Newsletter September 2014

The institutional model of care, centres on mitigating decline and disability. The person-directed model offers a radically different belief. Longevity gives forth its own promise and potential. From the employee care partner’s perspective, the institutional model offers little opportunity for personal growth in what are often considered “dead-end jobs.” In a person-directed model of care, Elders and their care partners have every opportunity to learn and grow. The opposite of growth is death — physical and spiritual. Individuals living with frailty continue to grow and teach us how to be human beings in a caring community. Everyone has the potential to be a “growth partner” to someone else. We thrive when we have good medical treatment and appropriate care. Someone can benefit from several aspects of well-being, but may have a health condition that is out of control which significantly inhibits growth.

Quality care enables growth, and medical treatment effectively serves this process. Care (helping another to grow) and medical treatment are skill full partners. Care for the individual comes first and foremost.

Bringing growth forward:

How are the strengths, dreams and goals of individuals captured and shared in the community?

How does the care partner team work together to help one another to grow based on individual strengths and goals?

What opportunities are all care partners given to be exposed to new life experiences and knowledge?

There are 6 more Domains within Well-Being according to the Eden Alternative on which we will focus in the following newsletter editions. GROWTH; AUTONOMY; SECURITY; CONNECTEDNESS; MEANING; JOY IDENTITY: Done! – See June 2014 Newsletter

The Eden Alternative Domains of Well-Being:

GROWTH

An extract from: Domains of Well-Being white paper, Revolutionizing the Experience of Home by Bringing Well-Being to Life.

Growth - development; enrichment; unfolding; expanding;

evolving

Residents from Huis Vergenoegd in Paarl, learn more about this thing called Facebook.

Never outgrow Growth

Virgil Thomas of Changing Aging wrote the following on 8 August 2013,

We at The Eden Alternative have spent nearly twenty years thinking

about how a life is well lived. The Eden Alternative Domains of Well Being were developed to try to capture the essence of a good life. Identity, Growth, Autonomy, Security, Connectedness, Meaning, and Joy all represent unique facets of well being. Each is irreplaceable and important in its own right, but I would like to take a few minutes to reflect on the concept of growth.

As a child or a youth the concept of growth is a visible part of life. The first twenty years represent rampant, almost daily physical growth, a developing mental and emotional state, and an almost constant state of learning. Unfortunately, that definition of growth is unfairly applied to adulthood and beyond. Physicality shrinks as our youth begins to fade. Learning slows as we fall into routines and comfort zones.

The institutional paradigm pigeon holds old age as a time when the body shrinks rather than grows and experiencing new things becomes impossible, so old age has become a time when, by this definition, growth is impossible. By the time a person reaches Elderhood the system is set up to stem the haemorrhaging of growth, by trying to keep the body and mind from declining any further.

The Eden Alternative rejects this youth-centred

premise of growth. Instead we define growth as engaging in a care partnership with others. Though the body may be frail, a care partnership provides the opportunity for spiritual growth and connectedness.

We are curious to know the numerous ways you help promote growth in the lives of Elders as well as your own.

http://www.edenalt.org/never-outgrow-growth/

On August 9, Virgil got this

response from Barbara L. Smullen,

Oh, my goodness, I really gulped when I read “experiencing new things is impossible”! I am so glad Eden refutes that definition of growth! I am an Elder, 70 years old, and an Eden Associate. I have experienced MANY new things in the over 7 years I have lived in an Eden Home…new things physically, mentally, emotionally and spiritually! Just a few examples of that growth would be – physically: grown (intentionally) thinner…(was quite obese) , and grown to adjust to the fistula and dialysis experience; mentally: I have learned so much about Eden that I have even presented programs on Eden to community groups, and I have read probably 100 books in those years, all of which taught me new things; emotionally – I have learned to deal much better with my bipolar disorder, in ways that have made much healthier emotionally; spiritually: I grown in reflecting on my faith in deep ways, leading to a major significant change in my worship community of choice…

In order to grow in these ways as a senior, we must feel safe and respected and valuable – safe in our environment, and safe in who we are. Eden provides that safety! LIFE is GROWTH at an Eden Home.

