CASE STUDY

PREPARING VOLUNTEERS TO ENGAGE WITH RESIDENTS WITH

DEMENTIA

Background
One of the three care homes that we are working with is a residential care
home that specialises in dementia. They accommodate 20 long term
residents and have 4 beds for short term or respite care, specialising in
dementia. They also have one 8- bed wing designated for Intermediate
Care. While the other two care homes are not specialist units, the
residents have significant support needs, of which dementia is often a
factor.

Issue(s) we faced
Volunteers unfamiliar with a care home setting do not always realise the
above. During the initial visits to all three care homes, we realised that
volunteering in this setting may place the volunteer in situations that they
were unfamiliar with and that they could possibly find daunting or at
least more challenging that they might have expected.
This made us consider the importance of explaining and preparing
volunteers for this during the initial volunteer recruitment and selection
process. We wanted to give volunteers as much information about the
residents needs and volunteering role as possible.
As always with volunteering, selection is a two way process we have to
decide if the volunteers are suitable for the role (including taking
references, DBS checks and so on) - but volunteers also have to decide
whether it is the right choice for them. Unlike recruitment for a job where
its a competitive process with a cut-off date, its a more like a pathway
where the volunteer, the Volunteer Centre, the care home and the
residents get to know each other better and explore whether they want to
work together. So the initial recruitment, interview, screening, training
and induction and visits/taster sessions are all part of this journey.

What we did

Recruitment

The Volunteer Centre has a high profile locally and we used our preexisting networks and communication channels to recruit volunteers for
example the do-it.org volunteering website, our volunteering e-bulletin,
CVS newsletter, local press and advice sessions at the Volunteer Centre. In
relation to the local press, we had a better response with publicity linked
to forthcoming volunteer training dates rather than just a general request
for volunteers (it seems to prompt people to respond immediately).
We also advertised within the care homes themselves (so that families,
friends and visitors were aware of the project), distributed leaflets and
displayed posters in local residential areas around the care homes, wrote
to parents at a school near to one of the care homes, and joined forces
with a Volunteer Centre in another district which was very close to one of
the care homes and which had a more active local presence.
First impressions

When volunteers attend their first volunteering interview we have open

and thorough discussions about volunteering particularly for those going
in to the specialist Dementia Care unit. We found that this really helped,
as some volunteers would explain that they had personal experience of
dementia. For example, they may have family members with dementia.
Some volunteers would disclose that they felt slightly nervous as they
didnt have experience of meeting people with dementia. This didnt
necessarily put them off wanting to volunteer there, but they felt that they
may need some support.
In some cases, volunteers decided this setting would be too much for
them, in which case we would help them find alternative volunteering
(this avoids wasting their time and the care homes before they get too far
into the screening and training process).
Training

The training that is delivered for this volunteering role plays a key part
during this period of time as well and forms an important part of the
selection process on both sides. It also clarifies the nature and boundaries
of the role from the very beginning, as well as exploring potential difficult
situations using discussion and role play. Some volunteers have decided
not to proceed any further and again, it is helpful to know this early on.
I was invited to attend training workshops, which were highly
informative and really gave a sense of what the volunteering
entailed. I learnt a lot about what the role was and what we could
and could not do.
We have found it particularly helpful when one of the Care Home staff was
able to attend the training (although it has not always been possible for
them to commit the time).
Introduction to the care home

Crucial to successful engagement of new volunteers is the support

provided by care home staff. Having a welcoming and supportive first
impression makes a big difference.
I was given a thorough tour around the care home and was
introduced to some of the residents who I turned out to see regularly.
The lady who showed me around also told me a bit about each of the
residents, which was very helpful as it gave me ideas about what to
talk to the residents about. The staff were very friendly, I felt
welcome from the start and it was made very clear that they were
very grateful for as much or as little time I could spend there.
We also ensure that a member of staff from the Volunteer Centre is
present with the Volunteer for their initial visit to the Care Home. At this
point we have got to know the volunteer, so it allows us to pick up
whether they have any worries or concerns and to offer support or
reassurance if needed.

What went well and why

Support from existing volunteers

Now that we are a year into the project, one thing that is very helpful is
that existing volunteers are willing to have a new volunteer shadowing
them at first. New and experienced volunteers are also given
opportunities to meet and gain peer support at training sessions and
volunteer meetings. This allows the new recruits to learn and gain
support from more experienced volunteers.
Taster sessions

Some volunteers have taken up the opportunity to try out (supervised,

one-off) taster sessions with residents where appropriate. This has been
particularly useful where volunteers had an idea about an activity or
interest they could share with residents, if we werent sure whether it
would be suitable or interesting to them.

A group of Young Rotarians (aged 16/17) from a local school took in

old photographs of the town and encouraged residents to share
their knowledge and memories. The residents were stimulated by
and enjoyed this very much (although it was during their GCSE year
so despite some initial enthusiasm none of the young people went
on to commit to longer term volunteering).
A small group of volunteers went in to offer a digital art session
however this turned out to be beyond the capacity of most of the
residents (useful learning for us)
A volunteer went and did a talk on his travels to different countries,
with copies of photographs for the residents to keep. This went well
and he has visited all 3 care homes more than once to talk on
different topics.

