Hobbies and relaxation are essential for good mental health

When taking time to enjoy the weekend, I realised the importance of hobbies and general relaxation for promoting and maintaining good mental health.  Without time to switch off from our busy working lives, our stress levels can increase and, over time, can potentially remain at a constant high; this is very damaging for our health, in terms of weakened immunity, poor sleep, changes in appetite, hormonal changes, increased blood pressure and cardiovascular health, coupled with poor coping strategies such as excess alcohol intake.  The overall danger of long term unchecked stress is that it also increases the risk of depression, cancers and cardiovascular problems.  It is therefore somewhat essential that we take time out to pursue hobbies that we enjoy, in order to relax and look after our mental health.

My favourite way to unwind is, undoubtedly, by reading books.  For purposes of relaxation, my reading material has to be fiction; non-fiction books are what I associate with study.  My chosen areas of fiction are very diverse, and range across titles such as Thomas Hardy’s Tess of the D’Urbervilles, the Scandinavian noir of Henning Mankell’s Wallander series, Jeffrey Archer’s Clifton Chronicles, George R. R. Martin’s Game of Thrones series to Susan Hill’s Simon Serrailler series.  Reading is a fantastic hobby that can transport you virtually anywhere; the pure escapism is wonderful and very hard to beat.  I established myself as a ‘bookworm’ from a very young age, and it is a love that has never abandoned me, and has helped to keep me sane!  Non-fiction books additionally serve me well, but the intellectual stimulation that they produce requires more concentration, and are hence less of an easy read.  Intellectual stimulation is good however, and for me is essential for a healthy state of mind.

susan hill   thomas hardy   mankell

The other way that I relax is by walking with my Basset Hound dogs.  Research has repeatedly shown that spending time with dogs is good for our mental health, as well as physically reducing our blood pressure levels through stroking and interaction.  As well as making loyal pets and companions, our canine friends are used as pat dogs for the elderly and for people living with dementia.  For me, it is my dogs’ qualities of loyalty, unconditional love, and the humour that they bring that makes them special; I cannot imagine a home and a life without dogs.  I also love the essential exercise through walking that accompanies owning a dog.  Walking is a great way to relax, to improve general mood and physical well-being.  Walking can also be an effective way to maintain or reduce weight.  Daily dog walks additionally allow people (and dogs) to connect with other people, whether they are other dog walkers, or neighbours / local residents.  Meeting other people is good for the mind, as it guards against isolation and strengthens our support networks.

barney basset

As well as having dogs, I also share my home with a beautiful Horsefield tortoise.  The tortoise’s dietary requirements form part of the daily dog-walking routine, as it is an excellent opportunity to gather fresh vegetation, such as dandelions, clover, grass and so forth.  The tortoise also shares many of my own vegetable dietary components, but there is nothing quite like being in touch with nature and gathering free food from the surrounding countryside.

tortoise

Although not one of my regular hobbies, this weekend I re-discovered the simple pleasures that can be gained from sharing ‘childhood’ box games with family or friends.  For a rush of competitive adrenaline, I find the best game is Frustration (sometimes called Pop-up); while for a longer more considered game, I personally enjoy Monopoly, draughts or Scrabble.

frustration game

Whatever your choice of hobby or pastime, it does not really matter, just so long as it is relaxing.  Working, resting and playing are all equally important, and can all be beneficial for our overall brain and body health.

Exploring Advanced Dementia

Appropriately for Mental Health Awareness Week, I today attended a seminar which explored advanced dementia. The seminar was kindly hosted by a local hospice, and examined many concepts regarding the topic of dementia: including types of dementia and their features, the importance of getting to know each person with dementia as an individual, effective communication throughout the different stages of dementia, recognising that we might be the problem and not the dementia, and making environments dementia friendly.

A new concept for myself was the introduction of the Dementia Bookcase. This is an analogy which I found useful and apt; so please let me explain. Imagine a bookcase with four shelves, which represents the life stages of the person with advanced dementia. Childhood is at the bottom, adolescence and early adulthood is second up, mid to late adulthood is on the second from the top, and now – the present – is on the top shelf.

Now – the present

Mid to Late adulthood

Adolescence / Early adulthood

Childhood

Working from the top, the metaphorical ‘books are falling off’ and cannot be replaced; rather sadly like the brain cells of the person with dementia. The next shelf down, of mid to late adulthood, is now forgotten, and this is particularly hard for a carer / partner who has cared for the person with dementia – even worse for a second (later married) wife. On the third shelf, of adolescence to early adulthood, the person with dementia remembers going out to work as a milkman. He wakes up at 4:00 in the morning, and is desperate to get out, because he needs to deliver the milk. On the bottom shelf, as the person is getting nearer to death, he remembers being a child and may ask for his mother or father, and may well be concerned that they do not know where he is. If childhood experiences were bad, this stage may be emotionally difficult. At this final stage, spirituality becomes extremely important, and will allow the individual to form a vital connection with a thing that is special to them. Depending on the person, this may be through a piece of music – or singing or dancing, watching football or stroking an animal. Whatever the choice, it can be a joy to witness a person ‘coming alive’ in this way.

donkeys

record player

Another thing that really struck me today was a discussion regarding validation. Imagine a situation in which the person with dementia asks for their wife, but you know that the person’s wife is dead, and has been for 20 years. What should you do? Do you lie? Do you tell the truth?