Eden Alternative Principle Nine Creating an Elder-centered community is a

never-ending process. Human growth must never be separated from

human life.

‘Human growth must never be separated for human life.’

Eden Alternative uses GROWTH as an acronym in the training to help plan our own growth path, that of our team members, Elders and our organisations:

G – get real,

R – reach out,

O – open up and dream,

W – work up a plan,

T – take action,

H – hold fast.

Growth is also one of the Eden Alternative domains of well-being. Without growth there will be stagnation. And yet, we have to ask ourselves what we have invested in our own growth over the past year. What new skills have we mastered, languages learned, books read or crafts mastered? What have we done to improve our skills as managers or care partners.

Phillipa Perry, in her very aptly named book “How to stay sane” says that personal transformation happens in four areas:

Self-observation

Relating to others

Stress

Personal narrative (what is my story?)

Self-observation (Get real…)

Perry quotes Socrates who stated, “The unexamined life is not worth living”. The ability and skill to self-reflect could often be lost in our daily rush against time, tasks, traffic and deadlines. A constant feeling of not getting things done and failing in our mission might lead to self-

criticism and an overwhelming feeling off failure. This is where we need to develop non-judgmental self-observation. Standing back from ourselves, observing our feelings and emotions and driving forces, in order to create a space in which we can make decisions on how we choose to act or react. Immediately one assumes a position of power – I reacted the way I did based on a calculated, informed decision, and not as an emotional reaction to a stimulus. I am in control!

Relating to others (reach out…)

The foundation of The Eden Alternative philosophy is authentic relationships. There is an old German saying, “Ich werde am du”, which roughly translated means that I become through you. We are formed and defined by our relationships. Tom Kitwood said that “Personhood is the status that is bestowed upon one human being by another within a social context of relationships. It implies recognition, respect and trust”. We need to be nurtured, we need to be in relationships where someone will hear and see us without us having to say a word. We need someone who will validate us through knowing and seeing the real you, and not just the label of “nurse” or “cleaner”.

Stress (Open up and dream…)

If our seats are too comfortable, we will never get up. We need positive stress in order to expand our horizons, to stimulate,

challenge and to grow. If not, we might find that the wheel is turning, but the hamster is dead.

Personal narrative (what’s the story? – work up a plan…)

What are the beliefs that drive our behaviour? What is the recording playing in the background? Is it our mother’s voice telling us that we are not good enough, not smart enough, not thin enough? Is it that schoolteacher who told us we will never make anything of ourselves in life? Non-judgmental self-observation will help us to listen to our inner voice, and give us the opportunity to change the discourse, to edit the narrative and to start living by a new, positive force. If we start by writing down three positive things every day, we will actually change the chemicals in our brain to create a different perspective. Our brain will start looking for the positives after a week or two, we will constantly search for the good things in life.

And this is where GROWTH will start happening. We always say in the Eden training – the only thing that you can change is you. If we start by changing our inner dialogue after non-judgmental self-observation, examine our relationships and start looking for the positives in life, we will not only grow but flourish like a tree growing next to a river.

Rayne Stroebel, Eden Alternative International Regional Coordinator South Africa

It’s a Process, Not a Program By Laura Beck, The Eden Alternative on December 17, 2012 As a society, we love our programs. Move around in any professional sub-culture and you will hear the word “program” thrown about repeatedly. We love methodically following their pre-determined steps and adding them to a list of other programs that we are already implementing. I have been to meetings and professional events where lists of programs pursued and pulled off are shared like a shelf of trophies. Done that, been there, next program please. Do programs add value? Sure they do, likely some more than others. When it comes to creating deep and lasting culture change, however, programmatic approaches and thinking won’t get you very far. A program typically becomes the focus and responsibility of a few designated individuals, who, alone, attend to each articulated, predictable step that defines it. While 2 folks are working on Program A, you may see 2 more managing Program B. No one else has to worry about the success of Program A or Program B, because, hey, its success is “not their job.” The result is a series of little separate silos within the organization, which may not account for developing a shared sense of ownership or the possibility of benefiting from and building on collective strengths. When it comes to person-directed care, step-wise approaches simply don’t deliver, as they don’t take into consideration how different and unique every individual is. Person-directed care is a process. This is why The Eden Alternative recognizes that promoting person-directed care means offering a philosophy based on guiding principles. Principle-based approaches offer both a shared language and direction, while also providing the flexibility to respond to the unique needs and circumstances of all involved.

