It was the power supply. Back up and running now thanks to Computers dotcom at 116 Winter Hey Lane, Horwich, Bolton, BL6 7PJ. I'll add their link which is down at present - another new site is on the way.
I've an old Dell PC case, I'd love to put some kit together a media PC, or Linux box - one of these days... Meanwhile back to catchup and writing...
- provides a space devoted to the conceptual framework known as Hodges' model. Read about this tool that can help integrate HEALTH, SOCIAL CARE, INFORMATICS and EDUCATION. The model can facilitate PERSON-CENTREDNESS, CURRICULUM DEVELOPMENT, HOLISTIC CARE and REFLECTION. Follow the development of a new website using Drupal (it might happen one day!!). See our bibliography, posts since 2006 and if interested please get in touch [@h2cm OR h2cmng AT yahoo.co.uk]. Welcome.
Thursday, November 29, 2007
It was the power supply. Back up and running now thanks to Computers dotcom at 116 Winter Hey Lane, Horwich, Bolton, BL6 7PJ. I'll add their link which is down at present - another new site is on the way.
Tuesday, November 27, 2007
Oh dear! My PC a senior citizen at 5 years old this month is poorly. The power supply had indeed given up the ghost on Saturday and I've a (red) confession to make: the CPU runs constantly, processing data from -
Not very green I know. I do invest time switching other things off at home and work, to save some money and CO2. We could save a fortune at work...
I'm writing this on Matt's laptop, so no Skype at present. Hope to be sorted soon - funds...!
I'm still reading and thinking things through - static archive, website, Hodges-informatics, students (podcasts!). It's quite frustrating having attended the Drupal meeting last Wednesday in Manchester. Having listened to some great talk-throughs covering specific modules, you're left itchy to try stuff while the thoughts are hot. The next meeting is December 19th, just hope there are no school carol services then! In the Pro Drupal Development book there's a section on a simple XML-RPC Server. Which is why I'm thinking.... Reading this stuff I feel like a Beach Boy - Wouldn't It Be Nice!! Well, it sure would... Chris, Steve and the other established Drupalers are keen to have others up-front, sharing their experience and for beginners to show work in progress and seek help with problems. Now there's a future aim and one that may be hard to dodge (which is what I need)....
I've been given admin rights to an established, but still emerging Drupal website. Someone trusts me and for that I'm really grateful. This is another very useful way to learn. I can check how this already well populated site is configured, how the content types are used... and pick up and report errors. Plus sharing some insights from Manchester.
On Saturday I lost an update to the socio-tech paper, the notes are no longer recycling bound. As you're reading this I'll be downloading the file from an e-mail I sent to myself last Friday night. Can't afford downtime on this project there's scope for 5-7k words, I've 6k, but a lot still to do. I'm pleased to learn I can include some B&W figures.
Speaking of 'P' again - some of our visitors arrive at the website having searched for 'p'. Google picks up the 'p' in p-jones. I should have realised of course: the heart of Hodges' model - COMPLEXITY. Although many of the forms of complexity are completely over my head. We need tools to understand complexity within the humanities - social sciences: is that possible without maths? There are certainly books and journals out there.
Must go: Sam - our dog is stood up at the door with his legs crossed and a wolfish grin (of discomfort). OK let's go...
Posted by Peter Jones at 11:14 pm | PERMALINK
Saturday, November 24, 2007
In addition to the USA and EU for several years now it appears that many of our website's visitors come from the Philippines. Brian and I greatly appreciate the interest of our virtual Filipino guests, so welcome one and all...
Over recent decades the global migration of nurses has become a much needed phenomenon, but one that can also quickly become a newspaper headline depending on where nurses are moving from and going to....
Given the (relatively) high profile of Hodges' model as a model of nursing on the web, I wonder if these visits reflect:
- An assumption by potential nurse migrants that Hodges' model is de rigueur here in the UK?
- There are tutors/lecturers teaching the model in the Philippines and directing their students to the site?
- They use a curriculum that is suited to, or finds merit in Hodges' model?
- With more than 180 languages and dialects perhaps Hodges' model is also helpful in this multi-cultural and ethnically rich country?
