But how can busy staff draw stories from elders, many with cognitive deficits much
greater than Wilfred's friend, Miss Nancy?
The Community Learning Circle is one way.
Action Pact Executive Leader LaVrene Norton designed learning circles in the 1980s to
spark involvement by all stakeholders, including frail residents, in changing the culture
of long-term care. With everyone given opportunity and encouragement to speak without
interruption or judgment, even the most shy and inarticulate contribute to decision-making,
and a sense of community emerges.
Inspired by late dementia researcher Dr. Thomas Kitwood, Action Pact's Megan Hannan
has modified Norton's model to better accommodate the cognitively impaired. (8)
The model often yields astounding results:
"The lady is crazy," thought Linda Frey, Nursing Director, when Hannan suggested
residents from the Meadowlark Hills Nursing Home Special Care Area join in an evening
Community Learning Circle with staff and family members.
Included were those with the most severe cognitive deficits. Their "behavioral
management problems" normally escalated during evening hours, so Frey feared they would
disrupt the meeting and gain nothing from the experience.
She was in for a big surprise.
"I was totally delighted with everything.. it was incredible.. when we started talking
and including [residents] in the conversation, they all shared," says Frey.
Residents were well-behaved as staff and family members escorted them to their seats in
the circle. The facilitator welcomed everyone and asked a resident to start the group off
with a song, My Darlin' Clementine, its lyrics so familiar even elders
suffering from severe memory loss sang along.
Next, the facilitator asked each to tell something about themselves: What's a story
about you, Mary, what's important to you?
Some needed family members or staff to help tell their stories:
"She likes to eat chicken and greens, she likes to talk, and she likes money," a
caregiver answered, looking at Mary.
A few residents responded only with gestures and facial expressions, all the while
basking in the glow of attention as they heard their names spoken and their stories told.
Family members smiled and workers' mouths went agape at what they heard from elders who
until then seldom spoke coherently: tales of childrearing, growing up on the farm, former
careers and lovers, even possible sightings of the gangster, John Dillinger.
Household pets roamed freely, providing a pleasant diversion when the conversation
ebbed. Eventually, the facilitator engaged everyone in the circle.
As residents began to tire, they ended the circle by singing another familiar song.
The experience proved residents are capable of much more than employees have come to
expect, and can function in a social model if given encouragement, says Frey.
"If we had learning circles say, twice a day, over time it may really change life for
those residents.. I'm very excited about that," she concludes. (9)
