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To truly promote a culture of gentleness one must apply it to all relationships in their life.

The nature of  the job at Creative Options Regina inspires  its employees to “take their work home with them”. It is my view that an ideal support at COR nourishes a culture of gentleness  in all facets of their life, not just when they’re on the clock at COR. Personally, I maintain a culture of gentleness in my life by applying gentle teaching principles to everyday relationships, and by persistent self development.

I firmly believe that gentle teaching is a mindset that one sees the world through. Although I feel that the pillars of gentle teaching are innate to me, there are always ways to improve and broaden ones understanding. Reading books about neuro-science and psychology has given me a much better understanding of myself, and hence others around me. I’ve learnt that you cannot truly understand others if you do not know yourself. The nature of my degree at the U of R has also contributed to my self growth at COR. The main objective of the inclusive education classes that I have taken is to provide people with intellectual disabilities the means  they need to succeed; many of these skills transfer over to my work at COR. Lastly, and most importantly, to improve my ability to create a culture of gentleness, I work on myself through introspection. For me it is as simple as writing thoughts, new knowledge, and questions down in a journal. This allows me to organize my thoughts and be able to focus on what is important when I am supporting.

As I mentioned above, to truly promote a culture of gentleness one must apply it to all relationships in their life. Naturally I apply what I have learned from gentle teaching trainings in my everyday interactions with the man I support, however, I am proud to say that I take my work home with me. I have used GT techniques to navigate my way through my relationships with family and friends. My relationship with my loved ones is one specific example where GT techniques have dramatically impacted my life. This way of life has enabled me to help a loved one through depression at a time when I was at a loss for what to do. I went from being just another person in their life, to being their mentor.

Personally I maintain a culture of gentleness in my life by applying gentle teaching

Upon doing my internship last fall at a community school, I quickly realized that the school setting was also a place where gentle teaching has great value. Being a community school, many of the students attending came from “rough homes”. My knowledge from COR enabled me to form meaningful relationships with my students. They were excited to come to school, and so was I. Being at school was home for many of the kids that I taught; I was the only stable adult in their lives. Were it not for gentle teaching I likely would have just been “another adult” to these students and squandered the opportunity to be a positive influence in their lives. Yet, with gentle teaching, I found I was being my candid self in front of the class, staying after school on my time to talk with the kids, and attending their events that they were passionate about such as sports, band and drama. I was completely invested in their lives.

The last facet of my life (and where it all started) where I promote a culture of gentleness is my relationship with the man I support. I often wonder whether he promotes a culture of gentleness in my life or I do his. Either way, I love the guy to death. He has been in my life for two years and he has become a brother to me. I’ve seen our relationship evolve from an awkward “get to know you” stage, to now, where we crack jokes and laugh our butts off. I feel like I can do and say anything at this point in the game with him. I trust him wholeheartedly and that trust is reciprocated. When he is upset I tackle his problems head on, I want him to be bigger than his fears and anxieties. I push him to be the best person that he can be. In any situation the end choice is always his; but you can bet that I’m challenging him improve the whole time. His growth in the past two years is astounding, it has been an absolute joy to watch him progress from one milestone to the next. In his life I switch between the roles of being his friend, family member, and motivator; it is a responsibility that I do not take lightly. My role in his life is ever changing as he becomes more independent, I promote a culture of gentleness in his life by actively listening and evaluating him, thereby providing the most effective support that he needs to succeed.

Creating and maintaining a culture of gentleness strictly within the individual I serve is a flawed mentality. To truly be an agent of gentleness one has to apply it to every area of their life. In doing this, I have found that each circle in my life feeds off of one another. Instead of feeling drained after a day with the students, I feel energetic and fulfilled, ready to support, and vice versa. At this point in my life I know one thing to be wholly true: My career will revolve around being in the “people business”. Gentle Teaching has proven to be a significant influence on me throughout day to day life in the early stages of my career. Without it I cannot say that I would be enjoying the successes that I am experiencing today.

 

Matt, COR Support

 

Who am I to come into this person’s home with demands and unrealistic expectations?

I consistently strive to build and maintain a culture of gentleness among the individuals I support and spend time with. When I am in someone’s home I try to put myself in their shoes. Who am I to come into this person’s home with demands and unrealistic expectations? Trying to be mindful of what I say/how I say it and how I present myself to the person receiving support is always at the forefront of my thoughts. By using the four tools (presence, eyes, hands, and words) positively, I continually try to build on the relationships I share with the individuals I serve.