- Perhaps the visitors are not primarily nurses?
Whether or not any of the above apply, I would love to hear from our Filipino visitors? How is Hodges' model being used in the Philippines?
I don't want to put any visitors off, but of course the website and this blog represent a call for research in global conceptual frameworks for health and social care and general education too. Wherever you are - you can make a difference...
All the best.
user: h2cmuk @
(My PC's off-line at present - power supply?).
To follow - another 'p'.
Friday, November 23, 2007
I've been working on the socio-technical (s-t) structures in nursing informatics paper....
The guidelines insist on definitions, so in addition to socio-tech and socio-tech structures I've added s-t-political. It is possible to consider s-t in isolation, but I don't think this is a valid exercise. The politics of matters s-t are all over. Hodges' model can really bring these to the fore.
It's always a struggle to balance the content, how much background to cover. In the paper I've thrown in a horse and litter, plus the moon for good measure. Instead of sociotechnical I've opted for socio-technical; the hyphen's important which I'll need to explain.
There is a question that's cropped up about this word - 'technology'. Is 'technology' special as an -ology?
I'm trying to get in the habit of plugging the Skype phone in, there must be a way to preserve the microphone setting!
Notice some hits on the website are through people searching for 'p' - mmm...?
user: h2cmuk @
Monday, November 19, 2007
I have always been interested in the theory behind the use of Hodges' Health Career Model. During my time as a student nurse (back in 93-96) I came across information about how the HCM could be implemented in practice. As a newly qualified nurse I took these ideas into my first development post at Kemple View in Blackburn, Lancashire and successfully introduced an adaptation of the model adding risk to the dimensions.
I understand that the model is still in use and many patients have benefited from its holistic approach to psychiatric care. I also note reference to this on your web page. I am quite pleased that a student nurse has clearly recognised the benefits as I did during training.
I am now working at Cygnet Hospitals at Bierley in Yorkshire and am again looking to introduce the model as a means to provide a framework to nursing care. The favoured approach on the ward (FAIRFAX Rehab - complex care for males) is PSI, but I am of the opinion that the HCM can be used as a framework for nurses to deliver such an approach.
I would be interested to know what your thoughts are on this and of course if there is any advice that you can offer.
Denise Banks RMN PGCM DMS JPhttp://www.p-jones.demon.co.uk/intro-hcm.htm
In December 2003 a student nurse brought information to my attention that Kemple View Psychiatric Services, Blackburn, UK are using the Health Career Model as an aid to assessing individual needs.
Links by PJ and reply to follow ....
Since I approached and met with Brian on 28 May 1997 about creating the website, I can count the number of times we have met on one hand. Sheffield and Bolton are not that far apart, but you know what it's like....
Brian and I have managed to meet up prior to site updates and we hope to catch up in person in the Spring or possibly sooner (February half-term).
This really helps to focus my efforts as I like to take along ideas, drafted plans and actual pages if possible. By then I should have a clearer idea of not just what I would like to do - including what goes where - but what I can do...
P.S. Other ideas and inputs are also invited!!
user: h2cmuk @
Sunday, November 18, 2007
Eclipse is an open source community whose projects are focused on building an open development platform comprised of extensible frameworks, tools and runtimes for building, deploying and managing software across the lifecycle. A large and vibrant ecosystem of major technology vendors, innovative start-ups, universities, research institutions and individuals extend, complement and support the Eclipse platform.- also made me hungry again (after some 12-15 years) to tinker with code. After installing and trying Eclipse and Ruby in the spring - time got the better of me.
Then last week I read an item from October's PC PRO - 'A total Eclipse'.
I removed Ruby, who am I trying to kid!
It was time to check out Ruby AND Rails -
Rails is a full-stack framework for developing database-backed web applications according to the Model-View-Control pattern. From the Ajax in the view, to the request and response in the controller, to the domain model wrapping the database, Rails gives you a pure-Ruby development environment. To go live, all you need to add is a database and a web server.I installed INSTANT RAILS and it's awe inspiring; so much to learn, but it really feels like the motor's running. I've had the Rails book since the spring with one reading and now the mini library (Ajax, PHP, Drupal, DOM Scripting) I managed to put together is paying dividends (I think!).
