Dementia Gateway: Keeping active and occupied

Developing community links

It is easy to become very insular in a care home and forget that we are as much a part of the local community as a school.

Care home manager

Explore the links below now to read more about this topic:

• 1. Why develop community links? Open

  Traditionally, care settings have had a tendency to be shut off from their surrounding community. In most care facilities, services such as catering, hairdressing, the doctor and so on are provided 'in-house' – and this has the effect of reducing the need to reach out to the wider community. And yet, creating better links with organisations and services in the local area provides many benefits for a care home, sheltered housing or day care centre. These include:

  • greater visibility of the care setting in the wider neighbourhood – this can help the general community, including older people still living in their own homes, to feel more positive about care facilities
  • greater variety and choice of activities for residents, including more social stimulation
  • helping residents to maintain existing interests and contacts
  • introducing new people, faces, different ideas and experiences.

  When thinking about care facilities developing community links, there are two possibilities: older people going out into the community more and/or 'bringing the outside in' that is, inviting visitors into the care setting. Care teams should encourage and promote both these positive choices.

• 2. What is in your neighbourhood? Open

  Take a walk around the neighbourhood surrounding the care home, day facility or individual's home (depending on where you work). With 'fresh eyes' you might find some new places to explore. A walk to a post box to post a letter or watching children play in a playground might provide a welcome break in the day for an older person who spends much of their day in a chair in one room.

  Visit the nearest library and look at the noticeboard and leaflets to see what is happening in the local area and take a note of options, ideas and contact details for more information. A tourist information office can also offer lots of ideas for places to visit.

  Talk to the librarian and ask if there are new ways to improve access to books for residents. Some may provide a mobile library service, but a visit to the library might be an even better experience for those who enjoy a browse.

  What else is in your area? A football club or a golf course might be of interest to some people. A garden centre or allotments might be a possibility for others.

  In a survey of 50 residents conducted by NAPA, many of the women said that the activity they missed the most after moving into a care home was shopping! One said, 'I like to pop out to the shops even if I don't really need anything. I really miss that here.' It might help to make links with a particular shop and ask for the support of the manager to enable a visit to go smoothly.

• 3. Learning to give full attention Open

  Care staff will need to allow themselves the time to sit beside a person and to be as fully present as they can. It is all too easy to be distracted, to be thinking about the next job that needs to be done and not to be focused fully on the 'here and now' relationship. One volunteer visitor in a care home said the most important thing she offered was sitting down with residents, 'showing that she is here to stay rather than just hovering to get away'.

  Many people with dementia will sense when we are not fully present and are less likely to connect with us in any meaningful way if this is the case. If we are not paying full attention we might also miss simple movements or sounds from the person attempting to communicate something.

  If you are going to sit with a person with dementia for longer than a few moments, consider the following:

  • Your colleagues will need to know that you going to spend say 10 to 15 minutes in the person's room and should not be called away to another resident or task.
  • You may want to take a book to read out to the person or a piece of music to play or perhaps something that you can do in front of the person such as folding towels.
  • Make sure you are in the eye line of the person if they are lying in bed or staring in a particular direction.

• 4. Reaching out: some ideas for what's on offer Open

  If you have a local museum, ask if there is a person who is responsible for providing services to older or disabled people. Often this person is known as an 'outreach officer'. Is there a facility for someone from the museum visiting the home or can some of the museum exhibits/artefacts be loaned to you?  

  It might be possible to develop a relationship with a local café or pub owner or even a cinema manager in order to organise a visit for a group at a less busy time with special rates. This might be good for their business as well as good for you!

  Margaret Powell is the home manager at Ashley House care home in Borden, Hampshire. She explains how the local ice cream van visits her care home: 'Our local ice cream van visits us on regular basis throughout the summer. Of course we can easily provide ice creams from our own freezer, but it wouldn't be the same. Everyone enjoys the walk out to the van, having a little chat and choosing what they want. Last time he visited, the ice cream man had found some cones that were more digestible for our residents. I think he enjoys his visits to us as much as we do!'

