues: empathising with the residents’ physical and mental condition better; developing their listening and enquiry skills and knowledge of ‘unspoken’ messages; helping them understand better the therapeutic value of reminiscence. 8. OUTCOMES In so doing, it was hoped that the teams’ relationships would 8.1 Children’s Workshop improve and through this, their job motivation and satisfaction. There were many learning outcomes for the children. The Above all, the objective was to show how important people’s life workshops brought life in the 1940s alive for them, they experiences are to them and also consider how their current discovered how children played and spent their free time, living in behaviours may be affected by them. circumstances of what they considered to be surprising poverty, made contrasts between life then and now; and learned how to speak with people with a variety of sensory impairments. 6. CHILDREN’S WORKSHOPS The staff commented that the children were sensitive to the older The children were prepared for their visits with discussions about people, empathised well and clearly enjoyed the interaction. One childhood in the 1940s, how to inter-relate with people who might boy with Aspergers Syndrome responded to the work particularly have communication difficulties, how to be a ‘detective’ and well, asking to look around the home and whether he “could start interview people and a brief overview about dementia. Up to 10 working here now”. children at a time visited the care homes. Using the Many Happy The teachers noted that the children “had really enjoyed using the Returns cards as prompts, they initiated one-to-one conversations Many Happy Returns cards as well as spending time with the with the older people. This was a new experience for nearly all of residents and want to use them with their own grandparents now – the children. as well as returning for more”. The older people were surprised that, contrary to their perceived Residents were also encouraged to provide feedback through image, (driven by the media, they felt) the children were polite, simplified forms. Observation of the residents showed how the well behaved and fun to talk to. They really enjoyed the company cards reduced social awkwardness between the age groups and of the children and reported that they looked forward to their created higher levels of attention and more engagement. One visits. resident said, “It certainly stimulated me! When youth and old age can talk together, it goes a long way to understanding both stages of life.” Another said, “I enjoyed talking about doing the 7. REALCOMMUNICATION WORKSHOPS washing… old places like sculleries… doing the laundry… 7.1 WorkshopOne putting it through the mangle… it was very hard work!” The Randell House Home Manager reported that even for those with Using ‘inhibitors’ to mimic a variety of different physical dementia so deep that they could not retain any information conditions, the first workshop helped staff to understand and afterwards, “their levels of attention, participation and enjoyment empathise better with people whose physical and physiological at the time alone, meant the sessions made a difference to people’s state is very different from their own. In one exercise, the 29 lives. The cards are a valuable asset to the home and are used all the time” Abbigail (Queens Court) said 8.2 Workshop One “The workshops have really changed the way the team works Although initially mildly embarrassed by the inhibitors, even the together. Recently, when we were very short-staffed over a most experienced carers said that they were surprised by what weekend, the staff pulled together as a team in a way we have they went through, and that it was good to get “first-hand never before. Despite the difficulties we faced, we communicated experience of what our residents have to deal with everyday”. more openly and supported one another better – and managed to share a laugh as well. It has never been like that before.” 8.3 Workshop Two One member of staff commented that “the enquiry techniques I learned have helped with a couple of residents in particular.” 10. PROJECT OUTPUTS Another said that benefits of the workshop included All younger participants completed detailed evaluations for all the “understanding the person’s background and awareness of them as workshops. About half the residents completed forms or were an individual”. “I can hold more in-depth conversations with interviewed about their experiences. Videos of the Children’s residents as a result of the workshop”, said another. Workshops in both homes were produced. All participating 8.4 Workshop Three members of staff at Queens Court were made “Reminiscence Champions” to pass on their learning experiences to other staff in The staff found this session the most challenging. Two younger the home. ones complained (much like older people sometimes do) that they “couldn’t remember anything”. But given encouragement, both went on to share a range of rich personal memories without 11. MOVING FORWARDS difficulty. Subsequently, they said that they had been able to use what they had learnt in their day-to-day interaction with residents. A further workshop set has been commissioned for another Barchester care home. The content will remain broadly the same but alternative and additional games and activities will be tried as 9. EXAMPLES OF STAFF FEEDBACK it develops. Longer time will be allowed for discussion and evaluation will be deeper. Philip (Randell House) said “I’ve come to understand that the way you phrase a question can make a big difference and I am a better listener now. Greater 12. OTHER DEVELOPMENTS: awareness has affected me not only at work but at home too and “COLLECTED SHORT STORIES” made me realise how bad I was at listening before!” A new project at Queens Court working with staff and residents’ Mary (Randell House) said families to collect and record residents’ life stories, will be “Recently what I learnt made a real difference in building a Care presented at the 2009 Dementia Congress in November. Plan for a new resident with dementia who we knew very little about. Using the techniques I had learned I gathered tiny pieces of disconnected information about her experiences and history to 13. ACKNOWLEDGMENTS begin to build a “jigsaw” of her life and background.” Our thanks to Queens Court Care Home; Randell House Care Home; Guillemont Junior School and Wimbledon Chase School. 30