Wednesday, 29 May 2013

Just Breathing vs A Good Life

Yesterday I tuned in to a podcast about a new model of care in Australia.  Initially I thought I might be able to double-task by writing some easy emails while listening.  But almost immediately, I abandoned that idea and grabbed paper and pen instead.  I needed to remember everything about this podcast and consider what it meant to me - both professionally and personally.

Social Innovation Generation (SiG) in Toronto, Canada sponsored this presentation by Sarah Schulman titled "Are We Doing Good?"  SiG described it this way:  For the past 5 years, Sarah Schulman has been ‘radically redesigning’ youth, family crisis, and aged care services. People in this line of work talk a lot about social problems (wicked versus tame). They talk a lot about methods (design thinking, systems thinking). And they even talk a lot about impact (effective, efficient). But, they don't talk nearly enough about what is good. Do you?

Listen to the podcast HERE

Sarah began by introducing Dudley and Daphne, a couple both in their 90's and still living in their home in Australia.  Dudley is a former race car driver and Daphne was his pit crew.  Now, with limited mobility and a range of health issues, Dudley and Daphne sit at home, either staring out the window or watching television.  Daphne reflects, "This isn't a life.  I'd rather be dead than live like this."  

Mary is Daphne and Dudley's care worker.  She delivers social and communication care to the couple for 90 minutes per week in addition to popping in six days a week to give them both a bath.  

Daphne and Dudley's adult children worry about their parents and were happy when they stopped driving.  They disapproved of their parents buying french fries on their outings, reasoning that high fat foods would contribute to heart disease.

All the parties contributing to Daphne and Dudley's care had a different idea of what was 'good' for the elderly couple.  The agency that employed Mary believed that good care was delivered if it 'did not go overtime and it kept the clients happy."  The government ministry that paid the agency to deliver care maintained that 'good' was achieved if Dudley and Daphne remained alive.  The couple's adult children believed that 'good' was upheld in their parents' lives if the grandparents did not die and did not cause worry by indulging in risk-taking behaviours.  Dudley and Daphne themselves were deeply unhappy and lacked purpose in getting out of bed every day.

Dr. Schulman's innovative program "InWithFor" seeks to develop a language to talk about what is good, for starters.  What does good look like for individual service users?  Questions like, "When do you feel most independent and in control?" lead to a deeper conversation about how help can become meaningful and helpful.  Dr. Schulman has set herself a daunting task - it is to seek the end of a flourishing life in those who need care.  In order to achieve her goal, new capacities must be developed in creative problem solving at all levels.  The values and ideals of service users must be actively sought and acted upon.  Schulman's model is certainly bottom up and not top down.

Dudley and Daphne are not the only examples of care receivers described in Schulman's podcast - there is a disenfranchised and employed youth and a recovering addict with ten children.  Redesigning services with a good life as an end goal for different sorts of care recipients is no simple feat.  But anyone interested in knowing how should begin by listening to this podcast today. 
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