Making Relational Care Work for Older People
A new book making an important contribution to improving the every day lives of older people.
Making Relational Care Work for Older People: Exploring innovation and best practice in everyday life by Jenny Kartupelis (Routledge, 2021) is reviewed by Julia Burton-Jones, our Anna Chaplaincy Church Lead:
‘Jenny Kartupelis will be a familiar name to many involved in Anna Chaplaincy, not least because she recently completed an independent audit of our work and is currently writing reports for BRF drawing from both her audit and our 2020 survey of the Anna Chaplaincy Network.
Over recent years Jenny has spent much time as a researcher alongside older people, listening to their stories and observing their experiences in a variety of settings. In 2018 she published a Jessica Kingsley book with James Woodward entitled Developing a Relational Model of Care for Older People, and in 2015 and 2016 published articles on spiritual life in homes for older people in Working with Older People and Journal for the Study of Spirituality.
Her new book considers what “relational care” looks like in practice, by exploring innovative models of care and support. Relational, or relationship-centred, care has been an increasing focus of researchers in the field of dementia care especially in recent years. It builds on concepts of person-centred care. What does it mean to offer support ways that prioritise relationships? In her introductory chapters, Jenny explores how relational approaches enable older people to flourish because human beings are programmed to derive meaning and purpose primarily through relationship with others. She makes a strong case also for spiritual care, drawing from the work of James Woodward, Albert Jewell and Donald and Harriet Mowat.
Relational care is enabled by creating a care home community which feels like “family”, by emphasising reciprocal relationships where older people are able to give and receive, by mealtime experiences which foster warmth and connection, by intergenerational relationships, and much else besides.
There are fascinating chapters looking at how care teams can be built through networks of trusting relationships, and loneliness minimised, both within residential settings and home care. Prioritising relationships in ways of working not only benefits older people, it also enables care workers to discover greater job satisfaction.
It was encouraging in chapter four to read of care homes adopting Montessori principles to allow older people to contribute as fully as they can to their communities, with relationships built on give and take; this is done through retraining the brain so individuals can restart doing simple tasks where skills have been lost, drawing on long-term (procedural) memories of how to do things. A care home environment might look quite different if it provides the tools for residents to engage in practical tasks – a care home manager describes this as “organised mess”, rather than a tidy but disempowering environment.
Another heart-warming area of innovation described in chapter four is intergenerational work in care home settings Nightingale House in London and Wren Hall in Nottinghamshire. Embedding a nursery in a care home has potential gains for children and residents. For residents, spending time with children brings “affirmative interactions” cognitive stimulation and improved coordination, balance and strength. It also brings many benefits for children, including improved social and verbal skills. It is noted that these advantages are maximised when relationships are built over time, as opposed to occasional contact between the children and older people.
There is a chapter in the book entitled “Technology – Friend or Foe” written by Loraine Morley which explores the extent to which new technologies can help relationships. This is highly relevant during a pandemic which has prevented face-to-face contact with friends and family for many older people.
In the concluding chapter of the book, the many challenges in establishing relational models of care are outlined, not least the difficulties in measuring relationships and funding obstacles. The book ends on a rallying cry that care services be enabled to adopt relational care; policymakers must “listen to the voices of older people and their carers and start to shift resource towards positively funding and encouraging the factors that underpin good relational care, whereby all involved can thrive” (page 142).
Though this is an academic book in the field of gerontology, its messages resonate for all with a concern for the wellbeing of older people. Putting relationships at the heart of care and support services is surely a goal to which Anna Chaplaincy aspires in offering spiritual care.’
This title can be ordered from Routledge. Get a discount on this book by entering a discount code SSB20.