I continually try to build on the relationships I share with the individuals I serve

Ensuring that person feels safe where they are and who they’re with is an important first step. Afterwards is the point at which the person can begin to be stretched and grow. Remembering that the relationship I have with the person I’m supporting is one of interdependence, allows me to teach as well as learn. This is an attitude that I attempt to maintain both within COR with the individuals being supported as well as in my other social circles.

 

Jordan, COR Support

 

Who The Other Is: Human Vulnerabilities and Gifts

Who the other is: HUMAN VULNERABILITIES AND GIFTS

Caregivers have to be very tuned into the life-story of the person and the significance and impact of inner vulnerabilities; we must also be astute at seeing or even sensing the life-giving gifts of each person such as forgiveness, curiosity, hope, and the slightest hints of a hunger to connect with others.

Vulnerabilities can be caused by a sorrowful, often undefined, vague, but morally defining, memories of years of segregation, loneliness, scorn, institutionalization, racism, sexual abuse, societal prejudice, illiteracy, poverty, imprisonment, neglect, war, dictatorship, torture, the loss of family members, political isolation, and poor health care. These experiences and often vague and ill-defined memories can be worsened by our lack of attunement or empathy for these conditions, ignoring their long-term effects, or taking a “lift yourself up by your bootstraps” attitude. Internal vulnerabilities can come from psychiatric conditions such as schizophrenia, manic-depression, depression or the often condescendingly cited “borderline” personality.  Caregivers frequently fail to recognize or understand the hidden power of past memories and the end result is comments such as knowing better, being manipulative, or attention seeking.

They can be made more difficult by physical disabilities such as seizures, sensory disorders, or the side effects of medications. The presence of developmental disabilities can make it more difficult for the person to defend self and reach out to others.

Each person is a unique expression of the human condition

Our human strengths and weaknesses are shared with those whom we serve. Each person is a unique expression of the human condition. Some are more troubled or burdened than others, but we all share the common thread of humanity. Within this fragile thread lie the values that bind us together. In our own personal lives, these vulnerabilities can arise at any time and threaten our well-being.

The question is to what degree does any individual need support when threatened by these and other forces. We need to recognize each person’s vulnerabilities and find ways to reach out to those who are more threatened. They are more than persons with vulnerabilities, mental illness, or behavior problems. They are full human beings with a range of gifts and vulnerabilities, a deep inner life that beseeches and long ago our attention, and longings that call for fulfillment.

While recognizing the need for teaching functional skills, our central caregiving role must focus on teaching each person to feel safe with us and loved by us. Although professional measurement tools to define the degree or absence of functional behaviors can play a useful secondary role in care giving, if the central developmental milestone of feeling safe and loved is not achieved, then any further discussion can be fairly shallow. If the center of the human condition has not been achieved or has been broken, the rest of learning is merely peripheral. If we can help form the center, skills will blossom. The assessment of our companion or becoming-companion is based on the assumption that we must focus on the center and then the periphery will take care of itself.

John J. McGee

The Caring Moment

In the beginning we must always be in the moment with two bits of knowledge focused on giving a feeling of being safe and loved. We should avoid lengthy case histories and cleanly typed plans. If need be, do these requirements. However, our task is to be in the moment; it is not to change anyone’s behavior, but to teach the person to feel safe with us and loved by us.

The present is a series of moments that tumble into the future. Yet, we should not worry about the future, only the present moment. The here-and-now becomes the future with each ticking second. Our encounters transpire in the moment and then transform the next moment.

The-joy-is-in-the-moments

Whether a mother, father, grandparent, or a person whom we are supporting, the most important variable is the moment, not the future, not a projected plan with outcomes, not behavioral change. No, it is our being present in this very moment and all the person sees, hears, touches, and feels in this mutual coming together. It is the tiniest amount of time, perhaps two or three seconds. Then, these moments are linked together with other moments and it is these moments that become new moments; it is the evolving chain of moments that creates our moral memory in us as well as a memory in the other person.

