The kindness of strangers

MISTRESS OF MOVEMENT: Faye Harbottle dances for residents and guests at Kingswood, Matamata.
MISTRESS OF MOVEMENT: Faye Harbottle dances for residents and guests at Kingswood, Matamata.

Faye Harbottle does a farewell dance for us as we prepare to leave. She moves fluidly to the music, graceful, practised, even a swish of the hips and an accompanying playful smile. Her grey hair is pinned neatly in a bun, she is slim, elegant, entirely the mistress of movement.

Faye attends the day programme at Matamata's Kingswood Rest Home, and that's where we are this Tuesday. Faye's been a dance instructor in Matamata for decades. It shows in her unscripted and unexpectedly poignant farewell. Other residents and staff hush their talking, watch her and clap when she finishes.

A few minutes earlier, everyone's been dancing and singing in the big lounge, belting out old favourites - You Are My Sunshine, World War I classics It's a Long Way to Tipperary and Pack Up Your Troubles.

A woman in a lilac tracksuit hugs me as she sings, asking "Did you know that all these lovely songs are coming back in again?"

It's the hour before lunch at Kingswood, a 25-bed dementia care rest home, and staff and residents are wearing quirky hats, milling around with music and games, partly organised, partly spontaneous. You feel the warmth - from the midday sun and the happiness of residents and staff.

Eileen Brierley has lived at Kingswood for six months. She has a gentle smile and says: "It's lovely here. The staff are the backbone of the place."

We're visiting Kingswood for the second part of our series on rest home care, looking for the positive experiences that largely go unreported in the media. Rest homes mostly make the news when there are complaints against them, as happened recently in theWaikato Times when 12 rest homes were named in complaints (seven substantiated).

People with families in care know, though, that mostly these facilities do a very sound job, often in challenging circumstances. So today the Kingswood staff, who run a rural town facility, and the manager of a large Hamilton dementia facility, talk to us about how they operate.

We start with Kingswood and the obvious pleasure of the activities session. And lest the cynics think this may be a colourful show for the media, they should listen to Katherine Ransom. She's visiting Kingswood this morning to see her mother, Betty Ransom, who has been a resident since May last year. Katherine lives locally; she visits Kingswood often.

Katherine and her husband cared for Betty themselves when she became unwell, and it wasn't easy. Katherine says she was close to crisis point when "just at the right moment", Kingswood had a space for Betty. She went into respite care and stayed permanently.

"It's a hard road," says Katherine, "and I'm so grateful I don't have to do it by myself any more. Everybody who works here knows how to manage people and keep them happy. Nobody here is mean to her, they all like her, they have strategies to help her. The staff are trained to recognise what needs to be done. It is fabulous.

"All I want is that she is happy. If that means someone else looking after her to achieve that, that's good. I couldn't keep her happy and occupied and busy at home."

Kingswood, Katherine adds, will carry on the quality and its fame will grow.

The Kingswood way is to make the rest home a better place for everyone: for residents, their families, and the staff. It is family-owned and operated and the compassionate care of vulnerable people drives what they do. General manager Tonya Holroyd is a shareholder, her sister Tammy Pienaar and brother-in-law Rocco Pienaar are directors.

Tammy says they're happy to have the media and the auditors visit Kingswood at any time. They are proud of what they do, their door is always open. She's also open about what it is like to have a complaint issued against them, which happened when a disgruntled former employee made an allegation about Kingswood.

There was a spot investigation by the Waikato District Health Board, the complaint was unsubstantiated. It was among those reported last month in the Waikato Times. It was upsetting for Kingswood, but staff felt completely exonerated.

The Holroyd/Pienaar family links here go back seven years, when Tonya Holroyd came to work at the facility after arriving from South Africa, where she'd been in private hospital administration. When the rest home was offered for sale three years ago, Tonya became concerned about what might happen to the residents and staff if maybe it had to close. She got together with Tammy and Rocco, they bought it, renamed it Kingswood.

"We fell into it by accident," Tammy says. "Tonya has such a huge passion for it." They've expanded: a year ago, they took over an existing rest home in Morrinsville, they renovated it, turned it into a Kingswood, and more recently they've added Kingswood Oakdale in Cambridge.

Tonya says they want to change the way the elderly are cared for, and they practise the Spark of Life philosophy, developed by world-renowned dementia specialist Jane Verity, founder and president of Dementia Care Australia.

Spark of Life is based on ensuring every resident has a happy and loving environment to live in, where staff are supportive partners rather than caregivers. The strength of Spark of Life strategies, the Kingswood leaders say, lies not in what you do but how you do it, not what you say, but how you say it.

It is about staff gaining genuine understanding of how things are for their residents, their viewpoint, engaging compassionately with them, boosting their self-confidence, strengthening their identity.

It pervades everything they do at Kingswood, starting when staff get residents out of bed in the morning. Instead of maybe just heading them straight to the bathroom, they talk cheerfully, address them by name, tell them it's sunny or rainy outside, ask how they slept.