So now Aptana is plugged into Eclipse and I'm up to Part II - Building an Application (just to put things into perspective that's p. 51/719 actually!).
If you follow this blog, you may be thinking he has dropped Drupal! Far from it. I can't wait for this Wednesday night and the meeting at Manchester Digital Development Agency. Books aren't the whole story: I have to add that installing Drupal, screwing up, deleting, installing again and finding some stability at last... such that I can check out the innards of Drupal (play!) has helped me enormously in starting with Ruby, Rails and Eclipse. Hope I can maintain this momentum.
I've also noticed the ads for Ruby and Rails hosting too - wish I could find a sponsor or two...
Spreading the cognitive and temporal jam yet further - I've downloaded Inkscape's Vector Graphics editor. Still need a decent banner (and finish the socio-tech paper - must contact the editors!).
On his blog Osbert's ethical enterprise Osbert Lancaster - [Executive Director, Centre for Human Ecology & CHE Consulting] recently posted -
13 books to inspire action for people and planet
- a couple of videos also feature.
Although I'm not a CHE alumni - just a prospective student - the posts and blog roll provide a rich sustainable seam.
Amongst a packed issue on Technology-Enhanced Learning (TEL), the latest edition of ERCIM news mentions how computer aided learning has become TEL.
If you are researching this field, or would like a heads-up on EU activity in e-learning this is a great resource. My interest is three-fold:
1. investigating CAL in the early years;
2. recognising h2cm's potential in curriculum development
3. and of course the possibility of producing TEL resources in the future.
The next ERCIM issue for January 2008 is on The Future Web, you can subscribe online.
Must check on the equivalent sources for the Americas, Africa, Middle East, Asia, Australia - New Zealand - Oceania...?
Bye for now - back to cooking, ironing AND writing ;-)
user: h2cmuk @
Saturday, November 17, 2007
Several other people and I received an e-mail yesterday - a reminder that a book chapter was a day late. (Wish that reminder had arrived a month ago - oh well.) I knew the deadline was nearing and with 4,500 drafted words I'm far from finished. The Hodges-Serres chapter will be published next year, and that was rejected in its initial form, so....
The subject of this effort - socio-technical structures - is a bit like playing Pooh sticks.
You see I'm standing on the bridge at the centre of Hodges' model on the I-G axis - and I can see the H-M concepts flow by underneath. Well, it's only a bit like Pooh sticks because sometimes the flow is tidal, and at others it is just plain weird. Walking home from Rivington in the dark, warm as much from having more writing under my belt as just having had a coffee - in my mind's eye on the bridge - I realised I was surrounded...
Tolerance and persistence were on both sides and heading my way.
Ideas are one thing, but writing something that is relevant, coherent and finds favour with editors is another, it's fun trying though...
Wednesday, November 14, 2007
Although it's a while since I ran around the school playground, mentally for the sake of my well-being, creativity and general zip-n-zest; I like to think that I'm still there (minus - knees plaster clad, nose running, sleeves flowing....).
Now, it's just that the playground is a tad bigger.
As an adult thinking about the banter and slang terms banded about back then the differences and connections between adult-childhood worlds become quite stark and makes you wonder - where does stigma begin?
When I first came across BonkersFest this year I thought "they can't call it that - can they...?"
Well they obviously did. In doing so this year and with plans for 2008 the participants, organisers and sponsors are addressing the question (issue!) of stigma around mental health and disability head-on.
BonkersFest, the ongoing attention of the BBC, the Independent newspaper campaign and efforts of others in the media are still much needed.
Monday, November 12, 2007
With the iPhone now available here in the UK, the mobile market is bound to change and quickly - the latest and greatest never last long.
"Unlimited data" sounds great, but the usual fair use caveats apply.
Elsewhere, Google has announced the Android Developer Challenge, supporting OHA ...