Caregiving’s simplification involves teaching caregivers to be in the moment:

  • In bad moments this equates with forgiveness rather than control;
  • In all the good moments this involves a series of accidental and intentional encounters throughout the day focused on safe and loved;
  • The accidental encounters are merely brief moments of passing by and encompass a wave, a wink, a smile, a name, a thumbs up, maybe a hug if there is time, a whispering of “You are so good.”
  • The intentional encounters are a bit more planned and involve a chunk of caregiving time—from a minute or two or a half hour or more. The time depends. It should be structured in the day with the only purpose being to give a memory that the person is safe when with us.
  • The key is to stay in the moment. Joy is found in the moment.

Our task is simple, just being in the moment with the gift of helping the person to feel safe and loved:

  • Not a moment before,
  • Not a moment after,
  • Just in the now.”

-John J. McGee, PhD

Psychology of Interdependence

“Regardless of the type of aggression, self-injury or withdrawal, we assume that a hunger for being-with-others rests in the human spirit, longs to be fulfilled, and , in many instances, needs to be uncovered. We struggle to uncover and fulfill this need in ourselves and others. We are often pushed by the fear of giving ourselves to others and pulled by the hope that such feeling give rise to. Our fear can lead us to lord over others in order to gain a false sense of power. But, the more we question our values, our hope can lead us to feelings of companionship. This pushing and pulling leaves us in a quandary–to reach out toward others or to preside over them. The desire to affirm the other is often buried in us by years of training that have taught us that independence is the central goal of life, and, for those who are on the fringes of community, compliance is the pathway to success.

Yet, self-reliance and blind obedience are lonely conditions that lock us and others out of the embrace of human warmth and affection. Those who are committed to care giving often do not recognize this struggle within themselves, let alone in the marginalized people whom they serve, So the first place to start in the psychology of interdependence is with ourselves, our values, and how we translate these into reality.”

John McGee

A culture of gentleness is also about being able to be vulnerable

“When I first heard about creating a culture of gentleness I had no idea what that meant.

After going to trainings, learning about gentle teaching, and seeing a culture of gentleness through the people around me in an organization that seemed so alien, I finally understood what it was. Talking about a culture of gentleness isn’t enough. You don’t really understand what it is until you start partaking in the movement of gentleness that has spread across Canada. It really is a powerful thing.

I learned that creating a culture of gentleness doesn’t just mean serving the people that we support, but serving every person you meet on the street and at home.

It is a way of life. I had to change my mind set and mold my thinking to something completely different and something unnatural to a lot of people. Growing up the way I did, I learned what it meant to love unconditionally and to care for people in a way that was personal. Maintaining a culture of gentleness is very personal. In order to have gentleness, I needed to care about another person more than myself and take their limitations and physical or mental state away from how I viewed them. I have come to do this everyday with the people I support. I see them more than just someone I look out for and someone I spend a lot of time with: I see them as friends and as a huge part of my life, because to them sometimes you are their family.

The way I create a culture of gentleness is finding a balance between being firm and being personal with each person I serve. The definition of gentle is to be kind and mild temperament; I have found that being that understanding person that will listen and care in a more personal way has created this culture of gentleness for our team. The more bonded we are on a personal level and the more we listen and show kindness to each other the more gentleness has spread.

In my team, I have had to hold team members accountable and have had to have some tough conversations, but at the same time, building each person  up and showing them that I care for them. In order to create a culture of gentleness, I needed to gain trust. In going out of my way to make team members feel comfortable with me, I demonstrated that I genuinely care for them and their life situations. I try and make the people that I serve feel appreciated and loved, I have written personal cards to each and every one of them praising them for things that I have seen them do well. To maintain a culture of gentleness, I have realized that taking the times is very important… A culture of gentleness is also about being able to be vulnerable with both the people that we support and those who we serve with. It has helped us grow individually, as well as grow as one.”

A-culture-of-gentleness-is-more-than...

Krystel, Team Leader

See Worthy

At the age of eighteen I had applied for a job at a coffee shop in the city that I had been living in. I had visited this establishment numerous times and fell in love with it; at the time I had seen it as a place that screamed adulthood, something that I was craving in my life. To my surprise, I had been asked to come in for an interview; I was ecstatic! As I entered the meeting I was greeted by the manager. He asked me a few questions about my work experience, desire for growth and future plans that I had for myself. The overall interview didn’t span more than ten minutes before the manager offered me a position at his coffee shop; My teenage dream came true! For the next few minutes he talked to me about work expectations (what I should wear and when I would be trained). For the next twenty minutes the manager began to blast me with statements such as,

“I know people like your kind–you better not disappoint.”