A volunteer organised a music quiz for residents (quote below)

again the activity was too complicated, but they did enjoy and
respond to the music, so the volunteer is now offering sessions
where he goes in and plays different kinds of music.
I was asked if I would do a quiz for the residents. It wasnt until I
actually arrived and started to set up my music system, that I
realised I would not be able to do a picture quiz and the music quiz
which would normally involve writing the answers. [The care home
manager] suggested that I play the music only and ask them the
questions, and rely on verbal answering.
I have never had much contact with elderly people, none at all really,
apart from my parents and in-laws, and they werent at the same
level as the residents here.
So I started, played the first tune and moved on. By the fourth tune
three or four people had come in with answers and others were
making piano style motions on their tables. From that point it
seemed quite a few were really enjoying it. You can tell.
Towards the end of the evening, by this time it was 7.15pm, long past
the original half an hour, one lady was dancing around the tables with
the help of the staff.
7.30pm and I said thats it for the evening, and there was an
audible oh no. All in all, I was really pleased with the evening. I
really got a buzz from seeing their reaction.

Be realistic about the commitment

Over the months we have gathered feedback from the volunteers. One of
the items that stands out is that volunteers feel they cope best with this
role if they set a time limit of how long they want to spend. For some, they
have found that an hour and a half is just right.
Interacting with the residents can sometimes be quite challenging
because of their dementia, and they still ask me things I have
answered a hundred times before, but a little bit of patience goes a
long way! Despite their forgetfulness, the residents are still very wise
and have definitely taught me a thing or two. I have found the whole
experience extremely rewarding and I am so glad that I got involved
because I have met some truly admirable people. I would strongly
encourage anyone with a bit of spare time to get involved, because I
have really enjoyed myself so far.

What could have gone better and why

In retrospect, it would have been useful to have spent more time
preparing care homes in a practical way for the arrival of volunteers and
for their role as day-to-day volunteer supervisors. This impacts
particularly on front line staff (the care home managers/owners were on

board and so we assumed that other staff would be). They need to
understand why volunteers are there, feel positive about their arrival and
be prepared for the impact on their time. Most of them were new to this
kind of role and so there were some misunderstandings early on.
For example, concerns that volunteers were there to watch them; or not
understanding the boundaries of the role and so asking volunteers to stay
longer than agreed or help with personal care. We were very focussed on
the recruitment and preparation of volunteers less so on the preparation
of those working with them.
As the relationship has developed we have realised how important it is to
have input and feedback from the care home staff from their perspective,
as this kind of setting is new to us. They helped us to understand the
importance of considering factors such as:

Does the volunteer have a basic understanding of dementia?

An understanding about different styles of communicating, for
example, non-verbal, physical communication. Getting past
preconceptions of how humans communicate
Is the volunteer aware that they may have conversations that dont
appear to make sense in the traditional way? For example past and
present events may be mixed up.
Is the volunteer aware that they may have the same conversation
several times over?
Need to reassure the volunteers that they will have ongoing support
and someone to talk to about their volunteering experience as this
can be a challenging yet incredibly rewarding role.

In response to this a Volunteer Centre staff member has been trained to

run Alzheimers Society Dementia Friends information sessions, offered to
all care home volunteers. They give a basic understanding of and
empathy with the experience of dementia and what they can do to help.
These have gone really well, with all those attending becoming an
Alzheimers society Dementia Friend. Volunteers in the dementia unit
can also access further (staff) training through the county council (which
manages the care home).
We also began with the assumption that we would be matching up
individual volunteers and residents in a similar way to a befriending
scheme. However, given the setting and the high support needs of
residents, we realised that this needed to be a much more organic
process, where volunteers begin by helping with or chatting to a variety of
residents, and allowing 1:1 relationships to develop over time. This also
allows for fluctuations in an individual residents mood, energy levels or
health or accommodate their need for quite short interactions sometimes
rather than the pressure of a volunteer expecting to spend a fixed amount
of time with one individual. We have found that befriending relationships
do develop naturally after a while, with a volunteer regularly spending
time with the same few residents with whom they find a rapport.

Outcomes and impact

The Dementia Friends sessions have been very positively received by
volunteers as preparing them for how to relate to and communicate with
people with dementia:
I just wanted to say thank you for an insight into the above. The
analogy between the bookcase and memory loss was very simplistic
but something that people can relate to. I told my husband this and
will try and explain it to my friends when I meet them. Many of
whom have had someone in their family with dementia.
Trying to understand from a person who has dementia's point of view
obviously is not easy. I think more and more people will be
interested as it has been highlighted in the media and more and
more families will have someone who has the disease. My father had
Parkinson's and dementia and was in [residential care] for a while
with about 20 other people and I can now understand their actions
better as some of them were doing various things and I now realise
through the lady you mentioned who was tapping out Morse code
messages, that they were doing something that related to their past.
It was enlightening and for me to see other volunteers was great.
There have also been positive outcomes for volunteers and residents.
While the recruitment/screening/induction process may seem surprisingly
drawn out, it does mean that those who complete the journey are properly
prepared, minimising drop- out rates. Not all potential volunteers who
register with the project do end up as active volunteers but those who
complete the process have generally made a long term commitment and
stayed with the project as volunteers. This minimises care home staff
time invested in the process and also minimises disruption to residents
from volunteer turnover.
Although I did feel nervous at first, after a few visits I really started to
enjoy myself. Over summer I spent at least a couple of hours there
every week, which usually involved just sitting and talking with the
residents, going for walks in the gardens, making the odd cup of tea
and sometimes playing cards and board games.
I feel like I really got to know the residents especially a couple of
my favourites and found it extremely heart-warming when some
started to remember my name and look really happy to see me. It is
so rewarding thinking that you probably made that persons day
simply by sitting and chatting with them for a few minutes, especially
to those who dont get many visitors.