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Vasey RSL Care Ltd

A Life with Meaning
Vasey RSL Care Ltd

ANZAC Hostel, Brighton, Vic. 

Residential - Metropolitan, 30-79 beds 

Award descriptors:
Health and wellbeing, Enablement, Social participation

About the program
Research shows that a sense of meaning and purpose in life has strong positive effects for people of all ages. To retain health and happiness in older age, it is important that aged care residents should continue to experience feelings of meaning and purpose.

In 2012, we discovered that many residents lacked purpose and a new approach was taken. We began by consulting with residents to identify their needs for purpose/meaning, and twelve separate types of purpose were identified:

  • Achievement/contribution
  • Expression/wisdom
  • Health/independence
  • Involvement/freedom 
  • Teamwork/winning
  • Challenge/learning
  • Giving/helping
  • Belonging/inclusion
  • Stimulation/appreciation
  • Faith/uniqueness
  • Fun/individuality
  • Connection/friendship

A complete activity program was developed, offering programs specifically designed to promote one or more kinds of purpose, with choices to suit residents.

Staff underwent professional development to enable them to identify each kind of purpose for each resident and to enable them to help residents achieve these feelings.

The results of this program were:

  • An additional 48 programs have been added to reflect resident preferences. 
  • “I’m more active than I’ve been in decades”: residents report being more active and are involved in an average of 28 programs each.
  • Staff can easily identify resident purpose and can successfully promote these feelings through their interactions with residents.
  • Far fewer residents report feelings of a lack of purpose and almost all residents can easily see many different kinds of purpose in their life. 
  • Staff job satisfaction levels have improved.

What we did 
‘A Life with Meaning’ involves a constant and enduring focus on the meaning and purpose present, or potentially present in residents’ lives.

The Lifestyle Coordinator began the initiative in 2012 with one-on-one conversations with each resident and/or close family member to elicit their thoughts and feelings about purpose and meaning in their life. This identified a large gap between how residents currently felt and how they could potentially feel, and 12 different kinds of purpose were identified. We observed that different types of programs and initiatives were successful in promoting different types of purpose, and set about designing an activities program providing several different activities to promote each of the twelve kinds of purpose, giving residents a choice of activities to choose from.

The following list shows the twelve kinds of purpose identified and examples of some of the program activities observed to be successful in promoting feelings of this kind of purpose, or designed specifically to promote one or more kinds of purpose.

  1. Achievement and contribution, through creative activities:
    Senior MasterChef Competition
    Greenthumbs Gardening Team
  2. Expression and wisdom, through discussion activities:
    Travellers’ Tales
    The War and Peace Panel (Veterans discussion program)
  3. Health and independence, through physical activities:
    Different type of exercise class offered each day, similar to a gym - Yoga, Pump Class (with weights), Tai Chi, Seated Dance, Falls Prevention. 
  4. Involvement and freedom, through community access activities:
    Out for Dinner program
    Winery tours
  5. Teamwork and winning, through competitive activities:
    Punter’s Club
    Men vs Ladies golf putting championship
  6. Challenge and learning, through cognitive activities:
    iPad lessons on the TV
    The Learning Circle, guest speaker program
  7. Giving and helping, through service activities:
    Charity Champions Fundraising Club
    The Get Well Soon Team (visiting the sick in their rooms and in hospital)
  8. Belonging and inclusion, through in-house community activities:
    The Annual Residents Awards Event
    March of the ANZACs (walking program with pedometers to record distance) 
  9. Stimulation and appreciation, through sensory activities:
    ‘Look Good, Feel Good’ Beauty therapy
    Classical Music Appreciation
  10. Faith and uniqueness, through spiritual activities:
    Resident-led memorial services following the passing of a resident
    Rosary group
  11. Fun and individuality, through special interest activities:
    Theatre Group
    Cheese and Wine Tasting Club
  12. Connection and friendship, through social focus activities:
    Welcome Morning Tea for new residents
    The Men’s Pub Review (monthly pub trip)

Staff undertook professional development to learn about the twelve types of purpose with scheduled compulsory training days. They were encouraged to reflect upon them in all their interactions with residents so that they can gauge which kinds of purpose resonated with each resident. Professional development gave them the skills to encourage residents to participate in the programs during their daily interactions.

Activities were reviewed and adjusted to maximise the benefits to residents in achieving purpose and meaning in their lives.