“All you teenagers are the same.”

” If you ever dare to call in sick because you are hungover, you can guarantee yourself an early retirement from this job!”

Your boss woud never yell at you at COR

I left the interview feeling deflated and heart-broken. ‘How could I be treated like this?’ I thought to myself. I wasn’t seen as the person I am, but seen as a stereotype. In that moment any worth that I had was extinguished with a swift blow and no filter on a over opinionated mouth.

In the world today, the idea of worth is something that doesn’t go unnoticed. A person is able to see the value of ‘worth’ on a daily basis. Whether it is the constantly changing stock market which drives the worth of our currency, the title that falls before the name of a person, or the color of robe that is worn at graduation ceremonies; a person’s worth is often built upon standards that society has crafted over time. While economics, academics and professional titles are not the problem, we need to work hard at challenging our perspective. Think with me for a moment: When a baby is born there is something magical about the community that seemingly appears out of no-where to celebrate this thing we call life. As quick as we take a breathe, this baby has been given value and worth–yet as the child changes and grows into an adolescent and then an adult so does the societal view of worth. Choices are made; some good and some bad. As much as we hate to admit it, we are capable of becoming hardened towards people and deflating a sense of worth.

Our role as part of humanity, friends and supports in building the worth of another person can be viewed through the  lens of a child’s building block set; we have three options: We can either stand idly by and do nothing, which is of little value, we can build the tower of worth up, or we tear the tower of worth down. In his book, ‘Mending Broken Hearts’, Dr. John McGee says, “The self is seen not so much as independent or self-determining, but as connected with others who help the person feel worthy because he/she is safe and loved.” The choice is yours– but I would challenge you to build.

Ben, Director of Culture and Mentorship

 

Our hope is…

“As care givers, we need to be well grounded. Our hope is not in independence, but interdependence. Our primary task is not to control others or force others to be what we want them to be or do what we want them to do. It is to bring a deep unconditional love to those whom we serve. Our central purpose is not self-determination or self-reliance; it is a feeling of connectedness between those whom we serve and ourselves. Our central role is to express a profound sense of companionship and community. What we often think are our primary tasks will come in due course if those whom we serve feel safe, loved, loving and engaged.

We are community makers. Community is a gathering of gifts. Our gift in the act of care giving is the creation of companionship and the formation of community. Those whom we serve bring their mind-body-spirit, their dreams denied, and their hunger for love. They bring their troubles and sorrows, their life story, and their broken hearts. We are to bring a spirit of gentleness to mend their hearts.”

John McGee
‘Mending Broken Hearts: Companionship and Community’

Why a Culture of Gentleness Makes Good Business Sense

The following article addresses the culture found in residential settings where the quality of life is shaped by the multiple relationships between residents and direct care support staff. I was struck by the correlation between the elements of a culture of gentleness and what LaLoux has described in “Reinventing Organizations” as new level of organization emerging that holds great promise. (see “Book Corner”) The organizing principle in this new tier is the constellation of the deep values individuals are liberated to express in their work. – Clint Galloway, Editor

Those of us in the business of providing care for others often find ourselves trying to balance sound financial decisions with decisions that directly impact the quality of care provided. Tipping the balance negatively on the economic side (we can refer to them as “scale tippers”) include staff turnover, worker’s compensation claims, unemployment claims and the cost of training new staff, all of which can lead to increased anxiety for those we support, lower staff morale, reduced quality of care and increased expenses. If we can agree that the scale tippers attribute to a majority of the increased costs then we can agree that by reducing the incidents of scale tipping we will be making decisions that can lead to expansion, fewer vacancies and other business opportunities. Fortunately, we are learning that the same things attributed to reducing expenses are also attributed to increasing the quality of care for the individuals we support.

