Coming Out of Your Shell in Aged Care - Navigating Aged Care Podcast Ep.4
Posted 31st May 2024
Written by Jesse Gramenz
Aged Care Resident Grace (left) and Sheridan (right) on the Navigating Aged Care Podcast set
In this episode of St. Vincent's Care's Navigating Aged Care series, the hosts discuss the emotional challenges of transitioning a loved one into aged care.
They are joined by residents and their families, as well as aged care staff, a geriatrician, and a psychologist.
"It often can't be done with a single interaction. Sometimes as you said before, we're working through this professionally. We've got a certain outcome in mind, but we need to be prepared to give families and my patients people time to work through these really complex decisions."
Dr. Richard on families processing a potential move to aged care
The guests share their personal experiences and offer advice on coping with the emotional journey of moving a loved one into aged care. They discuss the importance of support networks, therapy, and maintaining healthy relationships during the transition. The experts also provide tips on navigating family dynamics, maintaining boundaries, and creating a comfortable and personalized environment in the aged care facility. Overall, the episode emphasizes the need for empathy, understanding, and self-care during this challenging time.
Hosted by: Nicole Lessio
Produced by: MSQUARE Productions
Episode 4 Transcript
Welcome to episode four of St. Vincent's Care's five-part Navigating Aged Care series. I'm your host, Nicole Lessio, and this episode is dedicated to helping our loved ones thrive in aged care. We're focusing on positive engagement and personal growth in these next chapters of their lives. We'll be joined by the true experts in the field, the residents and their families, as well as aged care staff, a geriatrician and a psychologist in this series. Joining us again are Grace and Sheridan. Welcome back.
Grace:
Thank you. Thank you.
Nicole:
I'm really excited to talk about this because your flourishing story is one that really inspires me, grace, and I know that in your transition into aged care, you kind of thought maybe it was a bit of a full stop to your life, but you've realized now that it's a bit more of the next chapter and there are more chapters. So I wanted to ask you about what you're interested in, how you explore the things that you're interested in when you're in aged care and how that works for you.
Grace:
I think you take it on a day-to-day basis. You can wake up one morning and feel a bit down. You think, well, what can I do to make me feel better? And then you take it from there
Nicole:
And so it's just a day-to-day basis. Work it out on the day.
Grace:
I think so, yeah.
Nicole:
And the idea of flourishing, what does that mean to you? When I say that?
Grace:
I just think coming out of yourself and being excited to get up in the morning and looking at life a bit different,
Nicole:
Getting up in the morning. What's the routine for you?
Grace:
My routine will vary, but I'm usually a stickler for getting up, getting dressed, having breakfast, and just working out what I'm going to do for the rest of the day. Yeah.
Nicole:
How often are you volunteering?
Grace:
Four days a week. Four
Nicole:
Days a week?
Grace:
Yeah.
Nicole:
What do you love about that?
Grace:
Everything. Yeah, I just love everything about it. Yeah. I look forward to it. Yeah.
Nicole:
What's it like? What do you actually do with your day?
Grace:
Just greet people as they come in and just do whatever's got to be done.
Sheridan:
I think she's underselling herself there.
Nicole:
Yeah, go on then. Sheridan, you pump up your mom's ties for us, let us know.
Sheridan:
Well, from what I can gather, mom's sitting at reception. Not only does she answer the phones in a very complicated phone system, from what I've seen, she seems to do a lot of paperwork based stuff like archiving. She seems to make a lot of things. She even made my badge, I think, didn't you? Yeah. Yeah. Like all the ID badges. She seems to know all the details of all the residents and who can do what and when. Actually, to me, I could be wrong, but from my perspective, it seems like she actually has a fairly large amount of responsibility, so I think she's minimized what she actually does there.
Nicole:
Yeah, don't sell yourself short, Chris. We want to
Grace:
Know all that. I don't mean to, it's just I just get in and do it.
Nicole:
Well, yeah, that's true too. I can sense that about you. You're a get in and do it kind of girl. What about other residents? What does flourishing like for them? Because they're not all doing the same thing that you are doing.
Grace:
I think we're encouraging them to do more activities. We've got a garden section now, which is really great. We've got bus outings. We've got, because of Covid, we couldn't do it of course. So now the facility has got bus outings, shopping trips and different facilities. So to try and encourage those to go on these excursions I think is great.
Nicole:
Yeah. What's the best one you've been on?
Grace:
I haven't been on any because I have a chauffeur sitting right next to me. You're welcome. It takes me wherever I want to go, so no, I don't have to participate in that because I've
Nicole:
You've got a personal chauffer.