A lighthearted atmosphere continues through the day. There is dancing, dress-ups, pet therapy, games, gardening, art, involvement in daily household chores, outings, everything designed to make residents happy, less institutionalised, more at home. At close of play, there's a goodnight kiss as residents settle into bed for the night.

Senior registered nurse Stella McGuire, 25, has worked at Kingswood for two years. She loves the Spark of Life philosophy, the vision, the creative environment, seeing people respond. "On Sunday nights, I'm excited about coming to work [the next day]. I love it here." She has determined her future course in nursing: "I wouldn't leave this sector."

Tonya Holroyd and Tammy Pienaar echo their resident Eileen Brierley, saying their staff are the backbone of their business - they are good at what they do, they absolutely get what is required at Kingswood, and they undertake studies in dementia care.

At the funeral a while back for a longtime resident, the family ended up comforting upset staff. "Families come here because of our staff," Tonya says.

When we're talking about staff, it raises the often-discussed national issue of low pay rates for rest home carers. Tammy says Kingswood would like to pay more, but they are governed by what they receive from the Government. New staff start on the minimum wage if they have no experience, but experienced staff and those who have been at Kingswood for a while are way off that mark.

Kasey Sutherland, 21, has been at Kingswood for five years, she's part of the Kingswood family and last year was awarded the title of "caregiver of the year". Her motivation is straightforward: "I love the staff and residents."

Caregiver Irene has been there for 14 years. "There's not a day when I don't like coming to work."

Irene says while the pay rates may not be great compared with some other jobs, it's not all about the money. "If you're doing it for the money, you shouldn't be here."

"I love what I do, I love the residents, they've got so many stories to tell. How would you not like this job?"

A driana Ciolpan comes at rest home care from a different place, a bigger, more challenging place from Kasey Sutherland, Tonya Holroyd and Tammy Pienaar. But the basics are the same. "I've always wanted to advocate for the most vulnerable, those who can't speak for themselves."

She is facility manager of Rossendale Dementia Care Home & Hospital in Hamilton, owned by the global Bupa group. It is a 100-bed site encompassing a specialised hospital, dementia rest home, and a day-care unit with 10 places. There are 115 staff.

I wrote about Rossendale last week from a personal perspective of its being where my husband, Bill, who has a neurological illness, now lives.

Today I'm talking to the boss lady about how she runs it. Again, lest anyone think Adriana is courting the media here, I must say that I visit Rossendale almost every day, at different hours, and see first hand how she and her staff practise what she's talking about.

Adriana, 37, is Romanian. She trained as a nurse and gained a law degree in her home country. She has two sons, she came to New Zealand in 2003, didn't speak English, didn't intend to stay. She loved the landscape, the environment, decided to create a new life here.

She worked first as a caregiver, learned English, gained her nursing registration, worked with children with high-need disabilities, studied for a post-graduate diploma in management at Waikato University, and moved into dementia care at Rossendale. Last year she won a Waikato Times Make a Difference Award, in the category of individuals/teams who shine in whatever role they are in. Rossendale also gained a teams award.

Dementia care is challenging nursing, she says. Not everyone can do it. It has become her vocation because she likes giving quality of life to people with such illnesses. She wants to see her residents comfortable, pain-free, loved and well cared for until the end of their life.

"We can't change their illness, but we can make it better through quality. They need a lot of love. They feel very lost. They can be scared and lonely. They need touch, hugs, constant reassurance.

"It is a highly emotional job. We are dealing with families who are grieving, residents who are confused or frightened - they all need a lot of support."

Adriana spends time with families, explaining what dementia is. She is always honest that it is a terminal illness. She encourages families to see her at any time. Their support is important, she says. They help staff get to know new residents, help them improve their care. "They have vital information we need."

Recruiting good staff is also important. They are trusted with the care of truly vulnerable people. She doesn't necessarily look for a lot of experience - that can be learned - or a thick CV.

"I look for empathy, for a non-reactive person, someone who can observe and respond but not retaliate. I have to have peace of mind that the person on the floor looks after the residents like I would my own parents. Or I wouldn't sleep at night. I say to staff, think that this is your parent. You have to have your heart in it."

She praises her team, is grateful to them. Like the owners of Kingswood in Matamata, she says they are the backbone of her facility. Most of them work at Rossendale because they love their patients, she says. "The first foundation is empathy and love for people. Then they need to build good knowledge, to understand the illness."

She says Rossendale has a well-established education system, including compulsory training for staff in dementia care, and there is opportunity to gain qualifications beyond the minimum.

Staff discuss goals and performance, they celebrate successes, they have a monthly lunch, they talk about things that go wrong, they find solutions and try not to go there again.

"There are always things to improve on. It is never perfect. It's not about the same size fits all - it can never be that."

Adriana thinks they're doing a good job; it is a team effort from nurses and caregivers, as well as kitchen, laundry and maintenance staff. Everybody involved needs to understand the illness.

Of the people in her care, she says: "It's not about us and them. This is a home. We are all here together."

The last word for this story comes from Katherine Ransom, of Matamata, daughter of Kingswood resident Betty, who utters the wishes/hopes of all families who have someone in care.

"I love my mother and I know I haven't given her to someone who doesn't love her."