Oasis for the elderly


DUTY OF CAREAnnette O’Brien takes part in some activities with one of the residents at The Pilgrims’ Rest.  Pic: Michael McLaughlin

Áine Ryan

EVEN if it is celebrating its 20th anniversary, age is much more than a number at the Pilgrims’ Rest Nursing Home, situated in the rolling hills on the edge of Westport. For Noel Marley, who with his wife, Pauline, decided to move back home from Dublin over two decades ago and expand their nursing skills while rearing a young family, the care of our older citizens is central to our societal duties and must espouse the highest professional standards.
“In the early 90s when our kids were small we were both working in Dublin as nurses but coming up and down the road every weekend. So we began thinking about the possibilities of moving back home to Mayo and having a better family life for us and our three small children,” Noel tells The Mayo News in the sitting room of the Pilgrims Rest Nursing Home. The Director of Nursing, Paula Frain and the HR Manager, Yvonne McNeil and Senior Staff Nurse, Beata Marcinak also join us.
The Pilgrims Rest is in a mid-morning buzz: the hairdresser has just arrived; one resident is being wheeled to the dayroom; others sit in the foyer while a carer brings them tea and biscuits.
Noel Marley is explaining how he and Pauline ‘saw the potential and liked the challenge of starting our own business’ in an area in which they were already skilled .
“The other motivational thing was that we had friends who had moved back home to Mayo and started a nursing home and they assured us of its possibilities.”
So they started the ball rolling in 1995, sold their house in Dublin and moved back to Mayo in 1997, having identified a site close to Westport.
“We had opened the Pilgrims’ Rest by April 10, 1998. It was on a Good Friday, which is a traditional lucky day. We initially opened with 22 beds and it took us about nine months to fill the place. In the beginning it was just me and Pauline doing everything, from cooking the food to making the beds but as the numbers grew we hired staff accordingly,” he says.
Twenty years later they have  facilities for 35 residents and an overall staff  – some of whom are part-time – of 42.

Back to the beginning
BUT back to the beginning, what was the ethos of this couple, with a young family, starting out on this enterprising adventure?
“We wanted to have a care home that was homely and where people had a sense of family. At the time, our kids were there a lot and the residents loved that. I remember how one day a local GP was in seeing a resident when he suddenly heard a noise in what he thought was an empty bed behind him and it turned out it was our three-year-old daughter wakening up from a nap.”
Noel explains such a scenario wouldn’t happen today because of more stringent regulations.
“While regulations are very good and very necessary, they often throw the baby out with the bathwater. They may not be done with that intention but it can have that effect, which makes the experience more clinical.”
A great benefit to the homely atmosphere in the beginning was the fact that the vast majority of  residents either knew each other or their families did, recalls Noel.
Indeed, he says, on occasions a husband may have moved in for various reasons and his wife chose to move in with him too, not only for the companionship but because they had such a good social life in the nursing home.
What have the biggest changes been over the 20 years?
“The first thing is that there have been great developments in the treatment of dementia from a care point of view. Twenty years ago there wasn’t the same level of understanding of the personal process the person with dementia was going  through. Back then nursing home staff were trying to manage dementia whereas now we are more aware of what we can do to support our residents by communicating with them.
“When my grandmother got dementia, she moved in with my mother who was trying to rear six children. She used to head off across the fields because she wanted to go home. There was never any support for families and when they might have chosen to put their loved one into a nursing home the emotions were so complex,  filled with guilt. These days there is loads of support.”
Noel says they ‘have been blessed with the staff we have, some of whom are with us for years’.
“As somebody who has worked in nursing since 1976, I’ve always been impressed by the motivation to care, the levels of patience, endurance and kindness –  and I am not saying this about myself!”  
Noel is emphatic that nursing homes caring for the elderly should not be allowed to go above 70 or 80 beds as they then become too clinical and impersonal.” There is nothing. ‘impersonal’ about the staff at the Pilgrims’ Rest according to HR Manager Yvonne McNeil. She praises their great work ethic and unity.  
“I see how hard they work and how united they are. The role of the Health Care Assistant is such a vital role and such a support to the nursing staff. They take on their jobs every day with a smile on their faces and with such compassion. From the receptionist to the caretaker, the housekeeper to the hairdresser, the activities coordinator to the musicians, everybody interacts so positively. To me, this is a massive part of making it a home.”
She also observed how there is a seamless connectedness between the staff whether they are from Mayo or Poland, India or Africa.

Dealing with dementia
FOR Director of Nursing, Paula Frain the most important development in the treatment and support of dementia is that health professionals ‘are more in tune with their reality’ these days.
Paula has a Masters of Science in Dementia Care which obviously helps in her coordinating of the treatment and support of the residents.
“The majority of our residents have some form of dementia or cognitive  impairment. We do ongoing training with staff on managing behaviours that challenge to ensure everyone has an understanding of dementia and the realities of living with it. That is often manifested by being disorientated and looking to go home,” Paula explains.
Distraction, she says, is the best thing to do and so crucial in deflecting them from their worst fears which, for example, can be that the front door is locked and that they can’t get out.
“The distraction can be as simple as bringing them out another door into the safety of the courtyard, or just making a cup of tea and having a chat.”
Paula continues: “It is all about knowing the person and their needs. They are simply stressed because they are confused and, importantly, staff have been trained to identify triggers and how to use de-escalating techniques. It is also important for us that families continue to play a key role in the resident’s life. We don’t have visiting hours and family members regularly have lunch with the resident or even spend the whole day with them.”
Senior Staff Nurse, Beata Marcinak says that she has two families.
“Everyone is my family here as we all  have a second life here. No matter what our role is – whether it is the GP, the nurse or the Health Care Assistant – we are all at the same level as we provide the best care we can for our residents.”  
While the upbeat warmth of the Pilgrims’ Rest Nursing Home is obvious, there is one issue that concerns Noel Marley and the nursing staff alike.
“We do our very best every day to care for the residents but if they have to go to A&E they can be traumatised by the system despite the great work of staff there. We feel old people are not looked after as well as they might be in the general hospital environment.”

The Pilgrims’ Rest Nursing Home is celebrating its 20th anniversary with an Open Day on Saturday, September 22 from 2.30 to 5pm.