Knowing You Matter

Can compassion be taught?

begethers — Tue, 21 Feb 2012 19:18:12 +0000

It has been quite a day.

It was very good to see compassion in nursing feature so heavily on BBC breakfast and to have the chance to take part in a live studio discussion on the issues raised when we think about nurses and the extent to which their compassion is reliably present in their care giving.

Thank you to BBC breakfast and to BBC Radio Wales for picking up the story and inviting me to take part in a compassion specific phone in – more on this here

Thanks to NESTA and The Observer for vision in identifying Britain’s New Radicals – proud to be connected to such innovative and passionate people – more here

Thank you to Charlotte Ashton for her interest and research which has led to these stories and a growing conversation. See BBC on line features on compassion here and on social enterprise here

As I said when asked today I am not sure that we need to teach compassion – my assumption is that nurses want to be kind and want to show the care that (for the vast majority) bought them into the profession. Are leaders creating the conditions for compassion to be expressed so that patient care is continuously improving and staff are full of confidence and energy?

I suspect most leaders in the NHS have other ‘more pressing’ issues at the front of their minds and that they too need support to develop more healthy and reflective cultures.

The twitter response to a day exploring compassion ‘coaching’ has been interesting with responses ranging from the extremely abusive to the completely inspired – the subject has certainly got people talking.

My hope is that the nurses in Essex have been the catalyst for an important debate which will result in some deep changes in nurse education, integrated health and social care practice and the leadership style in the NHS and other care giving environments.

The compassion programme is working in everyday practice – that seems reason enough to feel a sense of urgency to invite more nurses and leaders to join in. When we feel vulnerable we all need to recieve compassion and kindness. It is a tragedy when nurses lose their way and the care they feel is not shown in the way they behave – for them and the nursing profession but most of all for the patients and their families who are on the receiving end of care that is lacking compassion and can even be cruel and apparently heartless.

I have three full days of travel and compassion training ahead of me and it has been a very long few days so I will sign off now – but not before posing a question that I plan to explore here and elsewhere:-

To what extent will the proposed reforms in health and social care create and sustain consistently compassionate care?

Please feel free to comment or to begin a conversation with us about compassion.

Warm wishes

Andy

Compassion is good for you

begethers — Fri, 28 Oct 2011 20:32:00 +0000

The research is clear - showing compassion boosts your immune system. We are hard wired to be good to each other, to meet suffering with kindness and vulnerability with strength. Compassion is never more that a breath away. Compassion requires a gentle invitation and a warm welcome.

We are inspired by the nurses and healthcare assistants we are privileged to work with – they are accepting the call to compassion and they are allowing their hearts to be involved in their care giving. Suffering is transformed.

Celebrate care giving; elevate the status of compassionate care – what are we here for, if not to care for each other.

Your thoughts and feelings on compassion matter

warmest heartfelt wishes

Andy

Can compassion be created and sustained?

begethers — Thu, 13 Oct 2011 17:25:13 +0000

The CQC report into the care of older people in hospitals has got the attention of the press – newspaper headlines and radio phone ins – all appalled and some seeking to understand the root causes of the problem. The causes are complex.

But what of the solution?

Lets start by assuming that nurses are good – that they want to show deep care for patients.

Imagine a moment in future when you are in hospital needing care – and a nurse is walking towards you….what quality do you hope they will have?

How reliably is the quality you thought of present in the care currently given?

The solution is to close the gap. Ask nurses to be the quality they wish to see. Appreciate them when they offer this quality.

Ask them this question:-

What do you think and feel about the care you give?

and then listen. Awareness brings change.

Every nurse and care worker could have a goal for improving their care giving.

That is worth managing and measuring.

And celebrating.

A compassionate health service can be created and sustained – we have just been going about it the wrong way. Compassion can only come from the inside out.

What quality do you want when you need care?

warmest wishes

Andy

Abuse, riots and loneliness

begethers — Thu, 18 Aug 2011 07:37:42 +0000

Thanks to the generosity of a friend and colleague I was fortunate enough to spend the week of the riots in southern France. We were all blissfully unaware of the chaos and fear bought about by the riots. It has been an interesting experience to catch up on the news and witness the reactionary nature of the commentary.

The people we saw being abused at Winterbourne View and the perpertrators of the abuse, the people who die lonely and afraid in some of our care homes and hospitals and (some) of the ‘rioters’ have something in common; their lives seem not to matter.

As we have seen and felt this phenomenon is dangerous – if you feel that your life doesnt matter, then nor do your actions – you will choose to withdraw (which many do) or (eventually) you will lash out.

