Connecting older adults in care with their families during the COVID-19 outbreak

When speaking to our Maister Lodge team recently, it came to our attention that the team were making huge strides in innovation and creativity when it came to keeping older patients and their families in touch during the Coronavirus lockdown period.

We spoke to Rebecca Dunning, Psychology Assistant at Maister Lodge, about her work at this time and how she is going the extra mile for our older patients.

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Why do you feel like it’s a good thing to go that extra mile for your patients, particularly at this time?

Working with older adults is a privilege. Our patients have generally lived long and full lives prior to meeting us; we get the honour of hearing their stories and being a part of their lives for a small period. Dementia is often a very confusing experience, whereby people become increasingly disorientated about both themselves and their environment. Therefore a hospital admission, which would seem scary even at the best of times, suddenly has the potential of being a terrifying experience.

Our patients have rarely been on this journey alone, they have been supported by their families along the way. The road to a hospital admission is often a long one – whereby families have often experienced lots of trauma and changes in their most basic roles. Many have transitioned from their role as husband or wife, son or daughter, to acting as a carer and have managed independently through difficult circumstances. Therefore, an inpatient admission can be difficult for some families; leaving them with feelings of guilt or sadness.

However, the opinion at Maister Lodge has always been that families are the experts and should be treated as such. We also strongly believe as a team that supporting families is an essential part of our work as they will remain in our patients lives long after discharge.

 

How has the crisis impacted your usual ways of working?

Usually, we offer a combination of face to face sessions, telephone support and impromptu support following visits to the ward. Family visits are an important part of our care plans as they are essential for both our patients and their families – sometimes even the most distressed patient responds well to the familiarity and security associated with a loved one.

In the current crisis, our patients fall amongst the most vulnerable in our society due to their age, physical health history and cognitive problems. Many family members also fall into this vulnerable group. This means that an already difficult period in someone’s life now has additional anxiety and uncertainty.

Prior to the COVID crisis, my role was split between the Memory Clinic and Maister Lodge. I have now moved to Maister Lodge full time with the main goal of working with families – to provide them with a clear point of contact to allow consistency for them and also remove pressure from the ward staff.

At Maister Lodge, we are trying to provide some level of consistency, even without the usual visitation. This has required some level of creativity to overcome various challenges – such as setting up Skype on the ward iPad, e-mailing photographs to families and posting things where technology is not accessible. This also includes offering regular telephone updates to families, some of which are daily and others less frequent.

Regular updates over the telephone allow families to still feel included in the care of their relative; and allow us to continue to offer them some level of support. For some of our families, telephone calls from me are their only form of social contact. Introducing Skype calls has meant that patients who struggle with the telephone can still connect with their families; offering reassurance to everyone involved that their loved ones are okay. For those families who don’t have access to this level of technology; posting out photographs, letters and cards maintains a connection between people. This works as a two way stream too – families have been e-mailing photos and videos to share with our patients and we have sent things back in return.

 

How do you think your efforts have affected your patients and their families?

Usually, our engagement with families helps them feel involved in the treatment and care of their loved one. It also allows us to support them and prepare them for the future – this can include processing events that have occurred, acknowledging the difficulties they have faced, discussing options for the future and also helping people begin the grieving process.

The measures we have put in place and the adaptations we have made are allowing us to continue with this work. In addition to this, continuing to engage families is helping provide some level of consistency in an otherwise uncertain time. For some, it has helped decrease levels of anxiety and loneliness amongst both the patients and their families.

 

How are you and your team getting on?

The morale at Maister Lodge is great. The team are working hard to support each other however we can through a whole variety of emotions – with everything from a cup of tea and someone to talk to when things feel overwhelming, to singing and dancing together during the high points. They have shown a remarkable level of resilience and comradery in an otherwise difficult time.

On the ward, staff have worked hard to create clear guidance regarding Personal Protective Equipment (PPE) – not just about the practical use but acknowledging that it can be difficult and uncomfortable, with staff needing regular breaks from it. The Occupational Therapy team are working hard looking for creative new ways to engage not just our patients, but also the staff on the ward. Staff from a whole variety of professional backgrounds are working together and supporting each other.

We have also set up a ‘Wobble Room’ away from the ward; somewhere comfortable for staff to escape if they need to. We have been well supported by other teams too; such as the COVID team and Infection Prevention and Control.

 

What do you feel you have learned from this experience?

Throughout this experience, we’ve had to think more creatively about ways to work and I’d definitely like to think that we’re successfully achieving our goal of involving families in care. Other colleagues are also finding inventive ways to adapt their profession to the circumstances.

My supervisor and I are working hard to find new ways to share our experiences throughout this crisis with other professionals both within the Trust and beyond. I’ve also been so impressed by the strength shown by the team as we’ve pulled together more than ever.

Personally, I’m still at the beginning of my career. This experience has allowed me to think more reflectively about my journey so far, but also about my longer term career goals.

 

Would you like to let us know about anything else you have been working on?

Our OT team have been working hard to create a social media presence for the ward. Using the Twitter handle @HumberOPMHTeam they’ve been sharing positive news stories and highlights from the ward regularly – some families have been following this to get updates on what we’ve been up to but other professionals have also engaged to share ideas between services.

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Rebecca’s wonderful work hasn’t gone unnoticed, with an overwhelming amount of positive feedback from both patients and their families. We have included some quotes below for you to take a look for yourself.

“Thank you for everything you are doing to keep him safe, but also for considering him as an individual. Thank you to the team for persevering with him and trying to engage him.”

Said she “I couldn’t wish for a better place for my mum to be right now” and appeared genuinely taken aback when we showed her mum the photos of her great-grandson and sent one back in return.

After we played a recording down the phone today, he became a little emotional and said “he wasn’t sure if he was more taken aback that his wife was doing so well, or that staff are thinking of him and taking the time to include him in these moments”. He passed on his thanks to the team and said he could never express how grateful he is.

We are proud to have members of our teams like Rebecca and thank her and her colleagues for their hard work at this time. It doesn’t go unnoticed and we are sure that our patients and their families are equally as grateful for you at this time.