Grace:
I've got a personal chauffeur. I hope
Sheridan:
That I wear a hat. We're on the same page there. I do wear the hat,
Grace:
So I'm really fortunate
Nicole:
For sure. But those activities, people either get involved or they don't get involved. That's right. And some of them can't get involved. Right. So from your point of view, grace, what does it look like for people who can't necessarily get involved? How is flourishing in aged care different for them?
Grace:
Well, a few of them are wheelchair bound and where possible the volunteers will wheel them to events, which is great.
Nicole:
And those who can't necessarily participate because they've cognitively declined a little bit too much. Is there any element of flourishing in those circumstances that you see?
Grace:
I'm not really involved in that section. I would like to think there is. As a
Nicole:
Volunteer,
Grace:
I think people like my daughter is able to see that and give feedback and say, this person would maybe need this or need that, and which she does, and then can be passed on to those that can help in that way. Yeah.
Nicole:
So then Sheridan, I'll ask you the same question. What does flourishing look like for someone who doesn't necessarily have the ability to participate in the way that mom does?
Sheridan:
Well, from what I've seen, being mindful over being there a huge amount of time. Yeah, definitely. There's a lot of things in place. Their pastoral care there is incredible. There's a beautiful gentleman named Andreas who does pastoral and I've interacted with him. So when I'm say doing the tea and coffee trolley, I might notice that a resident that the other day might've said, okay, today they're not having a good place. And so I'll go and inform him and I'll let him know. And then I have seen him then go to their room and he has a chat with them and he'll take them out of their room and he might take them into the garden. They've got a cat in house cat that lives there, so they might let him play with the cat. They do. So yeah, I have seen other staff members or I've even brought it to the attention of the RNs sometimes. So yeah, you definitely see that there is services within there designed to help these people live the best possible life they can. Whatever that means to them. I don't know. Yeah,
Nicole:
And that's the thing. It's different for all of us.
Sheridan:
Exactly. Yeah,
Grace:
It is. It is.
Nicole:
No matter what stage of life we are in, flourishing means different things at different times. Flourishing for you Sheridan. Yeah. Now that mom's not a caring responsibility, she gets to be a mom again, what does that look like for you?
Sheridan:
I dunno. I dunno. I think it is, it's still adult. Adult. I think there is the month. I think we've kind of passed that now. I think we have our moments definitely where mom saw me take my ventin puffer a minute ago and she panicked. She's like, I'm like, I'm not dying. I'm fine. So I think that will always be there. Of course, I think for me personally, it's the learning experience for me is becoming invaluable as with her and how we've changed and our dynamic right through to now. Me being a volunteer and just interacting with these people, seeing how it all works and me moving forward into my future career and even my future life handling people. And it's just completely changed my perspective of the world around me. I was always very patient with elderly people anyway. I always liked being around them and things like that, but this has totally shifted the way I see everything.
It is hard. Some days it's hard. There are certain wards obviously, that I go into and you will hear people calling out for their mom or calling out help and things like that. And it's hard that it's really, especially when it's new to you and you're not familiar with it, it can be confronting. But the flip side of it is I've, like I said before, I've gotten to encounter some amazing human beings and engage with them. So for me, like to use your word flourishing, definitely because I'm just constantly learning something new about the world but also about myself.
Nicole:
And I think that's another thing about flourishing is to keep learning. What are the things you are looking forward to learning as you keep going along there? Grace,
Grace:
Anything new that pops up?
Nicole:
Are you loving learning about residents and their families?
Grace:
Yeah, I love learning about anything. Yeah, I've got this great zest to learn and I am learning more at the front desk than I thought I would ever be able to absorb. And I've got a great teacher that sits next to me, Jennifer, and she's showing me some amazing things. So
Nicole:
What are you learning?
Grace:
No, just you pick up different things. How to apply different things on the computer results and different things like that. It's a learning curve. It's a learning curve.
Nicole:
Is that something you did in your previous life before you moved into aged care were
Grace:
Working in I did book work for quite a while. Yeah,
Nicole:
It's a bit different though, isn't it?
Grace:
It's a bit different, yeah.
Nicole:
A lot more personal interaction. Yeah. I love that you are continuing to learn and I think that that possibly might've inspired you as well. To go back to uni, what do you think Sheridan? Do you think mom's been inspirational in that?