  The team at Ashley House also invited the whole local church congregation to come in for a service held in the home. One of the women commented, 'We've been to church today and we spoke to real people!'

• 5. Preparation: what's involved? Open

  Good preparation is key to any organised trip out or a visit from an outside organisation. If you are working in a care home or day centre, you will need a member of staff who is confident enough to use the internet or pick up a telephone to talk to someone to organise an activity involving the wider community. Although it sounds simple, it can be very time-consuming trying to find the right person in an organisation to link up with.

  On trips out, having chairs available for some older residents – or knowing exactly where the chairs will be before you get there – might make the whole trip less stressful. Easy access to toilets is also important.

  Typically, the biggest practical problems are transport and having enough staff available to escort people, especially those who use wheelchairs.

  You will need to explore the costs of community transport options versus using regular taxi companies. You might want to recruit volunteers specifically to help with taking people out more regularly.

• 6. Preparation for bringing children and older people together Open

  If you are making links with a school or a children's nursery, good preparation will be even more important. You cannot just invite a group of children into visit older residents and expect everyone to know what to do! You will need to think about what kinds of activities the children might enjoy doing which could also involve older residents, for example creating an art collage or singing songs together. You will need to consider practical issues like welcoming the children, introductions, refreshments and what to do if anyone becomes distressed. Go to the activity at the end of this feature to consider what you might need to do to ensure a successful visit.

  The organisation Magic Me produces a useful guide to developing community links for intergenerational projects, called Sharing the experience (see 'Extra reading').

• 7. How to make links that support an individual's interests Open

  If you know something about a person's background and life story, it will be important to develop specific community contacts that are relevant to that individual resident.

  One care setting had a number of residents who came from a farming background. They contacted an organisation called Living Eggs who brings in fertilised eggs, incubation equipment and detailed instructions for hatching real chicks. One woman with dementia who had been a farmer's wife was often very restless and distressed but spent many happy hours watching the eggs and talking about them. When the chicks hatched, she held each of them very gently and her face lit up in delight. For more information, contact www.livingeggs.co.uk

  If a person has been a longstanding member of a political party or a trade union, then continuing their membership might be very important for them. Similarly a person's links with a particular faith community will be important to maintain if they wish.

  Someone who has regularly enjoyed watching football or cricket matches could be supported to continue to visit their local club. It might be possible to find a volunteer from these clubs to either pick them up or accompany them to matches.

  If you are working with an individual with dementia still living in their own home, it is equally important to help the person continue regular weekly activities such as the walk to the post office or having their hair done. Even if it is quicker and easier to go to the post office for the person or ask someone in to do their hair, it will be an opportunity lost for exercise and a retained sense of normality and routine.

• 8. How to make cross-cultural links Open

  Every week of the year is likely to include some kind of festival related to different cultures or religions. This offers a wealth of activity ideas and potential new community contacts. Whether it is Chinese New Year, St Patrick's Day, Easter, Divali, Eid or Carnival time, there will be people and organisations in the local community who might be able to add fun and diversity to your usual events.

  This can also help build up positive links across different cultural groups within your care setting especially when you have residents or staff from many different backgrounds.

  The Royal Hospital for Neurodisability has developed good relationships with their local Chinese association for arts and dance-related activities with a Chinese theme. These cultural groups often only need their costs covered such as transport so won't necessarily need too big a budget to organise. If good refreshments are offered this can act as a way of thanking visitors for their contribution.

  The Royal Hospital also teamed up with Sunshine International Arts to organise carnival-related activities in the lead-up to the London Notting Hill Carnival celebrations. The Sunshine team came and created costumes at the hospital which was very visually stimulating for residents to watch. They also ran a practical mask-making workshop. A Caribbean party was organised with singing groups using songs 'Pass the Dutchie', 'Feelin' hot', 'Gimme dat ting' and others. These kinds of community links require a bigger budget as you are involving a business enterprise to bring in their skills and resources.

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