An Australian Elder Story

This was told to me by Russell Elm, who I met at Eden Associate Training in Melbourne, Australia. He was from a facility in Queensland and shared a great story about their work shed and an Elder named Doug.

I knew that Doug had spent his entire life in mechanics, machinery and maintenance. Doug was having a pretty hard time adjusting to his new life in our aged care facility. A man's man, he was now surrounded almost entirely by women, caregivers and residents alike. So I thought Doug might enjoy becoming part of our maintenance 'team' now and again.

"Would you like a cuppa tea?' I asked Doug. "If so, come on down to our workshed."

"No, I don't want a cup," Doug replied in an irritated tone of voice.

"Well, would you like to come down the shed, anyway?"

"No, I don't want to come down to the bloody shed!"

"We're all blokes down at the shed, you know," I said.


Here's a picture of the blokes' shed.

Finally, after many invitations, Doug showed up at the shed. It took him ages to get down there with his walker. But once there though, we invited him to sit down and have cup of tea.

"No, I told you, I don't want a bloody cup of tea."

But it was obvious he enjoyed his visit and we showed him around. Took him out back where the guys hang out and have a smoke and talk. I could tell he was interested.

As he took his leave, I asked him again to come back for tea anytime.

"I'll bring the biscuits [Australian for cookies]," he said.

"You don't need to, there are usually plenty here," I started to say...

And then it dawned on me, and I quickly changed my reply in midstream.

"Please, bring the bikkies, Doug, and we'll supply the tea," I managed to say.

"Great, see you soon," he smiled as he waved good-bye.

Russell finished his story at our training. "And of course, that was it, Principle #4 of the Eden Alternative. We all, including the Elders we care for (like Doug), need to be able to give care as well as receive care. Otherwise, we feel off-balance, like we're a burden to others. So, somehow, we have to figure out ways to create the right climate where the residents are giving to us, giving to the community and giving to each other. And we need that care, too. It really made me feel good that Doug wanted to visit us, and wanted to treat us to biscuits."

I love the affectionate way that Australians talk. They often shorten words and end them with 'ie', like 'bikkies' for biscuits, 'ressies' for residents', 'barbie' for barbeque. They also create fun descriptive words out of common things. For example, 'sausage sizzles' for bratwurst and 'fairy fluff' for cotton candy. I found a great "glossary" of Australian colloquialisms online, Click here to browse through it. It would be great if we put a little more fun and affection into our English!

Interview with the MacKenzies

My interview, a very informal and enjoyable one, is with part of the MacKenzie family, owners of Aged Care Services Group in Australia. Dawn MacKenzie and two of her three daughters talked with me over dinner at their home in Melbourne.

Dawn: Peter was a plumbing teacher, I was a nurse. We were disillusioned about working for other people.  We owned our house, we had 3 young kids, two good jobs, we wanted to take a challenge.  Our own business that we could shape around a mission.  We thought about child care but it was too regulated we thought (see how little we knew?).

We wondered if we could find a way to make a difference in the world.  We looked at a plumbing business but the building trade was too up and down. Someone said, Dawn, with your nursing knowledge, why not care for elders?

We were inexperienced, and people told us that no one would take us on because of the capital investment.  We looked for two years, until this landlord said he’d take us on, because I was a nurse and he could tell we were good people.

It was a 44 bed unfunded low care facility. We put everything we owned into it and moved in with the girls, living on the premises.  

We literally each worked 100 hours a week. We lived on the premises, Peter kept his job. I would start at 6 in the morning. We employed people, did the marketing, and the cleaning and the caring. Our family moved into the little two bedroom flat. The girls were 9, 8 and 7.   They moved out of their house where they had their own rooms, and they lived and played alongside us as we worked with the elders. They only had one grandparent, and they fell in love with the residents.  We worked all through the day and I would do the night calls during the night. We did that day and night 7 days a week. We knew, even then, that we wanted it to be home. We knew it shouldn’t be institutional.

The girls grew up with old people, it was their life.  Sometimes I would feel like they were missing out, not having their parents all to themselves in the evenings. Sarah would bring home her reader, and read to the residents while I was working.  Their friends would come over after school or for sleepovers.  

Kate:  I was 9 and I remember I loved to have tea parties with the residents. But instead of tiny tea dishes and pretend, my tea parties were real.  There was one resident, Stella, we all loved her so much.  I remember when she was dying. For days, if you couldn’t find mum, you knew she was in Room 316 with Stella.  

Dawn:  The girls could do supper with the residents. They knew what everybody liked to eat and they sat and talked with the residents. Sarah has spent her whole life in Aged Care except for two years when she was 16 – 18 and she decided to work in retail.  She broke away to become her own person, but then she came back when she was 18 and trained as a personal caregiver.