Sheridan:
Yeah, absolutely. I think it's very easy to say, and I know I'm not particularly old, but it is very easy to say. I'm nearly at the end, my children and nearly awfully grown. Two of them have already left home. And so you sort of think, okay, well should this be the point in my life where I start looking in the other direction and I went the other way. I've wound up, I've gone the other way. And it is because you sort of go, well, hang on, I look at mom and I look at somebody much old. There's residents in there that are over a hundred and they're still going and you think, well, hang on a minute. Well then if I'm only, I'm 45 and these people are a hundred, okay, well then what the hell am I slowing down for? Well, I'm mentally and physically still able. Then the sky's the limit. So this is something I wanted to do as a teenager. So better late than never.
Nicole:
Yeah,
Sheridan:
Absolutely. Yeah. So just my going saying is the head first eyes closed, can't lose.
I didn't come up with that, but yeah, definitely. And she's been a huge support throughout all of it. She's my dumping ground for information. I'll learn something and I'll be like, the best way to learn is to obviously teach someone else. Teach someone else. And so I'd be like, ring mama or go and see her and I'd be like, oh my God, I learned this today and I did it the other day. I, so I ring and I tell her these things and like she said, she's got a thirst for it now too, where she's interested and she wants me to explain stuff to her and she'll be like, this person did this today. Why did they do that? I don't know. I'm only 10 weeks in. Ask me in a few years. Yeah,
Nicole:
Do your own psychology degree course. Yeah, that's right.
Sheridan:
That's exactly right. But yeah, it, it's really good because now we have these much bigger conversations than I think we ever had before.
Nicole:
What about your friends in aged care? What are they up to with themselves? What do they get to do that make them happy? Yeah,
Grace:
They join in the activities and go on. They love their bus trips. Yeah. Yeah.
Nicole:
I think you might need to join in, maybe just bring Sheridan with you instead of make her drive.
Grace:
No, I hear all about it from them and then I'm able to tell them what I did.
Nicole:
What are the other things that they get up to during the day rather than leaving?
Grace:
What are they up to do every day? Well, they go to bingo or they play cards or they do whatever's. And a lot of them unfortunately sleep a lot because they're tired. They're tired. Well,
Nicole:
You've done a lot, so I imagine would be pretty tiring. I'm tired now. The idea of flourishing I think for us feels like you've got to be active all the time. But I know in the previous episode, grace, you were telling us about you'd love to read. I
Grace:
Do.
Nicole:
Is part of flourishing just living the values and the ideas that you had before you moved into the community?
Grace:
Yeah. Yeah, I think so. Yeah.
Nicole:
What are the other things that feel like that you've been able to bring into your community?
Grace:
That's a hard one to answer. I dunno.
Nicole:
That's okay. No,
Grace:
I really don't know.
Nicole:
But you are perfectly wonderfully. You though in your new community, you don't have to change to be anyone different.
Grace:
No, no. Just what you see is what you get
Nicole:
And what we get is gorgeous. So thank you for joining us. We appreciate that. When you are thinking about advice for anyone, if you see lots of people coming in, grace, clearly you're there every time that they come in those four days that you're volunteering, what advice would you give families when they're coming in on those days to visit to help their loved one have the best day that they can have?
Grace:
Yeah, just try and be there for them as often as you can and tell them the truth.
Nicole:
Yeah.
Grace:
Tell them they're not going to just be there for two weeks and they're going to be picked up because when that two weeks is up, they think they're going to go home. So you've seen
Nicole:
That happen
Grace:
Them? Yeah. Tell them the truth because you're breaking their heart and a lot of them, they know when that two weeks is up.
Nicole:
Wow.
Grace:
They do.
Nicole:
And so that's something that happens, isn't that?
Grace:
Yeah, it does. Yeah.
Sheridan:
Wow. Yeah, I've actually had residents tell me that they're there because their house is being renovated and they're going home next week what their families have told them.
Grace:
But I think it's
Nicole:
Hard to flourish under those circumstances.
Grace:
Oh
Sheridan:
Yeah, a hundred percent.
Nicole:
Sorry, grace, I interrupted. No, that's
Grace:
Okay. But tell put it into more perspective of what this new life in aged care is going to be all about. It's not a helpless situation. There's so many things you can do. There's so many great people you can turn to and I think that's something that needs to be brought out. Yeah,
Nicole:
Well that it's not just the last chapter, it's the last of many
Grace:
Chapters. Age is only a number. True. Age is only a number. Yeah,
Nicole:
I think that's great advice because the only time that we're going to feel old is when we stop learning or stop doing new things.
Grace:
That's right. That's right.
Nicole:
When do you feel most young Grace,
Grace:
Virtually all the time look inside An old lady is a young girl trying to get out.
Nicole:
I sense a naughty streak in you, grace.
