«Q. WHAT DOES YOUR ACTIVITY PROVISION SAY ABOUT YOUR CARE HOME? A. Everything! It says to your residents, and to the world outside how much you really ...»
OUR CAREHOME MANIFESTO...
To be printed off and distributed to all care home owners, managers, activity organizers, staff, residents,
friends and relatives of residents, inspectors and other interested parties….
Q. WHAT DOES YOUR ACTIVITY PROVISION SAY ABOUT YOUR CARE HOME?
A. Everything! It says to your residents, and to the world outside how much you really value their lives,
and how much you really care.
WE CAN IDENTIFY FOUR TYPES OF RESIDENTIAL CARE HOME – WHICH ONE ARE YOU?
1. AWFUL – The worst homes never provide any meaningful & stimulating activity for their residents, and are dead proud of the fact – the people in charge of these should not be looking after anyone at all, ever.
2. BAD – Then there’s those who do nothing because they’re ignorant, and think their residents are somehow sub-human – these too should not be looking after animals let alone human beings.
3. MEDIOCRE – then there’s the vast majority who do little (“We have no budget – we have to raise the funds ourselves”), or do things just for show (e.g. for Inspections etc), or say about any proposed event of real quality such offensive things as “Ours wouldn’t appreciate it ducky – they’re all a bit gaga here”, and instead settle for ‘any old thing’, so long as its as ‘cheap as chips’ and doesn’t interfere with the staff schedules. They know in their hearts (or have been taught from years of working in a bad system) that their residents aren’t worth any time, effort or money (especially money) spent on them, but they’ve got to go through the motions to make it look like they ‘care’ – Now, answer us truthfully, is this where you would like to go and be ‘cared for’ when you have to sell your house to pay for the privilege?
4. GOOD (or at least doing their very best) – and finally there are the care homes who know in their heart that it’s a flagrant abuse of their residents’ humanity to fail to provide regular, high quality, meaningful & stimulating activity, and do so with more vision and care than the rest. Some are also aware that such activity, apart from being beneficial in itself, does say everything about their home and their ethos, not just to themselves, but to the outside world too. Some are even brighter still: they are passionate about the benefits, strongly encouraging good activities at all junctures, well aware of how this speaks volumes about their homes, and also what brilliant business sense it makes – for so little investment, you get so much return!
TIME TO THINK A LITTLE DIFFERENTLY?Since the early 1990s Frantic have specialised in performing quirky and original musical theatre shows in non-theatre venues such as peoples’ own homes (we call this “In-House Theatre”), and community centres.
The style of the shows emerged from work both caring for, and being asked to perform for, older people suffering from acute dementia, schizophrenia, epilepsy, MS, advanced cancers, respiratory illnesses, Parkinson’s disease, learning disabilities and many other chronic conditions to which the elderly are especially prey. In particular, in the right context, we found that singing and memory recall of old songs and rhymes, coupled with a playful openness and a willingness to ‘give and receive’ (‘therapeutic clowning’) that never patronises or offends, but plays with concepts of narrative through-line and paradoxical connections, can have astonishing effects on patients’ mood, outlook and well-being.
We discovered further still that by carefully researching and choosing the right songs, sketches, poetry, monologues, and ‘cultural iconography’, including knowledge of fashions, attitudes, and even ‘sayings’ from the eras when our audiences were younger and healthier - even to the extent of finding out what sort of popular culture their parents and grandparents would have handed onto them as children - we had a knack for creating entirely new pieces of inspiring and intelligent work which have all these ingredients woven into their seamless fabric. Added to this is a cheeky, daring, passionately-believing style of performance that treats the material at turns with reverence and a desire for accuracy, and at other moments with an anarchy and playfulness that allows us to make pointed comments about the universality, depth and ‘understandability’ of all good, beautiful and true theatre, and its radical ability to speak across boundaries such as sickness or ‘the generation gap’ to all people at all times. But that’s just the beginning.
We found too by experience that any perceived ‘lack of understanding’ in patients with acute mental health problems is pure myth, which only the ignorant or insensitive use as their excuse for their own grotesque failure to communicate adequately, humbly or respectfully with such sufferers. We have never had this fact proven as false to us in all our years of work, despite the obvious scandal it gives to certain people who wish to see the unwell elderly only as ‘life unworthy of life’.
The overall results and feedback from our work has been phenomenal, with over 10,000 performances of 20 new works having been toured to every part of the UK and Ireland (5000 of these shows in hospital, hospices and care homes alone), and has resulted in our inventing a new high energy musical comedy/ physical theatre genre that is at once both cutting edge and re-assuringly able to speak to every type of audience in a way which temporarily re-arranges the solar system! From late night gigs at the Comedy Store to humble homeless hostels, from prisons to palaces, the results are always the same - emphatic relief that there’s still something as good as this, as different as this, as moving as this, as funny as this, as thought-provoking as this out there. In the care settings we have had ‘miracles’ galore - people walking, talking, moving, laughing, and expressing themselves understandably to the outside world, in a way that was simply inconceivable before the show started. Relatives and carers of the long-term sick have sworn to us that the shows were the high point of what had been dark days for their charges and loved ones, and we have been deeply grateful for the experience of immediacy and excitement that our art form has helped to generate not just for audiences, but for us too.
