There are many articles that have been written on the importance of clinical leadership and its link to improved patient safety and overall effective management of care.
Taking the lead sometimes requires taking a step into new territory, to question and challenge the way that things have always been done and to step outside of the usual square to effect change.
Seadrome Home and Hospital is an aged residential care facility in South Auckland with a specialist Dementia facility that is committed to promoting excellence in dementia care.
Always concerned for the wellbeing of their residents, Seadrome prides itself on providing meaningful activities, based on values and beliefs related to past roles, interests and routines. “Enjoyment is a measure of what makes activities meaningful and also reinforces a sense of identity and a sense of belonging,” says Manager, Tina Chivers.
However, Seadrome recently realised that three of their patients seemed unhappy in their environment. They have a small cohort of dementia-suffering Maori residents who are all fluent in Te Reo Maori. This group of residents seemed to feel displaced and appeared to be disengaged. The feeling was best summed up by one of the Maori residents: “I am not like these people here.”
The three residents spent much of their time isolated and not engaging with others or participating in many activities.
Staff felt that things were not going well for the residents or the staff, until a visit from Dianna McGregor, Maori Nurse Specialist Gerontology from Waitemata District Health Board (WDHB), who introduced Seadrome to Kelston Girls’ College and suggested encouraging Maori students to come to Seadrome and engage with their Maori residents. She felt that the Maori residents were in need of reconnecting to their culture and people.
From this initial exchange, Project Toru evolved. Twelve Kelston Girls’ students came to Seadrome once a week on Wednesdays between 11.00am and 3.00pm. The intention was for these girls to develop meaningful relationships with the Maori residents through conversations, singing, making poi and flax flowers, playing cards, exploring the resident’s whakapapa, and joining them for meals of boil-ups and hangis.
The girls, in turn, attended lectures to learn about dementia, whakapapa, communication skills as well as good hygiene. Different career choices were presented to them by health professionals including nursing, dietician and physiotherapy. They were also assessed for the NZ Qualification Authority courses involving Lifting and Handling, Supporting a person to eat and drink, as well as two cultural standards.
Over time, Seadrome observed the effectiveness of the programme. It was not just that the girls were learning but the Maori residents became more relax and calm in the environment.
One of the residents in particular looked forward to the arrival of the girls by dressing up and putting on makeup and jewellery. Carers were able to discuss what had been upsetting her and she joined in the singing and her attitude to other residents was kinder with less challenging behaviours. The students also found the project rewarding and reported that it was an enriching experience; helping them to consider possible future work choices. One girl gained confidence and decided she wanted to pursuit a nursing career.
Tina explained, “When we started, we were unsure of exactly what assistance we were looking for. However, we were very clear that we wanted the Māori residents to feel connected to each other and to other Māori people and not feel isolated in our care. The ongoing visits of the girls from Kelston has added to the wellbeing and quality of life not only for our Maori residents but also for the non-Maori residents. We appear to be a more integrated group of people. We also found that karakia was effective at calming and settling for all residents.”