Grace:
Yeah.
Sheridan:
That was also a new discovery for me. Oh really? Yeah. Dirty mind on this one and the sense of humor that I didn't know existed for my entire life.
Nicole:
Yeah, well you don't have to be mum anymore. That's
Grace:
Right. Adults, that can just be me. So this is now the real me.
Sheridan:
I'm very pleased. I like it, I like it.
Nicole:
We're all loving it. Glad. How do we get the best out of people like that do you think? With their families, with the staff in the community? How do we get them to be the cheeky graces of the world?
Grace:
I think everybody's so individual. We've got to find that quirky little thing that they're hiding and bring it out. And you do that by talking to them. So talk to them as often as you can.
Nicole:
Making those connections
Grace:
And having make those connections.
Nicole:
Yeah. What's the thing that one of your fellow residents has told you that's been mind blowing to you that they've done in their life or that's really opened up a whole new conversation for you?
Grace:
We don't really get too discussed that much. I think we're too busy sort of. That's a hard one to answer. You're going to have to edit this out.
Nicole:
Definitely not. No, that's a great response though. It's a hard one to answer because you've got no time.
Grace:
No, it's not even that. It's just because everybody's so individual, you can't really answer that in a broad spectrum.
Nicole:
When your time is ready to go into aged care sharing, you've clearly just got to roll across the road, which is wonderful as long as they'll still have you. They've got your mom's
Sheridan:
Example. Yeah, I might have a reputation by them. They'd be like, nah, she's not coming in here. What are the
Nicole:
Things that you see mom do that you think, oh, I'm looking forward to that.
Sheridan:
I like the reception stuff that she does. I'm sort of the same way inclined in that I am people person, so I would like that a lot. I really like some of, I've seen the leisure girls that work there, leisure and lifestyle are hilarious. They were running around the other day in inflatable rabbit suits for Easter. So great. I really want a part of that, but as a resident doing that, I would like to be a part of that kind of thing where you're getting to go around and just be a bit silly, run a mark. That totally fits into my personality. So definitely stuff like that. I'm very arty, so I'm guessing the art stuff. Really looking forward to
Nicole:
Having the time to do that.
Sheridan:
Really looking forward to being in age care. So no, I like doing art and I've seen the art stuff they've got there and it's amazing. So yeah, then there's so much stuff going on in there. There's always something fun. There's always
Nicole:
What about the people who don't partake of those particular activities? Grace, what is life do you think?
Grace:
I think it's sad. I think it's very, very sad and I think more has got to be done to maybe bring them out. I haven't figured out which way to do it or which way that I think Sheridan is going to be great in doing that because she can get around and see them more in their natural habitat and you, you're seeing them more as they really are where I'm seeing people from a different point of view
Nicole:
And we all have different relationships with each other as well. Exactly. It's not necessarily one person who might unlock that little secret to get the cheekiness and the playfulness that comes out, but
Grace:
I'm sure it's in everybody. You've just got to tap into it.
Nicole:
Yeah, I think that's really true. So I think that if we can find it in ourselves to have those little conversations on the side and learn a bit more about each other, that's when we'll figure out what the thing is that that person's
Sheridan:
Got. It's about creating a safe space for them to do that where they don't feel judged. You're also looking at a generation too of people that had just a different way of seeing the world. You're talking post-war or sometimes even during war, some of them. So totally different way of seeing the world and so they're going to be a little bit more stoic, a little bit more starchy in the way I think. So if you give them this safe space to almost let their inner child run a bit of a mark and know there's no judgment and know there's no criticism, I think that was a big key thing for you was knowing that you could be and that it wouldn't change nothing was going to change my perspective and that it didn't really matter what anyone else thinks. It only matters what she thinks
Nicole:
And that even though there are routines and times that things happen, that doesn't mean you have to conform to a particular way of being. Does it
Grace:
Grace? No, I just broke all the rules last night. I just told them, I'm going out for dinner tonight as long as you tell people what you're doing and then I went, I had a lovely time. Good for you. Yeah, so yeah, it's great. I love that Depending on how you are, you are not fully restricted that you can go out. You're not just bound to the facility and I think that's what frightens a lot of people,
Nicole:
But they're stuck in some
Grace:
Way and you're not, sometimes they don't even tell her she finds out the next day, guess what I did last night?
Nicole:
So a big raging weekend coming up there. Grace,
Grace:
I'd like to think so, but also I've joined activists, which is a great thing and they can come and pick me up and take me up. I can shop, tell them, pick me up in two hours time, which they will do and take you back to the facility and it's a cheap and reasonable access for people in aged care, but that's another thing to look
Sheridan:
At. This wasn't a sponsored announcement so they could just slip us some money in the side.
