mailout creative care in Cornwall 28


FEATURE Photo ©Jenny Atkinson Breaking


the Cultural Paradigm


Nicky Puttick on Creative Care in Cornwall


Arts for Health Cornwall and Isles of Scilly (AFHC) has been working with care settings across Cornwall over the last four years to incorporate meaningful creative activities into what is available for older people in care.


Before our projects began, we carried out a survey of care settings and community hospitals within Cornwall to get an idea of the activity levels of older people in care (for any kind of activity, including, Bingo, exercises and cooking as well as more creative activities). Just 14% of the care settings that responded carried out any kind of activity more than once per week, and a staggering 22% of respondents never ran activities of any description.


This would seem to match up to our common preconceptions about care homes, most of us tend to consider them depressing waiting rooms full of tired, frail people. We wanted to understand why this was happening and how the arts might contribute to changing this.


We asked respondents about the limitations they associated with running creative activities. The vast majority reported that funding and staffing levels were the biggest obstacles to running more activities, as were staffing knowledge and confidence. All respondents asked for help and support in running more creative activity sessions.


With this as our starting point, we commenced a programme of projects within selected care settings … and developed training and support for care staff interested in running creative activity sessions. If the project was to be sustainable, getting care staff on board and inspired from the start would be key.


Our team of creative practitioners led creative sessions within each setting, with the aims of both improving the wellbeing of older people in care, and raising aspirations by demonstrating what is possible to care staff and managers.


This ‘Demonstrating what is possible’ has been key to the success of our projects in helping to transform the culture within care settings. A carefully planned and led creative activity session often occurs as an anomaly within the routines of a care home.


In care environments, there is often a strong unspoken culture, based on a set of well-established assumptions. We can call this a cultural paradigm. Thomas Kuhn in his book ‘The structure of scientific revolutions’ wrote about paradigms as being “prerequisite to perception itself … what a man sees depends both upon what he looks at and also what his previous experience has taught him to see.”


Cultural paradigms are like identities; they are so much a part of us that it is extremely difficult to become aware of them, and even harder to change them.


The old cultural paradigm of care for older people seemed to include unconscious assumptions such as: > Older people in care do not need to live fulfilling lives in the same way as younger people.


> Older people in care are too old and fragile to have any talents or create anything worthwhile or


beautiful.


> Older people in care can only be entertained if they remain passive observers.


> Older people in care do not need to talk to other people (research has revealed that a person in a residential home can receive as little as two minutes of verbal engagement with another person a day).


> There is no point in maintaining the independence of older people in care, since they will pass away soon anyway.


> It is acceptable for care homes for older people to be run as businesses with far less legislation about quality of life than care homes for other types of people.


> Care staff and older people in care are separate types of people, and will not have anything in common.


It should be reiterated here that these are cultural, not personal assumptions; the unseen foundations of a failing care system.


Kuhn argued that the key to changing paradigms and letting go of old assumptions is to introduce anomalies –realities that the old paradigm cannot explain. Over time these lead people to lose faith in the old paradigm, as they know that another ‘reality’ is possible.


Meaningful creative activity sessions can serve as the perfect anomalies to the old paradigm of care described above, as well as having a profound effect upon the health and wellbeing of older people in care.


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