Why we did it 
Research indicates:

  • Those with a strong connection to their sense of purpose tend to live longer (Tanno et al, 2009).
  • People with a low sense of life purpose were 2.4 times more likely to get Alzheimer’s disease than those with a strong purpose. Further, people with purpose were less likely to develop impairments in daily living and mobility disabilities. (Boyle et al, 2010 & 2012).
  • People with purpose tend to be more engaged with their families, colleagues, and neighbours, enjoying more satisfying relationships as a result. (Metlife & Leider, 2009)
  • A person with a strong sense of purpose remains satisfied with life even while experiencing a difficult day. (Diener et al, 2012)
  • Links between purpose and resilience: resilience can lead to better cardiovascular health, less worry, and greater happiness over time. (Fredrickson et al, 2008).

Consultation with residents indicated good understanding of the concept of purpose, experienced through their role in the family and their occupation. Familial purpose can be reduced following a move to residential care; occupational purpose is often lost upon retirement. Therefore we had to identify other ways to create purpose for residents in our care. 

The program was designed to focus on independence rather than dependence, to support feelings of purpose rather than helplessness, and to have a multidisciplinary approach incorporating all staff.

Who worked with us
The program is resident-focused throughout. During initial discussions, residents and/or family members shared their insights on purpose, or its lack, and helped us understand which programs/events provided what kinds of feelings of purpose. The program was developed and receives continual adjustment to improve effectiveness, thanks to the feedback from residents and the results gained.

The twelve kinds of purpose is an original and innovative approach, fully supported by management and staff to achieve a whole-team approach and maximise the chance of success.

The program was split into two main steps:
Step 1. New programs:  this stage was undertaken with support from all staff within the home, residents, family members, official volunteers and student volunteers. 

Step 2. Staff training:  the organisation’s Learning and Development Coordinator supported the training of all staff within the home by scheduling a training session about meaning and purpose, led by the Lifestyle Coordinator, at the home’s compulsory staff training days. Additionally, the home’s Residential Manager instigated a series of 30-minute workshops in order to further develop the concept and extend the reach of this initiative to ancillary staff, including cleaning, kitchen and maintenance staff members.

As well as formal evaluation, ongoing continuous evaluation gathered in the way of resident feedback. Residents were consulted at each care plan review on their feelings of purpose.

What we learned
Improved feelings of purpose
Baseline data from 2012 showed that 67.5% of residents felt that their life was lacking in meaning and purpose. The corresponding figure in 2016 is 10%, with the figure reducing each intervening year.

Furthermore, by 2016, 60% of residents were able to identify with experiencing all twelve kinds of purpose in their life, while 90% were able to identify more than eight kinds.

Improved leisure options
The program has led to an increase in the number and variety of leisure options available to residents. In 2013, the home offered 44 different activity options, and by 2016, this number had grown to 92.

Increased involvement
The program has led to significant increases in the activity levels of residents. In 2016, residents are involved in an average of 28 programs each.

As residents become involved in an activity that provides purpose, it is easier for them to recognise it: e.g. a resident is better able to acknowledge feelings of involvement and freedom if they have been going out regularly to the RSL.

Likewise, it is easier for staff to help residents experience feelings of say, teamwork and winning if they know they have been participating in Punter’s Club: “How many winners did you pick this week Joe?”

Improved job satisfaction
Following the professional development sessions, staff were asked:

  • Do you feel this session has improved your ability to promote feelings of purpose and meaning for residents? AND
  • Does helping residents to experience meaning and purpose in their life lead to better feelings of satisfaction for you in your work?

Participating staff unanimously said yes to these questions. 

Transferability
In 2015, the program was implemented at a second residential home. Using the twelve identified kinds of purpose, an audit of existing programs helped identify what kinds of purpose were lacking or could be improved. The activity program was adjusted and increased. Staff members were so inspired by the improved purpose/meaning they witnessed in the lives of residents, that they set up regular ‘Focus Resident Meetings’ where all staff are invited and a ‘focus resident’ is invited as guest of honour. 

Similar results are being seen at this home, with increasing numbers of residents able to acknowledge all twelve types of purpose in their lives. 

Inspiring results have been seen from Focus Resident Meetings for those with advanced stage dementia, with staff able to identify many different kinds of purpose in the resident’s life.

Sustainability
The program required no additional staffing or funding. It required an increase in the variety of programs offered, to ensure all twelve kinds of purpose were potentially promoted.

Professional development is scheduled into the existing learning and development program. Additional workshops and Resident Focus Meetings are conducted at different times each week to reach as many staff as possible. 

Staff are guided by the organisation’s Continuous Improvement Cycle approach:

  • Monitoring residents’ feelings of meaning and purpose (especially upon admission)
  • Assessing the home’s current capacity to support the resident to experience greater feelings of meaning and purpose
  • Actioning new programs where required
  • Evaluating the resulting feelings through annual surveys
  • Providing feedback to stakeholders at all stages.
     

More information on this program:
Janna Voloshin, or phone (03) 9810 5500

 

Changed
Friday, 21 December 2018 - 7:01am