Welcome to the Open Handset Alliance™, a group of more than 30 technology and mobile companies who have come together to accelerate innovation in mobile and offer consumers a richer, less expensive, and better mobile experience. Together we have developed Android™, the first complete, open, and free mobile platform.On the OHA site -
We are committed to commercially deploy handsets and services using the Android Platform in the second half of 2008. An early look at the Android Software Development Kit (SDK) is now available.
Participate in the Android Developer Challenge, which will give away $10 million to developers who build apps on the platform.Better watch that market space!
Sunday, November 11, 2007
Change at work tends to be viewed as just that - change within the sphere of your profession and colleagues. The changes inevitably affect your clients, but the bubble by-and-large stops there. In the 1990s community mental health resource centres were being built with kitchens to cater for day care/hospital patients. Now many of those kitchens are not needed as mental health services have stepped away from day care provision. This move is a smart one, since if you read (and contribute to) mental health news groups you note that current and former users of mental health services recognise for themselves the dependency that prolonged day hospital attendance can promote. That said there are many acutely worried people out there. Having lost day care services, they face interviews that seek to address their level of disability. Depression and anxiety need no introduction to helplessness and hopelessness.
Enter a further phase of change and one with much wider ramifications - tackling worklessness.
There is a new EU strategy for 2008-2013 which includes (with my emphasis):
The Commission report to the 2006 Spring European Council urged Member States to reduce the high number of people inactive through ill-health13. It stressed that policy in many sectors has a role in improving health for the benefit of the wider economy.Does overall planning, action and evaluation in physical and mental health call for an overarching framework? When possible the drugs may be replaced or combined with information prescriptions, but care is still needed in preparation, administration and monitoring the positive and negative side-effects....
Spending on health is not just a cost, it is an investment. Health expenditure can be seen as an economic burden14, but the real cost to society are the direct and indirect costs linked to ill-health as well as a lack of sufficient investment in relevant health areas. It has been estimated that the annual economic burden of coronary heart disease can amount to 1% of GDP15, and the costs of mental disorders to 3-4% of GDP16. Healthcare spending should be accompanied by investment in prevention, protecting and improving the population's overall physical and mental health, which, according to OECD17 data currently amounts to an average of 3% of their Member States' total annual budgets for health compared to 97% spent on healthcare and treatment18. [p.5]
Brussels, 23.10.2007 COM(2007) 630 final
WHITE PAPER Together for Health: A Strategic Approach for the EU 2008-2013
Saturday, November 10, 2007
Another barrier to trying to learn programming on the PC as a hobbyist, is simply being able to keep up. Versions change rapidly, the proprietary package adorning the shelf quickly becomes dated. If used regularly no problem, otherwise what a waste of money...
That's no excuse now, as there is a stable collection of languages to use such as Java, C and its many variants and IMHO Ruby seems an exciting and mature prospect. Plus, open source offerings like Ruby means a free entry ticket to tinker with soft tech. Today though the need for a database, styling, web, application interfaces makes for a complex mix of programs that must work together. As Drupal and no doubt other CMSs reveal there is no single DIY technology, you really have to look under the hood.
I'm well sorted with Drupal and can't wait for 21 November and the next NW England meeting in Manchester. It appears a time though of great change in programming circles. How so? Well I think it is significant that Microsoft's Vista and Apple's Leopard are creasing themselves to look 21st century and yet they have apparently caused incoherent waves in the market place - the former more so. In order to produce the software of tomorrow the tools must evolve. Widgets rule? The latest developments suggest some great opportunities (creative ideas and time permitting!) - for example:
Adobe's AIR used to produce - Acesis Point-of Care
Watching the tech media for things to try (and fuse together) I've also wondered for ages about SVG. It's been around for many years. Is SVG about to fully realise its potential, or has it been passed by...? Given where I am at - I'll revisit this topic again...
Well back to Drupe, PHP, SVG... and a really helpful blog in terms of sorting the tech-jig-saw New Web Order.