People who are routinely not listened to and who feel that they have nothing to contribute are at great risk of harming themselves and others – it seems to me that alongside the inevitable public outcry and need for punishment we are being given an opportunity to deepen our awareness of the healing power of listening and compassion.

There are people within our midst who live out their days in loneliness, fear, boredom and isolation, unloved and without hope – some are very young, some are very old.

Our education and health and social care systems would do well to place listening and the cultivation of a more compassionate approach at their heart; uniting around the practice of giving caring attention to each other may mean that the lives of the people who have been abused, injured who have lost their livelihoods or even their lives in the recent disturbing events may have a legacy that means something better for all of us.

We are all capable of being both good and bad.

Your own reflections as always are very welcome

warmest

Andy

The Four Energies and Dementia

begethers — Sun, 03 Jul 2011 08:56:38 +0000

For now this will be a little post about what I sense will become a big subject for us.

Thanks to Alister Scott, my friend and collaborator of One Leadership for first bringing this way of seeing the world to my attention (and thanks to Chris Barez-Brown for the image I just found online – this is VERY strange indeed as Chris was my best friend for a while at school and we haven’t spoken for years).

Anyway, why is this thinking relevant to people who have dementia?

Lets imagine I have dementia, how should you be with me to let me know that I matter?

The answer to this question will of course depend entirely on me as an individual but some clues i think:-

Be with me in the here and now. It may be that my mental (cognitive) energy begins to fail me so i suggest you tune into the other energies….so you might…

Dance with me (physical)

Be with me in nature, noticing and appreciating (spiritual)

Use gentle touch to reassure and validate me (emotional)

When we learn to be with a person with dementia in the here and now, a kind of awareness shift happens and the person with dementia becomes the teacher and we become their student. A student of now. Life always happens now but those of us whose energies are out of balance believe we are our thoughts and so are over cognitive, meaning our four energies will be out of balance.

I’m off to walk the dogs now in the woods. I will listen for the bird song and smile – in this way I find I don’t ‘think too much’!

A comment on your energies and your sense of the here and now would be recieved with joy.

warmest

Andy

Role Models for a Compassionate Culture in Essex

begethers — Sun, 03 Jul 2011 07:40:52 +0000

The first day of the ‘Everyone Matters’ project at Essex University on the 30th of June bought together 19 compassionate people who were seen as role models in the places where they work for the North Essex Partnership NHS Foundation Trust. Thank you all for an inspiring day.

We started with the question we now always begin with:-

Why?

why do you care, why do you do the job you do, and we all listened to each others stories and passion for figuring out how to give the most consitently compassionate care.

Lindsey – it is personal for me

Julie – it is about the here and now

Lynn – i do care deeply

Kim – customer service, moments of truth, i love the job

Jill – to observe, has the person lost something?

Beverley – dedicated and compassionate

Russell – a compassionate person, known since school

Lee – listening to families, they are the experts

Denise – youngest of eight, family gave me essence of compassion and compassionate skills

David – always been an OT without knowing; how can i help?

Preerna – a passion for the physical side of people who have mental problems

Simon – a naturally kind mother taught me about a ‘state of acceptance’

Maria – mum made me cut my neighbours toe nails – made me come and now I love it!

Sebastian – i am interested, motivated and open

Olivia – my mum said why don’t you try it – my passion is dementia

Zoe – i want to help, changed me as a person

Carol – it is interesting, rewarding, working with families

Priscilla – elders are inspirational, it is my love and my passion

Sharon – always compassionate and caring, love sport…best of both worlds, the care and the physical

Imagine a moment in the future when you no longer provide the care as you now require it. There is a care worker coming towards you, what quality do you hope they will have? Here is what this amazing group of people said:-

Look at Me; Kindness in Approach; Eye contact and listening; Treat me with respect; Privacy and the least interference; Listening in the moment; Calm, reassuring and inviting body language; Acknowledged; Time; Understanding; A genuine smile; Clear personal explanation; See me; See beyond what i am saying; Caring approach; Ask my permission; A natural smile which shows the person wants to be there.

We thought about power and relationships and the ‘distancing effect’ in which care can be cold, authoriatarian or overprotective. We all want the qualities above which we call SOLIDARITY.

A bit of an aha moment – we must………

NAME IT (the unhelpful way of caring) – THEN CHANGE IT (to a compassionate way)

How can people change and bring compassion if they are not first made aware?

This was a day to remember. The time by the lake thinking about how we know we matter will stay with me as i witnessed people in pairs listening to each other with a quiet mind and an open heart.