The ever changing landscape of our system of care pales in comparison to the changes experienced by those receiving care due to staff turnover. I recently went to my dentist and was informed that I would have a different dental hygienist. “What…no Dena?” I thought, “she’s been my hygienist for many years and suddenly they expect me to have my teeth cleaned by someone else?” (Maybe if I’d flossed regularly I’d be less concerned). The care that the new hygienist provided for me and my teeth was more aggressive than I’m used to, leaving me wanting Dena back. After my initial disappointment, I’m okay now with the notion of waiting six months to find out who will do my cleaning next. But I would be much less settled if I was to experience this uncertainty with every shift change, 547 times over the next six months. This uncertainty about whom we will be interacting with in a face-to-face relationship makes us feel less safe and precipitates negative feelings and actions. It invades the entire culture of care. It is an expensive drain on our resources as well as the peace of mind of those that we support.

Providers report an average turnover rate of 49% among frontline direct caregivers. For agencies that experience high annual turnover rates (hopefully you’ve calculated your annual rate, if not this would be a good first step to take), it is likely staff will leave within the first six months of employment. This is the period in which the initial, comprehensive training will occur for new staff. At an average replacement cost of approximately $3,500 per employee, these costs weigh heavily on the economic scale.

Other scale tippers that often appear in a workplace with excessive rates of turnover include worker’s compensation, health insurance premiums and unemployment claims. Worker’s compensation claims tend to increase when the people in our care feel unsafe and are more likely to be aggressive towards staff, resulting in injury. Insurance rates increase when claims expense increases, and conversely, rates remain more stable when claims expense decrease; in some cases refund checks are cut to providers when there is a well-established “culture of gentleness.” When excessive scale tipping is present we are more likely to find frivolous worker’s compensation claims. This can reduce morale, as well as your bottom line, due to time spent resolving the issues. Another hidden cost of high turnover is health insurance premiums. Decreased turnover means that a large health insurance claim can be absorbed over time if staff continues to be employed after the claim has been paid. Unemployment claims, whether you are reimbursing or a contributing provider can be incredibly time consuming and expensive, costing up to $10,000 a claim in some cases.

Not to be forgotten in the discussion are wages and benefits. These are significant factors in finding and retaining qualified staff. According to the Michigan Assisted Living Association’s (MALA) 2009 Strategies for Improving Wages, Benefits, and Training to Staff Providing Community Mental Health Funded Residential Services, “Wages for direct care workers among the providers responding to this survey are as much as $3.25 per hour less than wages in other similar sectors of long-term care.” Although it will not bring parity to our Medicaid reimbursement rates, an established culture of gentleness will increase our ability to offer more attractive incentives for our employees.

Now that we’ve identified the scale tippers, how do we begin to tip them in more favorable directions? We cannot support the people we support without feeling supported by the people who support us.

That sentence will gain few points from English teachers, but it does offer insight into what our focus must be if we want to create a culture that is conducive for healthy bottom lines and healthy hearts alike.

Have you ever heard of “seagull management?” This philosophy is indicative of a culture that offers little or no proactive support, and when things are not going well—for example, if a group home is in chronic upheaval—management (the seagulls) intervenes by providing plenty of white droppings to go around. The flock then flies off, leaving those covered in white droppings to rectify the scale tippers. So where do we need to focus if we want to prevent the seagulls from disrupting our day at the beach?

Creating a culture of gentleness starts with the leaders of organizations recognizing that the way we train, support, and maintain our employees ultimately has a direct effect on both the quality of care provided and staff retention. Just as those we support in our system of care strive for unconditional valuing, uplifting interactions, and encouragement so do our employees. We all do. It is imperative that all levels of management have an understanding of the six elements (safe, valued, praise, demand, structure, and transitions) that lead to a culture of gentleness. The key to higher quality training includes finding quality trainers and materials. The Center for Positive Living Supports (the Center) has been involved with supporting staff in numerous Mobile Response Training Unit deployments. Overall, we find that without understanding, commitment, and congruent behavior from the host provider and CMH staff, we often find an increased amount of scale tipping.

For example, our home managers play a vital role. Staff often quit a direct care position, not because of the people they support in the home, but rather the way they feel devalued by management. Many home managers also feel devalued from lack of support from above. One way in which we demonstrate our appreciation of the value of employees is by providing tools that give them the confidence to help create a supportive culture under complex circumstances. These tools come in the form of training and gaining a basic understanding of what we can do. In a best case scenario, it is estimated that 2% of annual budgets are earmarked for training. To use this effectively we need to incorporate ongoing support within the day-to-day culture and focus less on the external classroom. This requires developing trainers and recognizing that mentors play a vital role in creating and sustaining a culture of gentleness.

