About Moving Forward with Grief
Multi-disciplinary artist Helen Keenan facilitated drawing and movement classes for residents at Esker Lodge Nursing Home in Cavan. These were aimed at engaging the mind, body and spirit for processing emotions around dying, death, grief and loss. Individual sessions were hosted separately for people living with a diagnosis of Alzheimer’s and their relatives.
Encouraging Conversations on Dying, Death, Grief and Loss in Nursing Homes
Group sessions were initially tightly structured around a mix of conversation, drawing, and movement. Each one began with an invitation to talk about experiences of dying, death, grief and loss. Residents would then draw something on paper that represented how they were feeling. This was followed by movement and music designed to engage the nervous system into releasing any pent-up emotions and tensions stored in the body.
However, as Helen admitted, she was slightly taken aback by just how eager residents were to engage on a subject which, for most people, is one they tend to avoid.
“On our first day, the residents were asked to talk about somebody, or multiple people, that was a significant bereavement in their life. I really wasn’t expecting the level of sharing that happened. Children that have died, siblings that have died, and the death of a parent came up a lot. To hear people in their 70s, 80s, and 90s talking about their parents — it's really touching and at the same time heart-wrenching. But this act of being heard is so very important. To be heard, to be seen and to know that their stories matter and that their loss matters is huge.”
As the weeks went by, sessions gradually relaxed into focussing more on movement and simply allowing conversations to rise-up naturally, thereby fulfilling the ‘moving forward with grief’ ambition of this project. As Activities Coordinator Maria Cereijo told us:
“Grief and loss are natural elements of life and work in residential care settings. Helen’s willingness to address such issues creatively was most welcome and has greatly benefited our whole community – residents, staff, and relatives.”
Engaging with People Living with an Alzheimer’s Diagnosis
In separate one-to-one sessions, Helen used music and photographs supplied by a relative for engaging with people living with a diagnosis of Alzheimer’s. These proved hugely beneficial, not only for residents, but for relatives who wanted to learn how to do this for themselves. That said, as Helen cautions, navigating ways for engaging with people living with a diagnosis of Alzheimer’s can be fraught with disappointment, and often depends on the day that’s in it and how the resident is feeling.
“Music and photographs are a great way in when maybe conversation, as we might usually converse, is no longer possible. Sometimes it just takes a particular song or photo to spark something, to trigger a memory. However, with Alzheimer’s, this may or may not happen. But what's really beautiful, is they can blow you away by suddenly deciding to join in and then you're seeing them move in a way you haven't done before.”
Enhancing Compassionate Care in Nursing Homes
These classes were conducted in conjunction with Caru, a continuous learning programme for care and compassion at end of life in nursing homes. Alison McMahon, Caru Regional Lead, visited the project and told us:
"Caru delivers training workshops for nursing home staff. One includes training on conducting bereavement reflections for staff and loved ones. We also support quality improvement initiatives proposals. The idea is that Caru is supporting good practice — and there's lots of good practice in nursing homes already — and finding little things that maybe could be done better and helping staff turn ideas for this into a reality.
“Everybody wants to know how to grieve. We can't tell people how to grieve, everyone grieves differently, but just offer ideas and concepts that can help frame and channel this experience. Helen’s classes are a great example of this.”
Prompted by a question posed by a relative, Helen asked us to include some direction on how to care for and respond to loved ones living with an Alzheimer’s diagnosis who might be re-visiting past memories on a loop, particularly traumatic ones. The Alzheimer Society of Ireland have plenty of excellent guidance available to read about caring for a loved one living with an Alzheimer’s diagnosis.
Background
In conjunction with Caru (a continuous learning programme for care and compassion at end of life in nursing homes), Irish Hospice Foundation (IHF) awarded Seed Grants to six projects around Ireland to focus on creative exploration and responses to grief and loss in nursing homes.
These projects are aligned with Caru’s ambition for quality improvement in the culture of care. The focus is on the whole nursing home community — residents, staff, owners, relatives, kinship groups, and friends. These projects are being documented and evaluated throughout to demonstrate how creative work can mitigate the impact of the myriad of griefs and losses associated with nursing homes. These range from loss of home, pets, relatives, possessions, privacy, independence, friends (both old and new), to planning one’s own end of life, and everything in between. And for staff – enduing the inevitable loss of residents. Learn more about our 2024 Seed Grant Projects on Arts in Residential Care.
About Caru
Caru is an initiative of Irish Hospice Foundation (IHF) in partnership with All Ireland Institute of Hospice & Palliative Care (AIIHPC) and the Health Services Executive (HSE). Learn more at Caru.ie.
About Esker Lodge Nursing Home
Esker Lodge is based near Cavan Town and is home for 70 residents. It provides independently accredited, innovative cognitive impairment specific care in an environment developed in line with best practice dementia design principles. Learn more about Esker Lodge.
About the Artist: Helen Keenan
Helen Keenan is a multidisciplinary artist focusing on dance and drama with holistic movement. She has a significant community-based practice nationally and is experienced in engaging with persons who are cognitively impaired.