From the time they were little they set the breakfast trays at the end of the day.  They heard the calls in the night, they heard me getting up to answer them.  

I remember that one mother said to Sarah, "How are you going in the nursing home? Your parents must be very busy." "Yeah, they work a lot," she replied.  "How do you like it when you see your mom and dad there instead of spending time with you?"  Sarah replied, "I pretty well bring up myself!"  My guilt as a mother was heavy when I heard that story!   It’s true, they would come home with their  school bags and they had to put the school notices under my nose for me to see what I had to sign.  They had to be responsible very early. They grew up with old people and it was their life. I feel there was a lot of things that they missed out on that other kids got, kids who had doting parents in the evenings.   

Sarah:  But there was so much more that we had that other kids never knew.   I remember Roy, he couldn’t talk and it seemed to result in him being alone more.  And I knew he always had time for me.  So, that’s where you could find me, getting all his attention!  He and I became good friends.  He would say ‘doy, doy doy’ and smile, I’d laugh, and he’d laugh.   I’d make jokes and he loved it.  I remember friends coming over after school saying that the residents scared them. I just couldn’t understand that.

Dawn:  As much as its been Peter’s and my journey, it’s been their journey too, now for 18 years.

Our whole family worked every Christmas Day so that staff could have the day off. We’d do breakfast and then morning tea, and dishes.  We’d prepare a special day for the "ressies" [an affectionate Australian term for residents].  We worked every Christmas from the time Sarah was 8 til she was 20.   The first year we stayed home for Christmas, we didn’t know what to do.  The kids rang to see if we could work in a soup kitchen, or go visiting in the hospital. They couldn’t imagine Christmas with just family.  

Sarah:  Christmas is about helping other people.  It was just what we always knew.

I’d hear other kids complain about having to do the dishes at home. You know, putting the dishes into the dishwasher after supper. I’d think, "Oh, poor thing, you should see my dishwasher."

If you wanted some vegemite after school, go in the pantry and get it. Only it was in a 4 liter container! Everything was grand scale. You kinda got used to it.   

But there were built-in rewards too!  I remember my 8th birthday was before the residents moved in.  We had a sleepover. We had this whole big building to hide in, all night to run around. We took mattresses and piled them up and climbed up and slept, and jumped up and down. No one else had a home where they could do that!

Dawn and Peter own the Aged Care Service Group, a Melbourne based company that operates care facilities in Melbourne (Eden Terrace and Ashley Terrace) and on Bribie Island in Queensland (Eden on Bribie).  Find out more about them by visiting http://www.acsg.net.au/.

Culture Change Workshop: Dutchcare

I learned so much with this wonderful team of formal and informal leaders of an aged care facility.   Petra Neeleman, the CEO, had kindly educated me a bit before the workshop, as we’re all students of the culture of aging. I think you’ll enjoy reading a few excerpts from facts Petra pulled together. I've put her comments in the standard grey and mine in this black so you can tell which is which.

The Dutch Experience in Victoria

Although there have been Dutch migrants in Australia since the early 19th century it is not until 1950 that Australia adopted the slogan "populate or perish". The Netherlands encouraged its citizens to consider migration following the Second World War, with fears of overcrowding and another war with Russia.  As a result, there are about 85000 Dutch in Australia.

The Dutch have settled in many countries around the world and always melded themselves around the local communities.  We were known  as the "invisible Dutch". We quickly learned the language and the customs and looked like Anglo-Celtics.   We did not stick together or even stay in the cities. We were here to build a new life.

We left behind loved ones, family, friends, familiarity, and a society full of traditions, history and a warmth and sense of belonging we call gezelligheid.

Our community in Victoria stayed in touch through the Dutch clubs which organised balls, dances, card and film nights and of course St Nicholaas events for the kids.  But generally speaking this reached only about 20% of the Dutch in Victoria, the rest often content to be away from their country-folk.  The Dutch clubs formed an association and it was this group who would later take the lead in looking at our aged care issues.

Dutch here in Victoria are an aged community. The Dutch population clearly shows a peak at those born in 1955-59.  This 45-49 years group  is actually in the youngest 25% of our population.

Dutch specific services best suit the Dutch aged.  English language loss and language reversal is high among older migrants. Research shows that anyone learning a second language after the age of 12 can revert to their first language in times of stress or illness or simply as a result of the aging process.  I cannot stress the importance of language in providing care. Without a means of communication there is no point in living and many ethnic elders are doomed to being classified as difficult and with inappropriate behaviours when they are merely trying to communicate.

