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Volunteering in dementia-registered homes can be a rewarding experience.Jim Ellis is a former carer and university tutor with a background in education and psychology. He is deeply involved in the psychological aspects of dementia care, since his wife Margaret had early onset Alzheimer's disease. His experience has inspired him to volunteer and also to write many articles.
He wrote this article for the magazine ‘Working with Older People’ published by Pavilion:
“I was fortunate in being able to find a positive attitude and approach to my wife's dementia and that has contributed to the role I now have at the nursing home. Music, words and humour were motivating features.
A great success for my wife, Margaret, was listening and responding to my recorded stories on a Walkman. These always related to Margaret's actual experience (teaching, music, swimming etc) over the years before Alzheimer's disease, so that they included events in a school and trips to the seaside. Another great success was having a piano in Margaret's room at the nursing home where I could entertain her with popular songs that brought joyful responses and positive well-being.
All this has provided a rich background of practical experience that I try to bring to the present residents. While residents have much in common, they also have highly personal interests, sometimes arising from their former professional expertise, like Cliff who was a well-qualified engineer. He came up with the formula for the area of a circle and showed how it could be applied.
It is often the simplest stimulation that is the most effective in engendering well-being as long as the presentation is appropriate. For example, it could be demeaning to introduce a session of nursery rhymes, yet these have proved highly motivating for some residents. The cue for appropriate presentation came from a radio programme that drew attention to the number of parents and children who had no knowledge of nursery rhymes. I referred to this with Alice, expressing my surprise and how I still remembered rhymes learned as a child. Alice was eager to show her knowledge of nursery rhymes too and joined in as I began to recite, 'Three blind mice', before we went on to recall many more rhymes. An added bonus was Alice tapping out the rhythm of 'The noble Duke of York' with her fingers on the table.
Equally effective has been the sharing of poems especially those with a touch of humour. Our collective smiles and chuckles shared by just two of us and rarely more than three seem to suggest a secure relationship. The playful limericks of Edward Lear, and so much of his verse, are ideal for its humour and the short attention span that many residents have. The rhythm and selected words can be emphasised too, helping to make the reading more dramatic. Longer poems are possible especially when they have been known since childhood like, 'The owl and the pussy cat'. This seems to be known by virtually everyone and has been repeated eagerly, even by those who have not wanted to hear any poems normally.
Effective interaction does not need to have an identified catalyst such as a poem, nursery rhyme, song, photograph or picture however. Sometimes inconsequential phrases about general health, the weather and meal menu is appropriate, and occasionally even that might be more than the situation requires. A resident normally keen on poetry asks for no poems today; he seeks silence. In another case, one senses the need for a few quiet words of comfort and then silence with perhaps a gentle hand on his or hers. I sense sometimes that a resident, while choosing silence, does not want isolation so I sit there beside them and feel certain osmosis acting through the non-verbal communication.
The importance of the individual, personalised interaction is not to be underestimated but none of this takes place in isolation. The large ground-floor and first-floor lounges are the setting, not private rooms. Here, one feels the all pervading ambience of support and understanding that emerges from management, staff, residents and relatives. Without this I feel it would be difficult, perhaps impossible, to have effective one-to-one interaction. Certainly much of the informal social interaction arising from staff and relatives passing by and invitations to share coffee and biscuits with a resident, are added bonuses, which can only further the well-being of residents. Useful biographical details from relatives are also welcome and further bonding comes through the photographs I take of special events to display in the entrance hall. Everyone, including many residents, expresses surprise and pleasure identifying themselves and others in a photograph they had not even realised had been taken.
Over 10 years ago, Tom Kitwood was writing enthusiastically about volunteers in dementia care (Kitwood, 1997), envisaging a time when volunteers might be, 'fully drawn into dementia care', and even recognising, 'the possibility of having "staff " to client ratios of 1:1'. At about the same time, the Bradford University Dementia Group had published a booklet about guidance for volunteers working in dementia care (Heller, 1996).There has been, however, very little in the literature over the last few years focusing specifically on the experiences of volunteers in nursing homes and some of the major providers seem to have no declared policy on volunteers and no proactive programme to recruit volunteers for dementia registered nursing homes.
With projections showing increasing numbers of elderly people with dementia, it seems that large scale proactive action will be needed to encourage and prepare volunteers for work in nursing homes if we are to offer any semblance of one-to-one interaction within the affective domain.”
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