Gold Soul Companionship

Everyone in residential care needs to have a sense of security, continuity, belonging, purpose, achievement and significance. Relationship-focused care is a way of empowering people living and working in aged care (Nolan et al 2006). Relationship focused-care emphasises seeing the aged care facility as a community where older people, staff, family and friends are valued. It contributes to improved quality of life for residents, their families and staff by strengthening communication between these key groups. Building positive relationships is a vital part of improving life in these facilities.

Intergenerational programs

Studies globally have found that students, particularly in health professions, have a negative attitude towards older people (Lovell 2006). Research investigating intergenerational programs that promote interaction between youth and residents living in aged care, as well as student placements within aged care services, highlighted the positive response between participants (Chung 2009; Kim & Lee 2018; Lokon et al 2017). These projects report promoting a sense of value and belonging for the older adults, whilst the young people expressed greater respect and appreciation for the residents, as well as developing confidence in interaction and communication (Annear et al 2017; Kim & Lee 2018; Lokon et al 2017). Of concern is that when intergenerational visits stop, the residents’ health is negatively impacted (Schulz & Hanusa 1978).

One example of an ongoing intergenerational program is to have university students living on-site in residential aged care facilities and spending time with residents. There are anecdotal examples of this model for intergenerational programs (see box at the end of the article).

The Gold Soul program

• The Gold Soul Companionship Program is introducing increased opportunity for social and occupational engagement of residents in the Scalabrini Bexley care home in Sydney, NSW by enabling undergraduate students from the Faculty of Health Sciences at the University of Sydney to live-in at the facility. Since the program began in July 2018 students have been volunteering 30 hours per month in exchange for free accommodation.Sister Maria, from Scalabrini Villages, named the program. This is the meaning behind the name:
• Gold: being generous and giving, compassionate and loving, sharing wisdom and knowledge.
• Soul: the principle of life, feeling, thought and action in human beings.
• Companionship: the enjoyment of spending time with another person.Up to four students are involved in the program at any one time. Their agreement with Scalabrini head office usually lasts between a year and 18 months. During this time the live-in students are each allocated a ‘house’ where they volunteer. They spend most of their time with specific residents, many living with dementia, but they also run and contribute to group activities. At the moment the activities that live-in students and residents share include:
• Joining residents on weekly bus trips to explore the city.
• Games and everyday group activities with residents who do not often leave the premises, eg bowling, joining them for religious rituals and events, participating in meal times, accompanying them to musical events, hosting high tea for residents and their relatives.
• Individual activities, including going for walks, watering the garden, picking flowers, or just providing companionship when someone feels lonely. There are also opportunities to share music as part of the Alive Inside program, or to enjoy playing with the in-house pet rabbit.

Angelo and Loki

Lok Yi Cheung (Loki) was among the first group of three students to join the Gold Soul Companionship Program at Scalabrini Bexley. In building a relationship with Angelo, one of the residents living with dementia, Loki had the opportunity to understand Angelo as a person, to get to know his history, personality and needs. Loki developed a personal interest in dementia after her first hospital placement and wanted to gain more exposure and insight into how this condition impacts the ageing population. These are her reflections, written before Angelo’s death in June this year:

“Angelo had his 86^th birthday in Sorrento house last October [2018]. Staff at Scalabrini love him, and even posted a comment in the home’s monthly newsletter, In The Loop, which states: “everyone wants to spend time with Angelo, he is one of the most polite and respectful true gentlemen that I have ever met“. His birthday party was attended by kitchen and catering staff, nurses, residents, and even the contractor renovating part of the premises. Through this program, I was lucky enough to get to know Angelo as the person he is now, and also had an opportunity to understand his past.

“Angelo was born in Santa Marina, a small town in Italy. He was part of a big family of 10, and came to Sydney as a young man, where he met his wife, Nina. They got married in 1972 and soon after they had their son. He was devoted to his beloved wife and son. Unfortunately, his son passed away at the age of 20. Today Angelo still thinks of his wife, his son, and his dog, Bobby, and gets tearful when we mention them.

“Angelo moved into Scalabrini Bexley in 2016. I have been exploring his hobbies and activities that give him joy and a sense of accomplishment. These include gardening, walking and dancing. At Scalabrini we have accommodated his needs with a raised garden bed. I have also involved Angelo in group activities with other residents. Bowling, especially, has encouraged him to interact with other residents and created opportunities for shared fun and joy. These rewarding experiences will benefit me in my future career as a physiotherapist.”

The program’s impact

Our students say that they love living and volunteering at Scalabrini Bexley. Living side-by-side with frail and vulnerable people is exposing the students to real-life realities and challenges faced by older adults, especially those living with dementia, on a daily basis. Live-in students also value the range of training they can engage in (eg person-centred dementia care training; a virtual dementia tour; and a ‘Seated and Safe or Active and Engaged’ workshop).

Living in an aged care facility was quite daunting for the students at first and some found the initial couple of months quite overwhelming. They observed frequent ambulance visits and residents going in and out of hospital during the day and night. Regular supervision by on-site staff and University of Sydney mentors was introduced to support students from the outset and during their journey.

Staff report that the Gold Soul Companionship program benefits all those living and working at the facility. The students are supplementing the paid workforce by spending more one-on-one time with residents and running activities on weekends. As one care manager said: “It’s good that the girls can spend extra time with the residents themselves and get to know more [about their] background… . They have the time to build special relationships”.

Scalabrini Bexley Village Manager Joseph Massih is very impressed with the commitment of the live-in students. He commented specifically on Tanveer, the latest addition to the team: “It was really inspiring seeing Tanveer join the Gold Soul program and hit the ground running. In less than two months she was able to build an amazing connection with…a non-English speaking resident from a Russian background. Tanveer has brought back some quality of life for this lovely lady despite all the language barriers.”

Relatives are also appreciating this new addition to the services at Scalabrini. Wellness Coordinator Tracey Gill received an email from a family member who stated: “I am contacting you at my mother’s request. She has greatly enjoyed the company of one of the live-in trainee/volunteers there, called Gabrielle. Gabrielle visited her in the past and took her outside around the garden…being wheelchair-bound it was a highlight of her day.”

Staff are delighted by what they see, especially for those residents who do not recognise people they know. One lady living with dementia does not interact with people, but a care manager shared that when Hannah, the live-in student who spends time with her on regular basis, approaches her, “she seems to recognise…her. Which is good. She actually lights up and smiles, which is great!”

Conclusion

Creating collective living communities that include younger adults could contribute to maintaining and/or expanding meaningful engagement of older residents, especially those who are living with dementia. It is low cost and potentially sustainable.

This pilot program is currently being evaluated by the project team. An oral presentation on preliminary findings was delivered at the Australian Occupational Therapy Conference (Angelou et al 2019). We hope that other organisations might offer similar opportunities to create connections between young people and residents.

Sanetta du Toit is a Senior Lecturer in the Faculty of Health Sciences, Discipline of Occupational Therapy, University of Sydney (USYD); Lok Yi Cheung is an undergraduate student in the Faculty of Health Sciences, Discipline of Physiotherapy, USYD; Kylie Angelou is an Honours student in the Faculty of Health Sciences, Discipline of Occupational Therapy at USYD; at the time of writing, Colin McDonnell was Dementia Excellence Practice Lead at Scalabrini Villages; and Lee-Fay Low is Associate Professor in Ageing and Health, in the Faculty of Health Sciences, USYD. To follow up on this article, contact Sanetta at sanet.dutoit@sydney.edu.au