So how are we different? The Dutch word – gezelligheid – (cosiness, atmosphere, sharing, and company) was an important building block. People wanted the choice of communicating in either Dutch or English. They wanted traditional meals, the Dutch level of cleanliness that included vacuuming under furniture and washing windows. They wanted to share their last years reminiscing with others that understood the trauma of the wars in the Netherlands and the migration experience. To share with those who knew what it was like to leave your parents to follow your husband in his dream and now that he is no longer there, having to stay in what you have always called your new land but not your home because you cannot leave your children and your homeland has become alien to you.

DutchCare emphasizes providing ethnic specific services to the Dutch.  Staff, residents and volunteers generally speak Dutch to each other.  Dutch meals are cooked, Dutch games are played, Dutch music is listened to, and generally the recipients are more Dutch than those left behind in the Netherlands of the 1950’s.

Wow!  It makes me want to get in touch with my Polish heritage!  How many people here in the US are being cared for by people they can not communicate with.  What are we doing to communicate with frail elders who have reverted to a language that we can not speak?  Email me and let me know.  

My childhood memories of my grandma were of a quiet shadow, rocking in the kitchen, but (thank God) still baking the most delicious raisin bread.  She had reverted to speaking Polish, but to speed up our assimilation we had been raised to speak only English.   But at least she felt safe and loved and so did we. I can still smell that bread – I only wish I had the recipe.

Here’s a little more from Dutchcare – what they’re achieving in their aged care community.  In Australia, and at Dutchcare, they have high care and low care.  As you might guess, high care is like our skilled nursing homes, low care is assisted living.  At Dutchcare they are very serious about the Eden Alternative – here’s what their staff shared about their journey:

We’re doing a lot to change the culture here.  Our residents now have more choices. They can sleep in and stay up as late as they want, they have choices of what to eat, where to eat. If they want to share with someone else in another room, that’s okay too.  Staff will ask, when they get somebody up out of bed, "would you like a tea or coffee?" They can sit in their pajamas and sip a cup while watching Dutch news on satellite, and then come to breakfast when they’re ready.



We have permanent staffing, and the staff know the residents they work with.   Staff share their own stories, too. And, you can be sure, there’s lots of wise advice for them.  If you don’t have babysitter, just bring them in. We started it very informally and now we even have a school holiday program.  We all share roles, even if we work in the office.  We have crossed boundaries everywhere.  Many of our homemakers (cross of housekeepers and dietary) are PCAs as well.  It’s a home, and if you’re at home you do a lot of things, don’t you? You’re doing multiple tasks all the time.  I like helping people get out of bed, and having a laugh or giggle.

The residents too.  Many of them look to help in lots of ways.  Residents help with the cleaning of the bird cage, set the table, help each other.  We have one guy who constantly helps set the table.   He has a good idea of when people are going to come down for breakfast and gets their table ready, he anticipates their needs.  He can still get out and loves to shop for others.  People are always giving him their lists.  
                
Read more about Dutchcare, their philosophy and stories, by clicking here.

Beginning a New Journey..

Welcome to a new blog!  I can’t believe that here I am, an almost old woman, (got my AARP card) - and I am choosing to do such a wild thing as posting a blog!  And on such a subject: old, old, old (I wonder where that word comes from).

And, it came to me: this is what is needed - or rather, this is what I need to do - get the word out about ‘old’.  All the way from Senior to Elder, but particularly focusing on the frail and all that surrounds them. I want to be gutsy enough to talk about the ugly things. Nursing homes, being scared and alone at home, reading the obits to see if any friends have died, worrying that you’re a burden.

But most of all about the beautiful things. My mother-in-law (at some point I have to tell you about Marian) born in 1898 and truly my best friend, a friendship that continues as strong as ever deep in my soul, 12 years after her death.  I want to make this a place where we could honor our Elders, share our wonderful stories of them, talk of the Elders who have made THE difference in our lives.

And then, the caregivers. We have to talk about and with the caregivers, to discover what it is that makes it possible for them to continue day after day, giving and loving as they do.

And so, here is what I propose: since I practically live on the road anyway, traveling at least 45 weeks a year, what if I continue to visit nursing homes and to talk with Elders, caregivers, loving families?  I’ll just begin to collect and share all the great stories I hear.  

I’m going to have a few regular features: elder stories, interviews (with whomever will talk to me), pictures of people and places.  I want to share innovations, build excitement about shaping better care solutions.  I even want to share overheard conversations (from conference presentations and hallways.

And hopefully all of this will provoke emails, emotional and thoughtful, that I’ll sometimes share with my readers.

So, let’s get started. Come along with me to Australia (where they have old people, too!)