Go into most care homes and you will see a familiar array of staff, from carers to chefs, housekeepers to maintenance personnel. A role you will also often encounter is that of an ‘activity coordinator’. All of my dad’s three care homes had activity coordinators, all of whom were women and some clearly more suited to the role than others.
In essence an activity coordinator is charged with ensuring that everyone living in the care home gets to do activities that they want to do and enjoy doing. The scope for those activities is largely dictated to by budget, with some care homes having extensive ‘activity’ programmes that include trips out and even holidays, while others literally scrape around to find pens and paper for residents who want to draw.
Whilst I am the first person to advocate that people living in care homes should have opportunities to engage in ‘activity’, I am not a fan of the ‘activity coordinator’ role. Why? Because in my view activity is everyone’s business.
By creating a role in a care home that is centred around activity, everyone else working in the care home automatically defaults to that individual for anything related to activity. This is seen with other roles, where everyone goes to the chef for matters relating to food, and everyone goes to the maintenance person if something needs fixing.
The other reason I’m not a fan of this role is that activity is about everything that happens in the day, from the moment you get up to the moment you go to bed. Given that people living in a care home spend most of their day with care staff, it is vital that care staff recognise that everything they do to support that person is, in itself, an activity.
By taking this approach, it is then much easier for care staff to appreciate the need to support the person to do as much as possible, thus retaining maximum independence, rather than just automatically doing everything for them and effectively de-skilling them and taking over their life.
Making a cup of tea, having a shower, getting dressed – these are all activities, just as much as bingo and singing groups. And they can all be expanded upon to go beyond the purely functional. So, for example, making a cup of tea could be about doing it ‘the old fashioned way’ with loose leaf tea and a tea pot, sparking a reminiscence session. Having a shower could become a full on pampering session, with some gentle exfoliation of hard skin, a massage with body lotion afterwards or a full-on salon-style blow dry. Getting dressed could be about coordinating colours and outfits, dressing up or dressing down, and might even lead onto a mending session if clothing needs some TLC.
Throughout any of these ‘activities’ songs could be sung, conversation could flow, laughter could be triggered and memories could be drawn upon and mulled over. The problem is, if your care home has an activity coordinator, he or she is unlikely to be involved in these ‘care’ related activities, and thus these daily occurrences just become bland tasks for the care workforce to ‘get through’.
In my consultancy work with care providers, I look at the structure of the workforce in a care home, who is responsible for what, how those responsibilities are carried out, and whether there is, in fact, a better way of approaching how the care home operates. A huge focus for me is how holistic a care home can become, which in practice means frontline staff taking on a more fluid role that responds to the individual needs of the people living in the care home and treats every interaction as an opportunity to create a special moment with that person.
It is irrelevant if those moments will be remembered, and the fact that they might not is no reason not to create them. There is often a belief that group ‘activity’ sessions are more memorable, but actually as a person’s dementia advances, it is often the one-to-one time spent doing something very simple and very familiar, like eating, drinking, folding laundry or making the bed that enhances wellbeing and quality of life more.
Persuading staff to be creative and expressive whilst providing this type of essential support is often very challenging; many would much rather just default to the activity coordinator when conversation and interaction is needed. But care staff who approach their work with an emphasis on both supporting the person and creating an activity out of everything they do generally have much more job satisfaction.
So what would I suggest care providers do with their activity coordinators? By all means turn them into event managers, charged with creating those important community experiences in the care home, and indeed helping people living in the care home to get out and about. If they are great communicators and creative types (which they certainly should be!), then utilise that to show other staff how to communicate more effectively and be creative in their support.
Encourage all of your staff to show off their talents – you may have some real gems who can play instruments or sing beautifully, people who are good at needlework, crafts, gardening, cooking or DIY. Support them to bring those talents into their job, whatever their ‘official’ role is meant to be. And likewise with your residents and relatives – find out what talents they have and how they might express those for individual benefit or the greater good.
The best care homes do this seamlessly, because they appreciate that activity is everyone’s business and they facilitate that way of working. It may mean staff allocations need to change or rotas need to be adjusted. It may mean that someone in one role is actually much more suited to something else. It will almost certainly need training, mentoring and monitoring, but ultimately you will have created a care home far closer to what a home truly is, and what living a life in a care home and working in one should represent.