As a process, culture change is dynamic, always growing and becoming, and woven into how we move through every moment of our day. People often share that they don’t have time to “add” person-directed practices to all they already do. This, again, is programmatic thinking. We don’t embellish daily operations with culture change ideals; they become the very filter through which those daily operations unfold. It’s not about “what else” you are doing; it’s about how you are doing what you already do. It’s about creating a way of life, a way of being; and it begins with leadership modeling what it means to live and breathe these ideals each day. It also involves engaging everyone on the care partner team in discussions about how this process is different, and infinitely richer, than just another program. No matter where you land on the continuum of care, consider the following for conversations with employees, the people you serve, and their family members:

Distinguish the difference between a program and a process. What does this mean to different members of the care partner team?

Discuss why all members of the care partner team play a vital part in the process of integrating person-directed care practices. What feelings do they have about this important new role?

Explore examples of how this process is shaped and framed by the unique needs and preferences of the Elders you serve and all of their different care partners. Solicit additional stories from different members of the care partner team. The more that all involved understand this important distinction, the more successful and solid your change efforts will be!

From News from The Eden Alternative,

December 15, 2012 http://changingaging.org/edenaltblog/author/lbeck/

''We need to give each other the space to grow, to be ourselves, to exercise our

diversity. We need to give each other space so that we may both give and receive such

beautiful things as ideas, openness, dignity, joy, healing, and inclusion"

Max de Pree

A Story from the Free State. Huis Moria, a VVA home.

Op 17 Desember 2013 het Dries, voorheen van Bultfontein ouetehuis, by ons ingetrek. Hy is opgeneem met diabetes, regter hemipleeg weens ‘n beroerte en sy spraak was aangetas. Hy was permanent op inkontinensie-produkte, baie depressief en totaal en al afhanklik van die personeel vir als. Vandag 8 September 2014 stap hy alleen - was en trek homself aan, slegs met toesig van *Steven die versorger. Hy gebruik slegs een inkontinensieproduk per nag en glad nie deur die dag nie. Hy doen strek-oefeninge met sy regterkant. Daar is geen tekens van depressie nie. Hy sing en het ook begin tel. Hy het gaan kuier by sy familie en sy stiefdogter sê sy kan nie glo oom Dries het haar nie een keer gedurende die nag geroep om te help nie. Hy gebruik self die urinebottel en trek self aan. Sy diabetes het ook heeltemal gestabiliseer. *Steven was die tuinman vantevore. Hy het egter die wens gehad om ‘n versorger te word. Nou, nadat hy opleiding ontvang het, werk Steven as ‘n versorger binne Huis Moria.

Redakteur: GROEI? Beslis vir Dries en Steven! Dankie Edith (bestuurder) en die Huis Moria span!

On 17 December 2013, Dries, formerly from a home in Bultfontein, moved in with us. He was admitted with diabetes, right hemiplegia due to a stroke and his speech was impaired. He was also permanently using incontinence products. He was very depressed and totally dependent on the care staff. Today, 8 September 2014, he walks on his own and gets dressed only supervised by *Steven, the caregiver. He uses only one incontinence product per night and none during the day. He does stretch exercises with his right side. No signs of depression are observed. He has been singing and started counting again. He went to visit his family and his stepdaughter said she could not believe Dries did not call for help even once during the night. He used the urine bottle independently and dressed himself. His diabetes has completely stabilized.

*Steven worked as the gardener before he expressed an interest in caring. He received training and now is a caregiver at Huis Moria.

Editor: GROWTH? Definitely for both Dries and Steven! Thank you Edith (Manager) and the Huis Moria team.

