Walking with purpose - tackling boredom creatively

When it comes to the environment it is the most influential and the most overlooked asset any care home has. 

That’s not to say there aren’t some really good examples such as the #Sunrise property in Edgbaston. Great team, great philosophy, great building, and the management has followed through within the home and at senior level. I’ve worked there recently myself and there’s a mind-set of constant improvement at this home. 

If there’s a downside, homes like this charge a premium. But that’s the point, this type of care home environment is only available at a premium. It shouldn’t and needn’t be that way. 

Stimulating and appropriate environments can be made available in every home. In every home there are opportunities to use the available space to reinforce the locality (sense of place) and reflect the profile of the population to create an engaging and relevant environment. 

May I strenuously point out at this juncture that this need not be an expensive exercise. It’s more about changing an understanding and a way of thinking about the surroundings. What is needed is someone on-hand with the skills, resources and understanding to make it happen: that’s obviously where I come in!!

Currently, when the environment is broached it seems to be camouflaged as #walking with purpose. To walk with purpose you need someowhere to walk to: a destination.

If you haven’t been in a care home, 'wandering' is typically observed in the better standard of homes with more space where any number of of residents will be up and about and heading somewhere like they have somewhere to go. Some will be on the go constantly, occasionally at alarming speed. Others will wander around for hours going nowhere in particular. It's great that they are active but there’s rarely a destination. Walking with purpsoe requires that we create worthwhile destinations.

It's my belief that one of the reasons people wander so much is because they want something to do to relieve their boredom. I don’t often see the terms used but 'boredom' is a significant aspect living in a care home and a much greater source of problems than ever seems to acknowledged. Residents are BORED!

Who wouldn’t be bored? Restrict anyone to a limited environment with nothing to do for a few weeks and behaviours will change, frustrations will come to the surface and relationships will become strained. But that’s enough about #Lockdown and #self-isolation…..

So let’s forget the camouflaged title of ‘Walking with purpose’ and instead replace it with something more demanding of change - ‘Combatting boredom’. And lets focus on this from the perspective of residents with DOLS: people who no longer have the choice of leaving the building when they want to.

More progressive conversations about environments discuss Points of Interest or Destination Points in cares homes. But more and more I realise that what we should be aiming to acheve so much more and bring the whole world into the home, providing as many opportunities as possible to stay connected with the outside, to feel confident about the sense-of-place and be able to do the things we've always enjoyed doing. DOLS means a deprivation of Liberty, not a deprivation of Life. And when that thing is taken away, it should be replaced with something. Common sense isn't it?

Recentlly there's a bit of a bandwagon developed around Murals. These are great when done properly, but if you’ve read my previous posts or the Murals section of my website, you’ll know that Murals are invariably done badly and are ineffective. Done properly, they are fantastic but they do demand a certain commitment to both cash and space.

With genuine effort, we can make the environment rich with interaction and familiarity and it requires more imagination than it does cash.

Yesterday we went to The Range and bought a shelf about 300mm long by 150mm deep: £8 including the brackets. This is going into a dining room and will be filled with small breakfast cereal boxes (recognisable brands), individual jars of Marmalade and a few other things breakfast-related that we can use to fill the shelf with a strong theme of breakfast. It probably wont cost more than £30. The wall where this shelf will be located is going to be painted a bold colour (carefully chosen of course) to draw attention and create high contrast between the wall, the shelf and the objects. On the face of it this may seem like a token gesture or something of little significance. But have you ever gone to your kitchen cupboard feeling peckish, opened the door and gone ‘Ooo cornflakes, they’ll do!’.  Ok, so it may not be Cornflakes that float your boat, it might be Strawberry jam (phwoar, slice of hot buttered toast and jam!) or Marmite……anyway, moving on. We’re reinforcing the theme further with a themed #memory box with Weetabix, toast, sugar cubes, bacon and eggs (not real ones) all displayed inside the cabinet. The point is, this is how we work. This visual stimulus is massively suggestive, powerful and positive.

So take our little £30 idea and gradually develop other similar things around the home and you will start to make changes to peoples behaviour. Residents eating habits will change, weight losses will change and perhaps be reversed. Falls, agitation, drug use: these can all be influenced by thinking about and executing relevant ideas into the environment.

Perhaps the most powerful thing I’ve used in the last couple of years is artwork. I’ll make no bones about it, artwork in care homes is generally pants. Having been in the graphics industry for 30 years I know why homes are full of meaningless rubbish on the walls. It’s cheap and easy and requires (evidently) minimal effort, and for all that it becomes a complete and utter waste of money. Looks OK the first time you see it but it quickly becomes invisible art – I’ve got a follow-up post on why artwork is a massively missed opportunity - and meaningless images, even if you have memory issues, are always going to be meaningless images.

Using artwork that is content rich and relevant to the residents and the locality or cultural history is frankly, a gamechanger. I’ve created relevant, professional quality displays which have visibly changed people’s behaviour. My partner, who is a published dementia professional and massive advocate for meaningful surroundings, has used my artwork and mapped the behaviours. I was partially prompted to write this piece following a tale she told me a few days ago about a couple of ladies in one of her homes who would wander arm in arm around the home chattering away to each other. The chatter was about nothing meaningful and would often be unintelligible. When we introduced some specially created artwork they would wander up to the displays and have proper conversations between themselves about the subjects in the artwork. Let’s be honest, you won’t get many people having in-depth conversation when encountering a picture of a ball of wool!

‘Walking with purpose’ means ‘going somewhere with a reason. It’s a journey with an end, a destination. So my wish today is that we stop camouflaging boredom as something more complicated. Care home residents are bored, whether they’re wandering, sitting or lying down. We would all be bored in the same environment so we need to recognise this and address it in a practical and concerted way with simple, intelligent, low-tech solutions and fill our homes with meaningful, relevant, interesting, engaging objects and images. So please subscribe to this blog and help it grow. We can make it a place to share ideas and experiences and somewhere to come for inspiration. If you’re proud of something you’ve created I’ll be delighted to see it and share it.

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