Researching Therapeutic Activities at Jura Care

I was privileged last week to attend a wonderful conference in Stellenbosch. I celebrated “The Richness of Ageing” with South African Care Forum and about 200 delegates from all over the world. Our passion opening our own Jura Care Home for Dementia and Alzheimer’s, was even more fuelled, if at all possible.

During the past year, 2013 and 2014, I met so many people, visited and worked in so many homes, and I attended so many seminars and meetings, studied everything I could, did all courses available, and now I am ready to take the best of it all and give it to Jura Care! We are inspired and ready to make sure that Jura Care, will be making a difference in many people’s lives. We will not only touch the person living with the disease, but the family, the friends, the Carer and anyone with an open heart to this disease. While we are busy doing the landscaping of our Home, I am wondering. How will we design the garden, how will we entice our people living in our home to explore the garden, how will we add to their lives, and how can we give meaning? And then I am wondering if we give them a beautiful sensory garden, will it have therapeutic value to them? Health professionals who work with people living with Dementia, say therapeutic activities should focus on the person’s previous interests, cue the person to old and recent memories and take advantage of the person’s remaining skills while minimizing the impact of skills that may be compromised. Planning structured, individualized activities that involve and interest the person with Alzheimer’s may reduce many of the more disturbing behavioural symptoms of AD, such as agitation, anger, frustration, depression, wandering or rummaging.

What will be the effect of the hot house, where they can seed and pot their own plants? Will they remember to come back tomorrow morning to water the seedlings? What will be the effect to grow their own orchids or vegetables? How will I know if the old man busy in the tool shed is benefiting from his experience? Will he be able to complete his project or will it be just enough to be among familiar tools and objects? Will the bird feeder where they can put out the seeds every morning give meaning to their day, or will they just love sitting, watching the birds in the aviary? And when they stroll through the garden with its winding paved paths, covering about 4000 square meters, will the perfume plants, the lavender the plecantrus, and their own rose garden, will that put a smile to their day? And when they join their family and friends in the quaint Tea Garden under the huge old trees, will that bring back memories while they watch the grandchildren play around, feeding the pea cocks or the baby lamb? I wonder? Some of the therapeutic activities that have been shown in rigorous research studies over the years; to reduce certain problem behaviours in people with Alzheimer’s are:

• playing music of the person’s choosing
• one-on-one interaction
• playing videotapes/DVD’s of family members;
• walking and light exercise
• pet therapy

Is there new research to be done at Jura Care? Will the therapeutic activities be:

• Spending time in a hot house
• Spending time in a tool shed
• The bird feeder
• The aviary
• Planting herbs and vegetables in the boxes
• The gentle music playing in the garden
• The Tea garden where family and friends can come and visit
• Watching while grandchildren play in the garden
• Playing cards with a friend in the old caravan
• Having quiet and alone time in the little Quiet Room
• Painting the pyramid of tyres
• Caring for farm animals
• Walking the garden, unrestricted in a secure area of about 4000 square meters
• Picnic and fishing at the dam
• Having a braai at the Home for themselves or guests.
• Enjoying the local school choirs.
• Having an evening at the “theatre” listening to local artists.
• Being creative with a pot of clay, mosaic, or a paint brush.

Successful activities support a person’s sense of self – bringing out their skills, memories and habits – and reinforce the person’s sense of being in a group, which can provide friendship, mutual support and spiritual connectedness. Will the activities Jura Care is offering support a person’s sense of self? Sitting in the tranquil setting of the Quiet Room, enjoying the glow of the sun through the stained glass, just watching the birds in the aviary, chirping away, will that calm down a restless mind? Or will the two old men playing cards in the stationery caravan in a corner away from the hustle of the Home, will they talk about their days, long ago as eager campers, sharing their stories?

Research indicates that physical as well as visual access to nature helps people recover from illness quicker, reduces stress and lowers blood pressure. Spending time outside helps a person maintain circadian rhythms (the sleep/wake cycle). There is also natural absorption of vitamin D when exposed to sunlight for brief periods of time, which is important for maintaining strong bones. And when we walk down to the big dam, with a picnic basket, and a fishing rod, will we bask in the sun, taking a nap and go back to the Home, feeling revived? And the family, always feeling guilty leaving their loved one behind, will they go away knowing that their parent are going to sleep, while the sun sets over the Ocean, or knowing that he will be calmed by the silver rays of the moon over the sea tonight to help him fall asleep. A variety of elements in a garden helps a person stay connected to the world around them. Therefore, everyone who uses the garden will benefit. We do believe that our Carers will benefit too. We will be able to make their hands strong to help our people, to have a whole “toolbox” of activities available.

Has anyone thought about the effect on the person caring for people living with Dementia, not only the stress, but physically, psychologically, emotionally…. Will this be different at Jura Care? Will the Carers be able to form a family, dedicated to care for the people, not only their physical needs, but on all levels? How can Jura Care help their Carers? Will they enjoy the garden, will they also seed and pot and plant? Will they go home dirty after a day playing in the garden, painting fences, or hanging wind chimes in the trees? After a difficult morning with a person in the Home, will they enjoy the solitude at tea time, just sitting on a bench staring at the big blue Ocean? Will we have happy residents because of happy Carers? Often, we do not know how to reach a person with Alzheimer’s disease, and even friends and family are uncomfortable, but by creating environments that support their needs, it will help us better understand who they are, and really enjoy spending time with them. How do we get grandchildren to come and visit their grandparents, not because they have to? Will the sheep on the farm with the little lambs entice them? Will the long walk along the farm bring them back next time? Will they remember to bring their bicycles some time to ride along the farm road? Or will the little ones enjoy the play park, while grandma is watching. Or will they bring bread crumbs along to feed the hungry pea cocks? Will we help them build a new relationship with their grandparent? Sipping a cup of tea, and enjoying a slice of cake at the Tea Garden, will open our Home to the community, and they will be able to spend time with our people living here, and they will get to know them and the disease. Will the neighbour come over to read a book, or some beautiful poems, or will she sit with some ladies, teaching them to remember to knit again. Will all these activities outside the Home, calm a restless mind, or will the Snoezelen Room, be the place the person would like. Will the soft meditational music calm the soul, or the touch of fur against the wall, or the playfulness of the lava lamps, or the nuances of colourful lightning? What is the effect of this room in our Home on our people living with Dementia?

When we bake the bread early morning, who will smell the bread, and follow the flavour all the way to the kitchen? The lady sitting at the kitchen counter, is she the one, spreading the butter for her fellow residents? Are they going to the dining room, overlooking the green meadow towards the sea? Or are some lingering around the safe kitchen, taking part in the chopping and preparation of the food. And who will help with the dishes? While the staff, our chef, will be in the other half of the kitchen, obscured from their view, creating good nourishing food at the stoves, a normal life will envelope in the rest of the Home. Looking at the old scale from England, over a hundred years old, and the writers ’bureau filled with old books, or grinding the coffee in the old grinder, or listening to the old gramophone….this will fill our house, to make sure each one of our people living with us, can tell us their stories of days long ago. And every now and then the melody from the old wind organ will fill the Home with its whispery songs! So we will share old and new stories with each one of them. Maybe this will be worth our while to linger and to see the effect of these antiques surrounding our people living with us. When winter strikes, and takes a grip on the old bones, who is going to sit close to the crackling fire in the secure fire place? Or who won’t be able to wait to crawl into their beds at night for a peaceful nights’ sleep?