Nicole:
I love that cheekiness runs in the family.
Grace:
It does,
Sheridan:
It does. I had to learn it from somewhere.
Grace:
So there is great things out there that people probably aren't aware
Nicole:
Of. How do they find out then? Grace? Do they just have to come to you at the front desk?
Grace:
I can tell them a lot of things, yes, good and bad,
Nicole:
But that's the thing, isn't it? You've got to discover these things. You've got to ask the questions. That's what makes it more fun. I think that's
Grace:
Right.
Nicole:
Having a bit of curiosity about us. I love that I've been able to chat to these two cheeky ones here. I've really appreciated you sharing about how you can flourish in aged care. Thank you so much for you Sheridan. Thank you. Thank you very much, grace. Thank you. And we've got some experts coming along, well, different experts, you guys are experts, clearly different experts that are coming along to chat to us more about flourishing in aged care. We'll be back in a sec. We're excited to welcome back Mark and Zoe to the podcast. Thanks both of you for joining us. We're chatting about flourishing in aged care and that's something that you're obviously trying to encourage. Mark, I want to know about what are the things that you do at Heath Code that help aged care residents flourish?
Mark:
First of all, just getting to know the individual They're trying to get, ascertain what they're about as a person, what's important to them, what brings joy in their lives, and then trying to connect them with opportunities within the facility. They will facilitate that. So I think that's a critical step. First step in helping residents to settle in and flourish.
Nicole:
And what are some of the things that they tell you that you can then connect up to the things that you are doing within the facility or that you can start?
Mark:
That's a really good question because I think one of the things that's really important is trying to get a sense of where they've been, what their journey has been and what interests they have, but also, I don't want to say that that's the most important because people change and I think it's really important and as we were saying before, trying to get a sense of where they're at in their journey and what they want to achieve in the future, how they see themselves connecting in a new C community and your environment
Nicole:
And that community is not just made up of their peers, that community is made up of all of the staff and your fabulous staff that look after everybody, and that's also including the people that cook their meals and wash their clothes. It's a big community of people, isn't it?
Mark:
Absolutely. Absolutely. And our volunteers as well. We've got some wonderful volunteers that come in that support our residents and even some of the schools when they send their kids. We've recently started a program where we've hooked up children in schools and becoming pen friends with some of our residents and I think that's really, it's in the early stages and the plan is eventually when they develop a connection in the old fashioned pen friend sort of way, we'll be able to introduce our residents to the new pen friends, which are school kids. Oh, that's magic. And I think that's really important, maintaining a connection not only with the people that are part of your community, so the new residents, the staff, other families, volunteers, but also maintaining and connecting with the wider community
Nicole:
Because Zoe, a community is not just a bunch of people that are the same age all the time that are in the same stage of their life. Is it
Zoe:
Absolutely correct? Yes. Now community is usually a rich and diverse population of people who all intermingle and interact in some kind of way. There's actually some aged care facilities in other parts of the world where they very deliberately have a real spectrum of people across the lifespan all living together and that model works very well. I think in Australia here we have a lot of aged care facilities where we've got a range of different people living within the same facility and then we've got the staff population management, carers, visitors, volunteers, et cetera.
Nicole:
So it's nice to bring all of that mix in to the new community.
Zoe:
Yeah, absolutely.
Nicole:
When we talk about flourishing, we talk about thriving in aged care. That's not something that everyone is going to be able to do is it
Zoe:
Can be challenging I guess in any kind of circumstance. I think flourishing or thriving is essentially living a valued life. So it's living a life that is rich, full and meaningful for the person that's living it. And that's different obviously for every individual and people can struggle with flourishing or thriving in any kind of circumstance, but certainly I guess in circumstances that are challenging or throw them out of their comfort zone,
Nicole:
What are some of the behaviors that you see, mark, when people are thrown out of their comfort zone?
Mark:
I believe that would be one of some of the behaviors withdrawing, becoming hypercritical perhaps of some of the environment around them that they can't control. I guess not engaging with people and ultimately it's a really negative experience for the person and the people that are around them.
Zoe:
I think what Mark is kind of touching on a bit there too is sometimes when people get a bit stuck, they get a bit kind of stuck on a particular challenge that they can't move past or stuck in a particular way of responding to things that they can't flexibly change and adapt to. And that can often perpetuate the struggle
Nicole:
And what do we do for our families when that kind of thing happens, Zoe?