The leaders of this work understand that breaking old habits is complex and takes time and effort; cultivating new compassionate habits can then begin.

A wonderful start – a wholehearted thank you!

Please add your comments, they always mean a lot.

Andy

Wise Women of Oxford follow the signs to compassionate care

begethers — Wed, 29 Jun 2011 19:58:02 +0000

Just back from facilitating ‘Can compassionate care be guaranteed?’ seminar with 17 passionate and thoughtful women in Oxford. I am noticing that women are often at the forefront of making deep changes which place compassion at the heart of the caring relationships. I guess this is unsurprising as women are very often the homemakers who embody love and compassion as mothers.

We explored the question:-

What can be done to create and sustain consistently compassionate cultures in care?

….and this was the output from the wise women:-

Take personal responsibility and stop blaming others

Create a less task focused environment

Bring the best out of people

Ask the residents what they would like to see happen

Keep myself healthy

Support team

Listen to each other

Make the vision happen

Stop assuming that people think the way they do

Challenge people’s thinking

Appreciate the little things

Do as you say

Find out about the person behind the resident

Join forces

Explain what you are thanking somebody for

Include families

We worked using the ‘thinking differently’ method which meant the women exchanged undivided attention, explored the transformative question and practiced giving explicit and heart felt appreciation.

My friend and colleague Jackie Hume Richardson should have been there to facilitate, making it a room full of compassionate women but very unfortunately Jackie had a nasty accident yesterday so I had to step in at short notice. Jackie is recovering well so look out for opportunities to meet her at future seminars.

We imagine joining forces with these wise women to bring a more consitently compassionate approach to caring environments in and around Oxford.

We love to receive your comments about compassion or any aspect of care.

with thanks

Andy

Advocates for People with Dementia

begethers — Sun, 26 Jun 2011 15:47:03 +0000

I spent a very interesting and stimulating day with the Dementia Advocacy Network last week as I had been asked to facilitate a day of thinking about ‘non instructed advocacy’. For the uninitiated this means strengthening the voices and rights of people with dementia who may not have asked for the input of an advocate or who may find it difficult to articulate their views.

There are complex ethical issues around the mandate to advocate for people in these circumstances (which are explored as part of a more in depth training course) but the feeling in the network was that advocates must rise to the challenge of finding ways to work alongside people who are most at risk of being marginalized and excluded.

During the day we explored power in care homes with the common need for a shift away from unequal and controlling relationships to a respectful and compassionate way of caring. We explored some of the approaches non instructed advocates can take and generated questions which are frequently asked by families and professionals. Our ‘hot seat’ method enabled members of the group to practice their responses and to receive feedback in a safe space.

We worked together using the ‘Thinking Differently’ method which meant there were several opportunities for focused listening in pairs and the day ended with appreciation.

My own appreciation goes to the network members who came and to Jan Kendall, the network co-ordinator who does a really outstanding job of supporting dementia advocates to share perspectives and experiences and to develop their practice.

We are working with Jan to offer our two day course on non insturcted advocacy in the autumn. Please let us know if you would like to attend this course.

I am pleased to have been asked to speak on the subject of ‘Undivided Attention’ at the IMCA conference in Birmingham on the 18th and 19th of July. The undivided attention of an advocate in certain circumstances can transform the life chances of a person with dementia.

Please feel free to add your comment if you were at the network meeting or to share your thoughts on the role of advocates in the lives of people with dementia.

Many thanks

Andy

What quality in your carer will you most value?

begethers — Tue, 21 Jun 2011 06:24:23 +0000

Many of us will need care from people who are paid in the future.

Imagine a moment when your carer is walking towards you.

You are hoping in that moment that your carer will be a certain way, will have a certain quality.

What quality do you hope they will have?

Mine is warmth (smiles and sparkly eyes would show this warmth)

Our challenge is to create a future where the qualities we want are consistently present.

Share the quality you hope for by clicking below to add a comment.

Many thanks

Andy

For National Carers Week – The noble way of the carer

begethers — Wed, 15 Jun 2011 10:09:29 +0000

What more important work is there than to care for someone you love – unconditional love in action.

‘Till death do us part’

‘In sickness and in health’

The love we feel for a new born child that we know will last forever.

I am writing to thank and honour every carer and to suggest that the experiences gained of what it takes to care should be elevated and act as a catalyst for a deep change of culture in the way care is provided in our care homes and hospitals.

Caring for some becomes a way of life. What more important way of life exists than to care for someone you love.

My respect, admiration and appreciation is sent to every carer today and every day.

Please feel free to share on this blog what being a carer means to you.

with heart

Andy