P.S. If you are organising any conferences for 2008-2009 please let me know happy to link on the h2cm website links pages and seeking sponsors here. h2cmuk <> yahoo.co.uk
Thursday, November 08, 2007
Starting the server and delving into Drupal I'm reading too:
Babin's - Beginning Ajax with PHP
Darie et al. - AJAX and PHP
The code in these and most books is available on-line and while this makes life easier, I've realised that the time spent in the 1980s typing code into the Sinclair ZX81 (with 16k RAM pack) and BBC microcomputer provided a great way to learn programming structures and syntax. Now, I don't have time for typing even though I'm no keyboard slouch (posture! posture!).
Another thing I've never faced up to the challenge represented by the PC in terms of programming and networks. Lots of reasons including family, day job, a website, some publications and amongst the excuses is the arrival of OOP (object oriented programming). I found myself using C+ on my degree course (philosophy:computing) and worked through the assignments 'OK', but this was no springboard. There were no contented quacks and wags of the tail from this duck. My feathers remained bone dry.
In the books you can feel short-changed as the code examples include repeated functions - browser checking, error handling and such like. So what to do? Well, re-use of code is a key principle of programming and so whether a case of typing or copy-paste re-use makes sense.
I've got some of the chapter exercises working including this AJAX grid, which I know is no great shakes. What I think will help push me forward is to flavour this with data related to Hodges' model. That's a problem too - having meaningful data.
Anyway, must go - to check if the three updates in the image to the left are actually in the database table. MySQL is another thing to get to grips with and I notice that the latest version of PHP can be used to write object oriented code - OOPs - no escape!
Tuesday, November 06, 2007
Dear Rachel (Ms Magee)
Delighted to help you and well done on picking out Hodges' model. It sounds like an exciting time for you personally being newly qualified and working on a new unit.
Apart from several occasions as a student (late 70s at Winwick Hospital) and more recent liaison through my Trust's NHS Care Record Service Project I have not worked in forensic/secure mental health services. So what follows is a very generic over view. That said Hodges' model is more than an out-liner - brainstormer tool. As your experience grows the model will grow with you and your clients if it is appropriate to share it with them. Anyway, here are some initial thoughts a real mish-mash running through the care (knowledge) domains in turn (with some repetition).
If you wish to develop and elaborate on what follows, casting a distinct TEMSS light on each care domain I'd be happy to place your prioritised version in a graphic (with you duly ack.)
Screening on admission. Existing psychic 'injuries'.
An·a·gram: 'secure' = 'rescue' .....
Life history, experiences +ve/-ve (including hospital care), skills, strengths, beliefs, mood, expectations, RISK behaviour, personality, psychological reactions to situation (admission, secure environment, diagnosis, prognosis, treatment - psychotropics, locus of control, helplessness, motivation, family contact...), specific, individualised - person-centred care. Thought disorder? Attribution. Risk - self-harm, harm to others, self-neglect. Psychological dependence. Intelligence. Literacies: 3Rs, visual, social, information. Boredom, Mental capacity. Cognitive functioning. Religious beliefs. Personal skills, strengths, interests. Education - access to training. Response to stress - existing coping mechanisms. Sleep. Attitudes. Sexuality. Biopsychosocial influences PMT (sorry don't wish to seem sexist!)? Stress-vulnerability. Biases, prejudices. Orientation time, place, person (not just older adults).
(YOU as a nurse are also in this domain - your skills, control and restraint, anticipation of needs, observation, empathy, self-awareness, non-judgemental, bias etc....) Assessment tools. My care plan. 'personal' time. Quality - therapeutic time if used.
Family, pressure on existing - new relationships, spouse-boy/girlfriends, socialisation into the 'secure' environment, dependencies - children / pets. Observation. Group activities. Group therapies. Routine. Co-operation. Team work. Leadership. Status, stigma, respect. Communication. Social skills, Assertiveness. Media - papers, radio, TV. Qualitative research - client narratives. Demographic profiles - catchment areas - deprivation indices.