Zoe:
Yeah, I think the first thing is to really try and identify what it is they're stuck on and why and what are they trying to achieve? What is it that they're trying to get I guess from that particular activity and that often speaks to their underlying values. If we can identify that and then find another channel, another way to meet that need, that's usually the most effective way of responding. Yeah,
Nicole:
Because flourishing is having agency as well, isn't it Mark? So often aged care facilities take away a bit of a person's agency as Grace was telling us in a different episode that not having to cook also meant not getting to cook necessarily and not being able to do the things that she was doing previously. How does that manifest in a
Mark:
Facility? I'm glad you brought that up because I think that's where I think in our previous episode we talked about taking charge of your life freely and communicating what you want out of the experience. If cooking is really important, I think you need to communicate that so those opportunities are made available to you and you can't leave it for others to guess what you're wanting. So I think you need to be active, engaged, and as I said before, I think it's critical that when you're coming into an age care home, you see that as an opportunity to get the support you needed and remember why you came into the home in the first place, but not be limited by that, not be defined by that. There are other opportunities that will open up and if you are only receptive to that, I think you can absolutely thrive
Nicole:
Because we might need those supports, but that doesn't take away from the person that we are.
Mark:
That's right,
Nicole:
Yeah. How do we get to be a person when we don't communicate those things? So if I'm not telling you that I love to cook, you're not going to know that you need me to get involved in something that is cooking related, but they might be telling their families and just having a little grumble to themselves. How do you make sure that you've got a voice in aged care? How do you then bring that up to
Mark:
Get the result? That's a great question. I think that's where we talk about partnerships in care where we bring the family, we bring the resident and we bring all significant others friends and they contribute to form the whole picture of who the person is and what the interests were and trying to work from that to either connect them with what's really important to them or open new opportunities to new possibilities.
Nicole:
Like pen friends.
Mark:
Like pen friends. Absolutely.
Nicole:
And you were talking about gardening as well when we were off camera before. Is that something that is new to your facility as well, that you've got a garden for everyone to be able to?
Mark:
Heath code is quite fortunate. We're surrounded by the Royal National Park, so I think people that live around there appreciate nature and gardens and this is, if I can say I think because it is a community, I suppose I like gardening too. I'll put it out there. I enjoy gardens. I don't enjoy the process, but I enjoy the outcome.
Nicole:
Like me, I like to look at it. I don't want to have to do the thing absolutely,
Mark:
But because I open up and share, I am part of that community. I have been able to tap into residents that are passionate about gardens and we connect at a very personal level and have a shared interest in gardening. So our gardens as a result have really thrived. And I guess that in a way that sort of parallels our relationships. If you invest in something, gardeners is like a relationship, isn't it? You make an effort and you'll see the beautiful results.
Nicole:
It's like the perfect metaphor, isn't it? It is. Yeah. Zoe, when people move into aged care and they perhaps haven't necessarily been flourishing at home, is that transition really challenging to get into a space where you go, I've got those supports now, what else can I do?
Zoe:
Yeah, look, it can be game changing actually. If the reasons that they weren't flourishing at home was because of practical supports and because they didn't have a structure or they didn't have the right people around to kind of enable or facilitate their engagement, moving into aged care can be a huge shift in change, in pace in life, and you can start to see that person then start to flourish. It really depends, I guess, on what the reasons were for them not flourishing. Often we see I guess a transition into the later years of life into retirement, pulling back from our usual routines of daily care for family for example. There's a lot of structure and routine with those things and a lot of that comes from externally, from outside of ourselves, and then suddenly you have a person who doesn't have that external routine anymore and that all needs to be internally driven.
Now obviously different personality styles, some people are great at doing that and other people really struggle. Some people might've been good at doing it before, but maybe with cognitive changes it becomes more difficult. So it really is about identifying what some of the reasons for that difficulty were and then addressing those. I think the other thing that I wanted to pick up from what Mark said is just around that process of people telling us what they want when they move into age care. I think that's such a wonderful thing to recognize that. And yes, I agree that sometimes you do have to ask. I think often, and I hear this from families and residents as well, there's a sense of I don't want to be too demanding. I don't want to be seen as so true that person, but actually what I really encourage people to do is see it as you are helping the staff to help you. They don't know what to do unless they know you and you can tell them.
Nicole:
Yeah, I think that you're absolutely right there that not wanting to rock the boat, it's partly possibly generational, generational actually. But then of course as the children or the adult children are concerned, if I've rocked the boat, then maybe they won't be as kind to mom if there's that niggling concern about those kind of things. Absolutely. How do they come to you with those kind of ideas and issues that they might be having? Mark? How does that work?