Strong Communication Skills:

Step One to Building a Participatory Culture By Laura Beck, The Eden Alternative on February 13, 2013 Successful culture change calls on leaders to create an organisational culture that actively engages everyone in change initiatives. Leaders who just pay lip service to creating a participatory ethos find out very quickly that they

Dries giving a thumbs up to Huis Moria Steven went from gardener to carer and he is good at it

are building their culture change journey on quick sand. Teams that aren’t getting the tools they need to “dig deep” and build a solid foundation for change quickly lose faith in leadership’s commitment to their success. To create a participatory culture, leaders must back up their talk by providing the vital skills necessary to support this process. Without question, developing strong communication and conflict resolution skills across all teams should be the first tool set that leaders provide. Growing a shared commitment to excellent communication eases the way for every other aspect of the change process. So often, precious time is lost when agreed-upon communication guidelines are not in place to facilitate high involvement of all stakeholders. It’s about so much more than knowing how to communicate well. Teams need see, believe, and experience how solid communication and conflict resolution skills are the “connective tissue” for everything they will accomplish together. Together, they need to own its value and prioritize it as the key to their success. This way, they will hold each other accountable to excellent communication, and not just wait until leadership insists that they employ a particular communication protocol. Facilitative leaders have the skills to convince teams that building a shared communication standard was their idea in the first place. So, the teams themselves work together to envision how they will drive education and implementation to grow and support a shared communication and conflict resolution strategy. To explore this issue in your teams, consider the following Learning Circle questions:

How do we prioritize good communication skills in our organisation? What access do we have to educational resources to build our skills? Which ones shall we agree to use? What expectations should we have of each other when conflict arises? How can we work together to develop a proactive intervention strategy that keeps us committed to

excellent communication with each other over time? http://changingaging.org/edenaltblog/strong-communication-skills-step-one-to-building-a-participatory-culture/

WORDS make WORLDS

Words can make or break ...

Having to use different words, takes

awareness, being in the moment.

'ward'

Means '' a section in a hospital or a prison'' This word again reminds us of hospital and even worse a prison. You live in a neighbourhood, a house or a household. Or even better, let the residents of the section of the home choose a name for their neighbourhood. We would like to challenge everyone who works within a home where older persons live, to become aware of the words ''ward'' and stop using it!

Words from previous editions: Not patient but rather the resident/John/Mr Smit. Not sick bay but rather Care Centre. Not admit but rather move in, became a member or joined a community.

The Denali Center in Fairbanks Alaska, is

a Registered Eden Alternative Home even though they share a site with a hospital. Here is how they describe their home. ''Following the Eden Alternative, Denali Center has a neighborhood-like architectural style and layout. We have beautiful plants, visiting pets and laughter. We encourage generations to talk and get to know one another in our comfortable, homelike atmosphere.

Our highly skilled and compassionate staff strive to meet residents’ needs while respecting their privacy and individualism. Denali Center also gives residents access to daily activities, visits from friends and family, a place to worship and on-site shopping options''

Read more about this home at https://www.bannerhealth.com/Locations/Alaska/Fairbanks+Memorial+Hospital/Programs+and +Services/Long+Term+Care/_Denali+Home+Page.htm Watch a video about this home at https://www.youtube.com/watch?v=vfPmHDLK3as

Eden Alternative

INTERNATIONAL

Eden Alternative South Africa Direct +27 21 461 7754 | Fax +27 21 461 6328 Block C – Boulevard Office Park – Searle Street – Cape Town – 8000 PO Box 5342 – Tygervalley 7536 www.edenalt.co.za | www.facebook.com/edenaltsa

There will be a great Eden Alternative presence at this Festival, with Carol Ende, Leader of Transformation and

Growth - Eden Alternative Home Office as well as Al Power, MD and author of the award winning book,

Dementia Beyond Drugs: Changing the Culture of Care. Dr Power will present a training workshop before the

Festival commence. Contact sgrant@geratecza.com for more details on this

training.

Dr Al Power in South Africa!

Workshop in October there is still space ...

Dementia Beyond Drugs Workshop book now at

http://sa-careforum.co.za/dementia-

beyond-drugs/

Riverside Park in

Pietermaritzburg, a PADCA home, is creating opportunities for

relationships to grow every chance they get.