Screening on admission. Existing injuries. Access to GP, emergency services if needed. Physical characteristics, height, weight - BP, temp, bloods, mobility. Evidence based care? NICE. Drugs, side-effects (+ substance misuse / alcohol), physical effects of addiction, physical environment - lighting (on-off [fade]), noise (acoustic) signature, colour, architecture (sharp corners vs curves), physical health problems, trauma. ADLs. Assessment toolkit - what's in yours? Nursing (care) process. Hygiene, Domestic services. Infection control. Physical space allocation. Multidisciplinary assessments - occupational therapy, physiotherapy, psychology, pharmacist. Unit viewed as a system - ecology. Complexity within TEMSS. Literature review. Site visits / conferences. Learners. Staff course study opportunities. Academic partnerships. Quantitative research. Triangulation. Statistics. Data gathering processes. Geographic profile of referrals.
Human rights, policies, protocols, GP service provision, right of appeal as relevant, 'disciplinary constraints', compliance-concordance, 'offence' category. Client space - privacy / dignity. Access to therapies, rehabilitation, training opportunity, AUTONOMY, ability to exercise choice, institutional 'rules' make-up, clothing, bathing, kitchen, toilet facilities, dignity and privacy, 'unwritten' rules - bullying - vulnerable adults, abuse, financial, sexual, physical. Inspection - Commissioners - accountability. Referral process-pathway. Thresholds, waiting lists? Travel distance - regional resource. Transport links - visiting times. Cost of fares. Staff establishment. Health & safety rules. Disability. Care transitions. Learning disability. Early onset dementia. Ageism (other '-isms') RECORDS. CPA. Community Team. Qualified-unqualified staffing. Patient-relative groups. Service user representation on management. Academic links. Visiting. SAFETY - patients-staff. Serious untoward incident reporting. Translation. Advocacy - short-long term. Other agencies - Social Services, third sector voluntary partners? Philosophy of care, OUTPUTS vs OUTCOMES? 'contracts', Mental Health Act, appeals, hospital managers. Politics of care. Psychiatry in Dissent. Audit, data collection, IT systems. Access to REPORTS - INTELLIGENCE "How are we doing?" "Where are we going and is that the right way?" Your involvement - engagement - in these processes. Client - carer - public involvement. Finance budgets - (unit budget - resources), staff support / supervision. Energy use. Recycling. Client abilities with finances / debts. Homelessness. Re-housing. Existing tenancy. Opportunity for (regular) TEAM BUILDING ;-) Innovation and creativity. PDP - KSF. Targeted issues: Managed care. Personality disorder....? Professional associations, groups:
No group for TEMSS for women? Over to you! .....
As you can see the model is high level. It does not DICTATE how your unit is run, what therapy is undertaken. It can help as an aide memoire prompting you and your colleagues to systematically consider all the care domains according to the context-situation and can help ASSURE an holistic assessment and evaluation.
The model can also be used to help explain problems, issues and their solution - or realistic outcomes to clients and their families. So the model doubles as an educational resource - very helpful to engage the INDIVIDUAL or a GROUP (family). You can do this EXPLICITLY using paper or flipchart for example, or implicitly with you using the model mentally as you go along...
By including a POLITICAL domain Hodges' model is ideally suited to your speciality - in fact POLITICALLY and SOCIALLY there are 'nested' issues within your 'secure care' context: gender, ethnicity, equality and equity, public attitudes, institutionalisation, citizenry, public involvement....
This blog includes many labels (on the right hand side) I will also add 'secure services'.
Rachel - I noticed on your organisation's website there are the names of the wards and address - there's a space to fill there...
Good luck, hope this helps and thanks again for your interest.
Monday, November 05, 2007
about a day in which you have seen four beautiful sunsets.'
I blame Apollo and Gerry Anderson too
for wanting to be an astronaut.
What must it be like
To have the right stuff?
To have the courage
To do the things that must be done
Mind, heart, soul: moments - case of stress
Potential spent - kinetic venerability
Cast adrift, burdened wait lifted: sweet release -
Flotsam, jetsam :object: back to Space
The world is suddenly lighter and older
To remind us of who we are and once were
To look after the where, when, who and see the whole
Trying to keep the stars alight at home
The world is full of astronauts
Call them Carers
Above All - they travail alone
Thanks Apollo and Gerry A. wouldn't want it any other way...
Next April the website will be 10 years old. Here's what the first version looked like.