Mark:
I think it goes back to the relationship. I think if you set that in the beginning and your expectations and you've discussed that with the person coming in, I think you're very clear about what you are wanting out of the experience, and it's easy then to build on that. It's not an issue. It really is that an issue once you have established those relationships, that connection. But can I add also thriving also sometimes means sort of taking control. There's saying, and I think it might be a Montessori where they say, the more you do for me, the more you take away. So really it says to you that if you come into aged care home, it's really important for you to be engaged because you can become very deconditioned and withdrawn if you let other people just do things for you. So the more you do for me, the more you took away from me. Yeah.
Nicole:
Does that ring true Zoe?
Zoe:
Yeah, yeah, absolutely. We know that autonomy is a foundation, I guess, of our sense of self-esteem. So if you can do things for yourself, it feels good to do that. And sometimes when other people take those things away from you, it feels bad. So yes, I'd encourage autonomy, choice, a sense of agency in making decisions about the kind of care that you want. I think the other thing is that obviously families and residents probably have to have a degree of realism about what they expect from the aged care provider as well. So to Mark's point, it is far more effective for the person. It's better for them, for them to do as much as they can themselves, but it's also not helpful for them to expect their care providers to do everything for them or to make all those choices about what activities you're going to do today, for example. Yeah,
Mark:
And can I add on that, Zoe, you and I talked about it earlier for families, also for the relative to thrive, it's also accepting that some of the decisions I make about themselves may include risks that you may not feel comfortable, but there's a lot of things that I do that others may consider risky and scuba diving. It's one of those things, but it brings a lot of joy. It brings an incredible amount of joy and we just have to accept that as an adult, if you've come in with falls but you like to go for a walk, you may fall, but the home will do is try to mitigate against injury, harm, mitigate against reduce harm, but we can't cotton wool a person, we have to accept that in living there is some level of risk and the person will thrive if they are allowed to be autonomous and exercise agency and take risks where they feel is beneficial for them.
Nicole:
There is that balance, isn't there Zoe, between taking those risks and living a full and wholesome life?
Zoe:
Absolutely. We all make those decisions every day. When we hop in our car, when we walk down the pavement, we're all taking risks and that continues obviously into late life. I think where it becomes challenging is, and it's often adult children looking after their parents who perceive that their parent is in more risk than they ever have been before and therefore kind of feel responsible. They have to kind of step in and stop them from being in any kind of danger. And again, I think to Mark's point, just really appreciating respecting that if that person has the capacity to appreciate that risk and they're making the decision to do it anyway, it is their choice
Mark:
Even if they don't align with yours. It's really, really important. I think it's really important that agency is critical
Nicole:
Because that relationship flip is quite a challenging one, isn't it, Zoe, that you've been a child to a parent and now almost you are behaving like a parent to absolutely your own parent. You
Zoe:
Can feel that way a little bit, I guess for that adult child that it's funny, even the terminology is awkward, isn, what do we call ourselves?
Nicole:
What do we say?
Zoe:
And I guess when you reflect on it, we've had our childhood, we've now moved into a stage of life where we are used to caring for others. Often we've got our own kids or our own families or work responsibilities, and so it's kind of quite natural for us and morph into that, well, I'm just going to take care of everyone kind of mentality. Your parent has also gone through that and they're still there. It's not like they've suddenly switched into Childr. They're still an autonomous self-functioning adult who does want to make their own decisions in most cases. So it's a delicate kind of balance. Then that has to be struck between, okay, well who has responsibility here? Who gets to make the decision? And typically if the older person has capacity still and they're aware of what the situation is and what the risks are, they would have the decision making responsibility,
Nicole:
But that's hard to let go of that control, isn't it? If the adult child's been caring for that parent for a while without the aged care supports, it is hard for them to let go, isn't it? It
Zoe:
Is.
Mark:
It's someone you love, so you're not doing it out of malice or disempower. You're just doing it out of the best that you possibly can, so there's no ill intention. It's that you just want to protect the ones you love, and sometimes we overstep those boundaries and disempower people and
Zoe:
It does. It comes from a place of love and it comes from a place of fear typically, that they really just don't want anything bad to happen,
Nicole:
Which is beautiful, but also takes away their agency and actually makes it more difficult for them to integrate and flourish. What about those, Zoe? We know that a lot of people don't get visitors in aged care and that perhaps the adult child or children are not able to come and visit. Part of flourishing is having those great relationships. How do they maintain those from a great distance or perhaps if there is not a physical distance, but an emotional one?
