Compassion Matters: Megamorphosis pre-work begins at Youville
Submitted by Jo-Ann Tait, program director - Elder Care and Palliative Services, and Kimberley Smith, site leader and manager, Youville Residence
"In order to demonstrate compassion to others, we must first show compassion to ourselves" was how Kimberley Smith, site leader and manager of Youville opened the week at Monday morning shift report with her staff. Last week's focus on Compassion Matters was the first of three weeks of pre-work preparing staff for the upcoming Megamorphosis, which will shift the culture towards the renewed vision of residential care at PHC. The first exercise was to identify how compassion manifests itself in us, what traits we wanted to grow and when staff recognized those traits being demonstrated in their colleagues, they acknowledged their achievement with a simple sticker on a card that they wore. Traits included: courage, forgiveness, acceptance, being in the moment and more. Kim led the group in the morning and afternoon shifts, along with Joseph Sun (educator) and Janet Hoffman (CNL).
Each day was focused on experiential exercises in helping remind us what it might be like to be in the shoes of the people we serve and their families. The following day (Tuesday) staff and nursing students experienced what it may be like to see the world through the eyes of those suffering with macular degeneration, almost complete blindness or loss of peripheral vision, and some chose to experience being deaf. Staff also donned hand coverings to mimic people who have lost their fine motor skills. Staff and students were asked to continue with their regular shift report while in their sensory modified state. Staff experienced significant difficultly performing their regular duties at the beginning of their shift and described the experience saying, "I found that being blind made me want to retreat from the world. I just wanted to close my eyes because it was so disorientating." Others shared, "I was so frustrated - I felt like I wanted to hit someone just out of frustration!" When staff removed the sensory modification devices, there was a minute when we all sat in a quiet moment. Staff breathed a sigh of relief and said, "I am just so grateful I don't have to live like that." We talked about the specific people we serve and what the world may feel like for them - especially when they are not able to do the things they want to do because of their aging bodies.
The next day (Wednesday), we opened up a dialogue about caring for people with a broken brain who may not understand their regular bodily functions any longer and find themselves in situations where they discover they have become incontinent and are not able to independently take the steps necessary to address the incontinence. Joseph Sun started the shift with cups of chocolate pudding saying to staff and students, "What is this?" After staff answered the obvious, he asked, "How do you know?" This resulted in a conversation about how we experience things in our environment using all of our senses: taste, smell, feel, seeing and even listening, as staff ate the chocolate pudding. The exercise went on to discuss a common scenario where a person with dementia may have become incontinent, and the group walked through the experience through the eyes of the resident to understand the steps they may take to understand what has happened to them - similar to the steps the staff took to confirm that what they were eating was chocolate pudding. The discussion lead to talking openly about how to respond to a resident who may be incontinent, has BM on their hands, is using their senses to understand what this "brown matter" is, perhaps is on the walls around them - in an attempt to wipe it off . Staff talked openly about maintaining a calm approach and trying to preserve the dignity of the resident at all time and suppressing the urge to "jump in" and stop the resident from trying to figure out what is happening related to their incontinent episode.
On Thursday, the entire Youville team continued with their second of four sessions with the Centre for Practitioner Renewal (CPR). In order for this significant culture change to happen, the Residential Leadership team has partnered with CPR to create the space to go deeper into Enhancing Compassionate Care with Self and Others within the context of the overall vision for residential care. CPR creates a safe space for staff to be able to surface issues that need to be shared with their colleagues in order to be ready to begin the culture shift called "Megamorphosis" that will officially start on Feb 14th at Youville.
Friday ended the week with a lunch hour experience where staff had a chance to taste the pureed foods that they commonly serve to the residents. The catch was - the residents had to feed the staff! Staff donned "shirt protectors" and residents, regardless of the progression of their advanced dementia, couldn't stop laughing as they saw staff struggling to reach the shaking spoon coming at them! Residents who were not assisting staff looked on with smiles and disbelief. Staff shared that the experience "made me feel like I had to eat and couldn't stop even if I wanted to because the spoon kept getting refilled", while others said, "What I found interesting is that I was never asked or told what I was about to eat - I realized that I rarely tell people I am assisting with at meal time that they have a choice in their pureed food or tell them what they're about to consume."
By the end of the week, staff were pleasantly surprised by the activities and reflected on the impact that being part of the experiences had on them as individuals. Some chose to write out the impact on cards that will be used to evaluate the Megamorphosis methodology we are utilizing to transform a culture shift. Staff said, "Thank you. It's funny how we can get so busy sometimes. We forget what it's like to be in the shoes of the residents."
Stay tuned for next week's article on Week 2 of the pre-work focused on Language Matters.
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