On an occasion at work I was aware of a staff member communicating very negatively, for example sighing and tutting and general negativity. Supervision was due so it was brought into meeting that last had concerned had noticed a change in the person’s general attitude, I asked if there was a specific reason and was told there was not. Although they agreed that they were being negative. We discussed the workload and it was decided it was not that. It was mentioned by the staff member that they were feeling a little unsure of how to deal with a service user who had dementia and was unpredictable and seemed to have taken a dislike to the staff member .We discussed at length the way forward and I arranged for some training in challenging behaviour and dementia. The staff member realised she could not avoid the service user and that if she had mentioned her concerns sooner the problem would not have escalated. She tried to hide her feelings but they were shown in a different way.
I agreed to mentor and support the staff member with the service user helping her to find an appropriate approach, the service user was feeding on the negative behaviour of the staff .In a few weeks the situation was improved undoubtedly and the staff member is more positive and no longer showing any sign of negativity. I recorded everything we had discussed and we both signed it. At the following supervision the staff had been on a training workshop and was awaiting further news of more. She mentioned previously that she felt it was a weakness in her that is why she had tried to cover it up but since our discussion and my ongoing support she would never hesitate to mention any concerns she had in the future.
I felt that we needed to improve activity at the Centre; the service users are a mixed group (physically and mentally frail) so I needed to find something they could all do and enjoy. I signed myself onto three one day courses with another staff member. The courses were all different but aimed at dementia sufferers. The first one ‘Bringing stories to Life ‘, I thought was going to be about putting together a Life Story, I could not have been more wrong! The ice-breaker at the beginning of the workshop was letter bingo, it involved walking around so I have adapted this so that my service users are seated, we use sets of the 26 letters of the alphabet and the service user chooses a letter and then gives me a word beginning with that letter before answering a quiz question, which I write down and while they are playing two alike trying to match up.
I take the words and make up a little story or poem. The feedback from that activity has been very positive. Also from the workshop which involved using props to tell a story I have been able to do this activity several times? Using the props seems to help the quietest of the service user to join in and the feedback discussion afterwards have become very enjoyable to all. The second workshop was about using pictures (not personal) to story tell. Again this activity has been very successful, there was one or two people who were unsure but has we progressed they too joined in.
The picture is given to the service user and they are asked open ended questions about it and everything is validated. Before we start we decide who is going to scribe and afterwards that person will firstly read back what as been said and ask if the service users would like to add anything? When everybody is satisfied the scriber will type the ‘story ‘ up and each service user gets a copy , we keep a copy in a folder for all to look at and we also pin a copy too our notice board .
The third workshop was along the same line but using senses to make a story/poem, again we have done this a couple of times. We used a bottle of water some soil in a bag, cotton wool, leaves and bubbles, we pass the items around the room one at a time and ask the service user to say the first word they thought of when looking / touching or smelling the item .one thing we came up against was that the service users said the same thing as the previous person, so we are trying to adapt this activity further.
From all three workshops I and my staff member redeveloped our armchair exercise which we do daily. We had heard the service users discuss how they were bored with doing the same exercise week after week and listening to the same music disc. So we put together some more upbeat music and sat and compiled our version of seated exercise ,using the same safe exercise taking advice from one of our other services ‘Ageing Well’ who had spent several weeks showing us seated exercise .
Of course before we started any of the new activities we had a meeting with all the staff who were going to be involved. We discussed what we had learnt from each workshop and asked for feedback from the staff, some of them felt unsure about using the props and pictures, so me and the staff member who came with me agreed to lead the first one, we arranged a date and agreed on a theme for it and it was decided we would use props for the first one .I was to lead and the staff member was going to scribe. Before we started we went to each service user and asked them to sign a consent form to allow us to take photographs. This would allow another staff to get a little involved with out feeling to unsure .the discussion /feedback with the service users was great ,they were still talking about how much they had enjoyed themselves when they were going home.
They were excited when I told them that there would be photographs to look at the following week. I discussed with the staff the following day how they felt about the activity and was pleased they were all positive. I continued to share taking the lead with the staff member who attended the training with me for several sessions to enable the other staff to be able to learn from us. Although with all the activities there is no right or wrong way. That is why we validate everything that is said. The change in the majority of service users is a pleasure to see, even the quietest person as become much more vocal and willing to join in with most of the activities we do.
One person in particular who is hard of hearing and registered blind joins in, when in the past he as chosen not to. He still talks about certain themes we have done the story telling to, for example at Halloween we took the opportunity to do this theme, we used pumpkins and plastic spiders, I passed these things around the room and we used ‘The Monster Mash’ song to do some light movement to music before using props to make up a story relevant to the theme. I asked the service user to describe the spider, for example what he thought it was felt like and he got really into it and even had a photograph taken.
Since then I have heard him telling others about ‘the day we let him hold the Tarantula ‘and how he danced to ‘spooky music’. Changing what we do and the way we do it as had a very positive effect all the way round. We still do the other activities for example Bingo, dominoes etc.During our action plan meeting we discuss which service users are in the centre that day and adapt our activity to suit, of course what we plan for the day may change if we ask the service users they may want to do another thing so if we can we will accommodate the majority. Usually the day is spent doing group work but if needed we do offer one to one.
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