Zoe:
Yeah, I mean, so there's lots of reasons that people might not get frequent visits in aged care, and it might be something as simple as they've never had their own family. They can be living on their own for quite some time, or it might be that their family live interstate internationally or just very busy with their own lives. Lots of different things can go on. There's obviously technology as our friend here at as much as possible where we have facilities that can really enable and facilitate the connection via video calls, telephone calls, emails, et cetera. That's fantastic. A lot of facilities will also have a volunteer visiting program where they'll have people from the community who do have the time and do have the space to come and spend some time with. People do come in. There's obviously the internal communities of other residents, staff members, groups, the program of diversional activities, et cetera, so there's different ways of building a community to sometimes compensate for family that might not be able to or available to come and visit.
Nicole:
And that's something that you thrive on doing, isn't it,
Mark:
Mark? Absolutely. Can I also add that sometimes families don't come because they do find it difficult to connect with a person that is no longer the parent that they knew because they are entering advanced dementia, and that's where talking to the home, talking to staff, they can help you facilitate that relationship and connecting in ways that are still meaningful, but if you're finding it difficult, I think it's really, again, goes back to that relationship stuff where we maintain communication open.
Nicole:
I think that's a wonderful tip though, that that's an experience that you guys have every day that you are with the residents who are having those cognitive declines perhaps, particularly dementia. I think we're a little bit afraid of it, aren't we? Wow. Absolutely.
Mark:
Yeah. It can be scary
Nicole:
Confronting then not coming to visit is something that is just a bit easier than having to,
Mark:
It's confronting. It's confronting. When you say that decline in a parent and someone that you love, but it doesn't have to be. I'm saying that with the right support, you can still get an incredible, bring a lot of joy to your relative, to your loved one and still have a really meaningful, joyous relationship, maintain that. It's
Nicole:
Just a different one, isn't it though? It's different
Zoe:
Sometimes it's about doing things differently. Yeah, communicating in a different way. I know in an earlier episode you mentioned memory boxes and I heard Grace talking earlier about the photographs that she's got in her room, and I think there's obviously other ways that we stay connected with our family even when they're not physically present, so having some of those memory aids, having the photo albums, the photos, there's memory boxes there to remind those persons that even though this person is not physically in the room with me, the relationship and the connection is still there,
Nicole:
But that difficulty of the relationship changing, I think that often there's that idea that this person isn't the person that I knew. We're all changing though all the time, aren't we, Zoe? It's not necessarily just because of dementia. We're all becoming different people constantly,
Zoe:
Always in different circumstances. We become different versions of ourself to suit the circumstances. That's
Nicole:
True too. That's part
Zoe:
Of just being a normal person. Yeah, absolutely. I guess what a lot of people are really getting at when they talk about caring for a loved one with dementia not being the same person is that even when they're with the person, the person's way of relating to them is different. They might not recognize them, they might not kind of laugh at their jokes the same way that they used to. They might forget some of those important shared memories that they have, and so it becomes a real challenge for those people who kind of feel like, well, what is our relationship now based on? I completely agree that relationships do change over time. Not quite sure what I want to say with that one.
Nicole:
They just do. They do. They do. And Mark facilitating that for you, what kind of great interactions have you seen between residents who maybe are struggling with flourishing and their finally coming out of their shells?
Mark:
I'm thinking of a lady that, for example, I think we've may have met earlier episode Carol, where her passion for gardening, and I think I alluded to that. I like gardening, but the flourishing Annie came When we make things happen and the person gets to feel like they can still exercise choice and engage in activities that are meaningful to them, it's a vested interest here, but we get great gardens out of it as well.
Nicole:
I love that there's a perk on top of actually having great flourishing experiences in aged care. I want to thank you both so much for chatting to me about flourishing in aged care. It's been wonderful talking to you both. This episode, we've focused on fostering environments where if they're able, our loved ones can truly flourish as part of their aged care community. We've learned that aged care is a journey, not just a destination. Thank you to Grace and Sheridan, mark and Zoe for joining us again, and thank you for tuning in. If you enjoy today's episode, be sure to hit the follow button and share it with your friends and family. Don't forget to visit our website, www.svcs.org au to watch the videos from our latest campaign, which inspired this podcast. You can also stay connected with us on Facebook, Instagram, or LinkedIn by searching St. Vincent's Care, and if you've enjoyed this podcast, leaving a rating or review would really mean the world to us. It really helps other people find this content. In our next episode, we'll be talking about the sensitive but essential topic of death and how we can navigate the final stages of our loved one's lives with compassion and dignity. We look forward to talking with you then. Bye for now.
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