When the going gets tough, the mentors get going. Not exactly the adage with which we are all familiar, but a culture of gentleness requires us to invest in some of the more skilled staff, enabling them to become mentors. They are able to assist in some of our more difficult situations that traditionally may have escalated into scale tipping events. If you can build a capacity of at least one mentor for every 50 staff you will be investing in someone who has the skill set to assist in our most complex situations. The goal of mentoring is to create a sustained environment that will begin to make everyone that lives and works in the setting feel safer, more valued and less volatile. MALA’s findings, from their aforementioned 2009 study, concluded, “Education related to this culture of “gentleness” should be broadened throughout the state.”

According to projections from Michigan’s Department of Labor and Economic Growth (DLEG), employment in the state’s long term care industry is projected to grow by 20 % over the decade from 2006-2016, adding nearly 25,000 new positions. May I take you back to the dentist chair experience for a moment? When it’s time to see your dental hygienist wouldn’t you rather have Dena, whom you have grown to trust and respect? Me too, and for the same reasons the people receiving our care and those we employ will look to you, and want to stay with you. We need entire organizations that embody the elements that constitute a culture of gentleness. Working within an organization built on trust, mutual respect and valuing, dedicated to quality service, is like a sunny day at the beach engaging in experiences that can be meaningful and fun without worrying about Seagulls hovering overhead. They have also learned the prerequisites for landing and being warmly welcomed on the beach.

Example: Ayanna is extremely bright, has a wonderful sense of humour, likes to shop, and cares deeply about her family. She has had over 15 different placements over the past several years and more recently spent two-thirds of a year in psychiatric hospitals. Ayanna spent 45 days at the Transition Home and her future caregivers attended the preliminary training offered by The Center. When Ayanna moved to her new home, our staff worked for approximately three weeks with her caregivers during which time the six elements were demonstrated, coached, and observed by the Mobile Response Team Mentor. Her current provider remains committed to supporting her in her home and for the past year she has lived successfully in her home having only been hospitalized for a week.

Ed Kiefer, B.S., L.B.S.W
The Center for Positive Living Supports, an affiliate of Macomb-Oakland Regional Center.

 

Download the PDF version of the article here: Why a Culture of Gentleness Makes Good Business Sense

 

It’s all about your pace.

Have you ever stopped to think about the way that you walk?

I know that it is a strange question and if you chose to stop reading here I would likely understand. But  I promise you, I’m on to something. Now I am not talking about the physicality of your walk: do hips sway with a hoola-hoop like action, or is one leg shorter than the other causing a noticeable limp. More so, when you walk with a friend or companion, do you walk as if it is the end of the world and speed to wherever your destination may be or do you walk intentionally taking in your surroundings and the conversation that you may be having.

For the past three years I have been married to the love of my life. It has been an incredible adventure and we have enjoyed every minute of it: including the bountiful walks that we have taken. However one of the things that I noticed early on into our marriage is that my wife walks as if she is an Olympian speed walker–it eventually got to the point where I had to tenderly grab her hand and ask her to slow down. To ally my naysayers out there, it wasn’t because I couldn’t keep up to her, rather I didn’t like the feeling of being rushed in moments where I felt like I could relax.

I have been thinking about this idea of “pace” for a long time and it finally struck me: the way we pace ourselves not only determines when we finish the proverbial race, but also how we finish it.  As supports, friends, family and others associated with COR and the Gentle Teaching movement has this idea fully penetrated our hearts and minds, thus being embodied in our words and actions?  I ask this because I was convicted about it in my own heart, when I began noticing the young man that I support was always a few steps behind me. At first I didn’t think much of it, but as time passed I was frustrated: not at him, but myself. I had become the ‘Olympian’, though accomplishing much, missing the view.

So do me a favor, after reading this blog: stop whatever you are doing and ask yourself a few questions:

  1. What is the pace you are moving at?
  2. Are you noticing the ‘view’ and slowing down to assist others?
  3. Take a few moments to review the four tools of Gentle Teaching  and honestly ask yourself how you are doing in each of the following areas.

a)Loving Eyes/Gaze

b) Hands

c) Loving Words

d) Loving Presence

 

Ben, COR Support