Some compelling stories from Riverside
Older People’s Mental Health Ward’s
weekly church services.
Lorraine Turner & Laura Critchlow
(Riverside Ward Occupational Therapy Team)
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Hello we are part of the Occupational Therapy
Team who work on Riverside.
We help our chaplain Lida provide a weekly
church service for our patients. We have been
facilitating the weekly church service for
approximately 18 months.
Riverside is an 18 bed Older People’s Mental
Health Assessment Ward, serving the older
population of the Derbyshire Dales.
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As Occupational Therapist's one of our
primary aims is to help people participate in
activities of everyday living in order to
promote their health & well being.
This is achieved by careful analysis of physical,
environmental, psychosocial, spiritual, mental
and cultural factors to identify barriers to
participation.
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Not experts
Answers /solutions
Share our experiences of promoting spiritual
care needs on Riverside Ward and then
together we might consider & explore ways of
supporting colleagues in our care homes and
other care environments both to recognise the
importance of and meet the spiritual needs of
those older people in their care.
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- the search for meaning & purpose in life, which may
or may not be related to a belief in God or some form
of higher power. For those with no conception of
supernatural belief, spirituality may relate to the
motivating life force, which involves an integration of
the dimensions of mind, body & spirit. This personal
belief/faith also shape an individuals perspective on
the world & is expressed in a way he/she lives life.
Therefore spirituality is experienced through
connectedness to God/higher being &/or by one’s
relationship with self, others or nature. (Johnson
Mayers 2005)
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Beneath this increasingly jumbled layer of
emotion is the true self that remains intact
despite the ravages of dementia. This is my
spiritual self or transcendent self. It is the ‘me’
that relates to the beauty of a garden, of the
leaves or flowers; it is the ‘me’ that relates to
God; it is my spirit, the essence of me.‘Christine
Bryden (2005)
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In Dementia ‘Memory may have faded, but something of the past
is known; identity remains intact, because others hold it in place;
thoughts may have disappeared, but there are still interpersonal
processes; feelings are expressed and meet a validating response.
In simple terms personhood is “a standard or status that is
bestowed upon one human being, by others, in the context of
relationship and social being.....implying recognition respect &
trust. Good dementia care aims to maintain personhood in the
face of face of failing mental powers”.
(Kitwood T (1997). Dementia Reconsidered: The Person Comes First. Open
University.
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Dementia affects cognitive skills and ability to
effectively communicate – therefore an individual
might struggle with the more complex activities
/interactions but may have an enhanced appreciation of
the simple aspects of their life such as nature or
listening to music.
Therefore important that as health professionals we
take the time to find out from carers what things were
meaningful to the person so that we can then try to
provide appropriate spiritual care to meet their needs.
Historically spiritual care has been identified as a role
for chaplains
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Rev Dr Lida Ellesworth is our hospital
chaplain – provides service sheets.
Arrives every week and joins in with
our introductions and an initial
activity. She then proceeds with our
service. She also where appropriate
offers individual prayer.
No organist? Not a problem. CD’s easy
solution we have Kevin Mayhew
Hymns old/new from Anglican shop.
com; but there are a number available.
Invite patient‘s to participate
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We try very hard to gain informed consent with our patients. At
times this can be quite difficult especially with very impaired
individuals.
‘Seeking consent is part of a respectful relationship with an older
person and should be seen as a process, not a one-off event.’ (Dept
oh Health: seeking consent p. 3)
Look for other signs that can be reasonably interpreted as
agreement to participate. Look at the behaviour / Lida seeks
consent a second time to offer communion or a blessing.
We believe that we should always note the relationship between a
person’s ability to give consent to participate versus the possibility
of exclusion.
We involve families, both to inform the consent process but also to
share positive experiences which their carers can so yearn to hear.
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Compelling stories help us demonstrate how we
deliver care .
Enables staff to reflect on the work we have
undertaken and especially the relationships made
and the outcomes gained for all involved.
All the following stories are true but anonymous;
however we hope they will illustrate some of the
poignant and moving experiences we have
encountered as we strive to improve the quality of
service we deliver to our patients on our ward.
Our first story illustrates how important a person’s
faith is and how it can influence their daily life and
actions. This is Alice’s story
As the disease progresses changes become more marked. The
person may now possibly require assistance with many aspects of
daily living. They may present with confusion, repetition & also
agitation. They may be disorientated to time and place. Risk might
also be a significant feature. It is often accepted that insight and
judgement are increasingly impaired affecting the person’s
personality. Carers often start to struggle at this stage.
We should note that in response to significant illness or difficult
situations, many people turn to religion as an avenue of support.
Our next story we think not only illustrates how the individual
valued prayer but also we believe challenges some of the
assumptions held around dementia. This is Fred’s story:
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Bakewell..... Can hardly be described as a multi
cultural area however…….
Our next story describes the importance for
practitioners to inform their knowledge base around
multicultural faiths. And we think failure to do so can
risk affecting the correct/appropriate outcome for an
individual.
This is Bert’s story.
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During the later stages of the disease most people become
increasingly frail and likely to eventually become totally
dependant upon others for their care. However the dementia
experience is very individual.
It is likely during this stage that their memory is very affected and
they may not recognise everyday items; places or even those very
close to them.....often believing they are living in another reality...
Windows of reality/recognition .
Need to remind care staff & professionals alike that a person’s
faith & spirituality is for many one of the most effective coping
strategies available to us all. We hope our next story will illustrate
the importance of this connection and how faith has the potential
even amongst those very impaired individuals to unlock
memories and emotions and reconnect the person with
meaningful and valued aspects of their lives. ..... Miriam’s story
Our weekly services we believe not only provide the opportunity
for worship but also helps bring hope and meaning to what some
might view as hopelessness and sadness. As demonstrated in our
stories we so often connect with the person they were and most
definitely we believe still are: e.g. The spontaneous singing of a
familiar hymn or prayer. These are such precious & meaningful
moments that should be shared and celebrated with everyone.
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No guarantees but we never stop trying to provide opportunities
connect & engage our patients with their spirituality.
We hope that other professionals and colleagues may feel that
they are able to support the spiritual needs of those in their care.
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Art and creative activities.
Music.
Connecting with Nature.
Multisensory environments.
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Everyone’s responsibility
Requires confidence - therapeutic self.
Nothing to do with learning new skills etc
What we have learned is that it is also to do
with who WE are; how we perform our
interventions is just as important as what we
do.
Indeed has anyone any compelling stories they
would like to share with the group?
Has anyone got any views or ideas how we can
promote/acknowledge/support others to meet
the spiritual needs of those older people who
are in our care facilities or who are
experiencing the dementia journey?