If you have any thoughts on the home page, things to remove, update or add please let me know...
user: h2cmuk @
To follow - TEMSS Therapeutically Enhanced Medium Secure Service for Women [II]
Sunday, November 04, 2007
I'm continuing to explore Drupal amid some reading, blocks, menus, content.... Searching for content to practise upon, I checked one of the old (1997-8) introductory pages - Brian's course notes - and found my closing sentences were utter drivel! [Well it was a surprise to me.]
Although the prospect of a winter through spring clean is daunting, it will also prove an exciting completely about-time refresh.
Drupal is forcing me to do things I should have done ages ago:
- Separate the content from styling;
- Separate the static (historic) content from dynamic;
- Review the graphics;
- Thinking about audience(s);
- - and related content and solutions (archive, computer aided learning, prototyping).
It's cool to find there is a version of jQuery in Drupal. With a bit of PHP code I can fade text onto the screen - like many other sites and one of many effects to learn (and use sensibly!). Keith's DOM scripting will also finally come in handy through the dark months. I can't wait for the next NW England Drupal meet, it seems ages since the Cornerhouse get together. I'd put the modules and themes in the default directory, oops - that's sorted now. Need to explore content creation, the theme files and templates (CSS!) and the CCK (content construction kit) and views modules. Aaaarrrrghhh! Must also dream and think, dream and think, dream:think ....
If you are into Being & Time, you may like to listen to Hubert Dreyfus' current lectures. This week will see his talks on Care I & II being added to this excellent resource:
Have a great week!
Saturday, November 03, 2007
It goes with the job, seeing people in residential care and nursing homes. The past few weeks walking through several care facilities - corridor-lounge-corridor - you pass a series of open doors, an invite to gaze that way. (People do ask to have their doors left open and visitors should not be able to walk past open doors if privacy and dignity are at risk?) Walking along - a smile, nod of the head, wave of the hand it's like a gangway.
Recently, though it was a case of 1, 2, 3 and counting: residents sat in their rooms; chair, wheel chair, special chair bound.
A gallery of still-life studies. So many heads bowed, cast as life and world-weary statues. So many aged variations of The Thinker.
The homes and their staff do the best they can, some employ people dedicated to 'activities'. Despite this, it's not easy for many new carers to appreciate the value in engaging people who are disoriented for TI:ME, PLACE and PERSON in chit-chat or a group activity when five minutes later they have forgotten all about it. People are referred to mental health services because they have a mental health 'problem' and yet in many cases their bags are packed and they are ready to take you on a journey: if you care to listen.
We seem to focus on the cognitive value of the things we do, but is this a variation of task orientation that delivers a concrete output (PROCESS vs PURPOSE again)? What about the emotional value of the things we do and the possible benefits, whether visible or intangible? ALL work and the effort it requires carries a price and despite the forgetting, the emotional engagement and safe social contact can still make a real positive difference to people. The price paid by residents in being engaged in conversation, can reduce any sense of alienation, loneliness and the aggression and agitation that can follow.
What do I mean 'safe' social contact? Many people in care are disinhibited; they say things to their fellows and staff that are very personal and upsetting. Cognitive decline is a fact of life, but even for people diagnosed with dementia, the damage done varies from person to person. For many they are profoundly impaired and yet their personality flickers through and with it sensitivity to things said by their peers. Remember those anxious moments in the play ground? Social mores are deeply ingrained in us. Maybe this is why for youngsters the current spate of e-bullying is having such a impact. Bodies may be battered and worn, but INTRA - interPERSONAL and SOCIAL exercise mediated by carers (and relatives!) can pay longer term dividends.
In between care needs that also demand quiet, rest and sleep and our need to be realistic and objective; personal and group engagement can I'm sure make a real difference. It depends on the resources + the right attitudes to make it happen. To see the person not the statue.
bringing statues back to life is real magic.
Walking the gangway is one thing,
but residential care should not be the gangplank
as it is so often portrayed for residents or staff.
Rodin image original source: http://users.ox.ac.uk/~ball0888/oxfordopen/Rodin.htm