We feel, or at least we are made to feel, that we are bringing something special, priceless even, into peoples lives, where theatre really is needed most although few dare to go there - the general level of other forms of theatre or ‘entertainment’ in this field are, if available at all, woefully inadequate and notoriously weak - at best it consists of squirmingly patronising ‘pantos’ exploiting underpaid & undertrained actors, or more usually its the sad end-of-pier amatuerishness of variety acts going through the motions – its true that it can be ‘cheap as chips’ for 2 hours of bad karaoke, but it can also re-enforce a stereotype that the elderly are not worth much more than this. We at Frantic are passionate believers that older people deserve better, and we strongly feel that the level & competence of activity provision tells you everything you need to know about how an institution sees the people it was designed for, whether it values their lives and their dignity as unique individuals, or not, and we feel too that activities provision is the most obvious direct measure of whether a institution deserves the title ‘care home’, since genuine ‘caring’ and ‘homeliness’ are about having a very strong ethos and high standards in a sector where abuse scandals, poor staff training and retention, and neglect are always waiting round the next corner. All other residential institutions (e.g. military centres,boarding schools, even prisons) provide stimulating & meaningful activity as a matter of course – the only ones who think it’s an unnecessary ‘extra’ seem to be care home operators.
WHY IS THAT?
Because the elderly long-term sick are surely one of the most despised and neglected groups of people in our society, particularly if they suffer from mental illness too. It’s a sad fact that ‘old age’, frailty, mental illness, ‘dependency’, and ‘care homes’ must surely be the least media-friendly topics of our day, and consequently we have close to half a million people who, because as a society we are no longer willing or able to care for them in our own homes and families, are effectively excluded from real community. The psychological impotence this causes certainly adds to their anguish and surely makes their condition far worse.
Care homes exist first and foremost as businesses whose job is to meet the necessary day-to-day physical care needs of their patients, but they are not usually able to meet the needs of the whole person, as anyone who has visited a care home even once would see as self-evidently true, even if the carpets and wallpaper give the place an ‘expensive’ or ‘hotel’ feel. Attempts to make a ‘care home’ feel like Home for each patient is an impossibility, because the community there is not a real community but a provisional or synthetic one, which good homes will try to enrich by, for example, providing an ‘Activities Co-Ordinator’ (often a care worker or volunteer) to try to generate a programme of necessary group activity for the residents.
The success of this activity is down to three things: the attitude and insight of the person in charge (the manager or proprietor); the personality, skills and insight of the activity coordinator themselves; and finally, most revealingly of all, whether there exists a budget for such activity, since, although some activity costs little to organise, without a full range of provision including trips out, or special events ‘inhouse’, the whole impetus behind this crucial piece of community building soon falls flat, and in many cases is quietly dropped altogether to save money and hassle. From our point of view it is rare to find the same Activity Coordinator at the same home 12 months apart since the impossible job of trying to get something of substance together with little money or help (often obstructive attitudes of other staff and their rotas make any planning or spontaneity impossible) is enough to wear anyone down. Why bother spending your whole time, time which is supposed to be for the good of the residents, trying to fund-raise, when the provision of funds for such activity should be a basic human right?
The number of care homes in the UK (from our own research) who at present would even consider booking a professional specialist theatre company is only 2-3000 out of 17500, with the main reasons why most don’t do such things being because of a widespread ignorance of its huge benefits, unawareness of what’s actually possible for them or their residents, ignorant views on the nature of mental illness (yes, in care homes!), ignorant views concerning the arts generally (Philistinism), ‘no budget’ (in a place where ‘care’ costs on average £20k per year per resident and is supposed to address ‘the needs of the whole person’!), or simply dodging responsibility – its too much effort, and besides, who cares anyway.
LIVE MUSICAL THEATRE - THE BEST ACTIVITY BY FAR?
Our performances at residential care homes are a wonderful opportunity for managers to hold an event which celebrates and values all of their residents and staff, whilst bringing in the local community as if to say, “here we are, our doors are always open to you, feel free to visit us more often, especially when we hold inclusive celebrations such as this,” celebrations which act as a strong focus for what should be normal community-building. It gives each home a massive opportunity to publicise themselves, their work and their ethos, and, it provides their staff with a perfect opportunity to learn the vital task of project management, how to make the most of events such as ours, how to get residents, friends and family involved, how to get the local press on board, and more importantly how to organise events like this more often by forging links with local businesses, charities and support groups, and persuading them to sponsor shows at their site too. It’s an opportunity that is too good to miss, since most staff would never even feel empowered enough to organise such a thing off their own back, especially since they would normally be told that there would be no money for such a thing. A show by Frantic Theatre Company is a hugely exciting opportunity to think differently, to not accept that care homes need to be isolated institutions but can have a vision of caring for the whole person too, which is worth shouting about. The publicity that each individual show generates can in turn have a major impact not only on the values and ethos of a care home, but is an encouragement to other care providers to get their act together, and to start seeing the case for providing meaningful and stimulating regular activity in their homes (we repeat regular: not just for Christmas or when an inspection looms). To continue to neglect this matter is a national disgrace. There is a very strong business case for holding such events as specialist theatre shows at care homes too - not just the publicity, the staff involvement, and the good resident/staff/community relations it develops, but simple economics and investment. If as little as £5 per resident per week were invested on such activity for each home (whose annual fees are approximately £20,000 per resident) there would be a budget to do much much more, and life at each care home would improve dramatically. These events really can bring a care home closer towards the ideal of ‘home’, and help to seriously lessen the ‘them-and-us’ tensions that can quietly develop between carer and patient. And if a care home has a more enlightened or ‘happier’ feel, its reputation grows stronger locally, and it’s obvious that more people will choose a happy home with a good reputation for care for the whole person over another home which couldn’t care less.