If the person wants their wife, then you should validate the person’s needs by talking about her. “Tell me about your Sarah, where did you meet? Can you remember your wedding day? What was it like when you had your first child?” Talking about the person’s wife will bring comfort and a moment of happiness. They will feel that you really care. The person may well soon forget what you have just talked about, and may ask about Sarah again, or possibly they might not. Validation is surely better than telling a bare-faced lie? Consider for example: “Sarah is staying with her mother at the moment, but she is probably going to come and have tea with you tomorrow.” Or even worse, imagine the alternative, although it may be true? “Don’t you remember? Sarah died 20 years ago.” Imagine the person with dementia having to live through the pain all over again; it just seems so cruel. Validation is surely most appropriate.

On a warmer note, a concept called doll therapy was also briefly discussed. There was a story regarding a lady who longed to see her daughter, who was living far away in another country, and did not get to visit her mum as often as she would like. The lady believed that her daughter was still a child; and so when finding a doll in the residential home where she lived, the lady joyfully announced that the doll was her daughter – she had come back to her mum. The lady became totally attached to her newly found ‘daughter’, and took her around with her all of the day, slept with her at night, and ‘fed’ food to her at mealtimes. The doll became quite grubby with food around her mouth!

feeding doll

Some people may criticise this behaviour, and consider it inappropriate for a grown woman to be ‘playing’ with a doll. Doll therapy however, was clearly hugely beneficial for this particular lady. While it is clearly not ethical to treat a person with dementia like a child, through representation of the person’s former memories, doll therapy serves a completely different function. To live in the person with dementia’s world is a good and productive task of engagement. Approaches such as doll therapy can bring much happiness and benefit. The world of dementia may at times seem strange, but as discussed today, perhaps we are the problem and not the dementia? Person-centred, individualised care remains to be the main priority.

Fifth placement over and exam complete!

Last Friday I officially completed my fifth placement out of an eventual nine – so there are just four more to go before I qualify as a nurse. Yesterday I also sat the Year Two Semester Two exam on physiology, pathophysiology and assessment, which was three hours in length. All the hard work is hopefully starting to pay off, and the distant end of March 2016 is gradually getting nearer, and is less than half-way now.

My fifth placement with the Crisis Team (now called the Home Based Treatment Team) was exceptionally good, and I feel that I learned plenty. My prime objective was to complete a full patient assessment and all the associated paperwork – face-to-face client contact, initial assessment documentation, risk assessment and care plan. Fortunately this placement provided plenty of opportunities to practise these skills, and I had the benefit of working alongside a very experienced team, who demonstrated some very skilled interactions and interventions with clients.

It was good to support patients within their home environment, and to help prevent them from deteriorating and having to go into hospital. Naturally, this was not always possible, but on the opposite side of this process, we would often support patients upon arriving back home after being discharged from hospital. When improvement and stability was gradually achieved, it was then also possible to transfer the care of our patients back to the Community Mental Health Team.

fingerprints

Alongside the placement I was able to complete four ‘spoke’ days, in order to gain extra experiences. Two days were spent with the RAID (Rapid Assessment Interface and Discharge) teams at two separate A & E departments, one day was spent at an inpatient psychiatric hospital, and another was spent with a Community Mental Health Nurse. During the latter, I was fortunate enough to experience a visit to a closed high security prison, and upon entering, was subjected to a body search and scan, the taking of my index finger prints and the removal of my shoes. It was amazing to go inside the old Victorian prison and onto the wing. If anyone can recall the old prison comedy drama called Porridge; well that is exactly what it was like inside.

prison

Other notable placement experiences included: talking to a suicidal patient over the phone, and being able to calm them down enough for me to call for an ambulance; making an adult safeguard referral; and taking part in a home visit involving an interpreter. It was a rich and rewarding placement experience with a wonderful team to assist me in my learning; I was very fortunate.

I had been building up to yesterday’s exam for the whole of my placement, and initially I was concerned that I would forget much of my university lecture content whilst working in the community, but fortunately this was not the case. The main medical conditions that we focused on were diabetes, heavy alcohol consumption, osteoarthritis, and stress, anxiety and depression. During placement I was able to meet real-life patients with all of these conditions, and I found that I was able to talk with them and advise them directly, with confidence, about many aspects of their condition. Much of my recent learning became relevant with clear practical application and knowledge based in reality. Accompanied with some evening and weekend revision, I felt well prepared for yesterday’s event.

exam room

Like all exams that I take, I wrote non-stop for the whole duration of three hours. Historically, I never finish exams early, and usually have to rush with the final question; and yesterday was no exception. Fortunately I was able to sleep well the night before, and did not let nerves affect me too much. I was panicking a little about remembering quotations and evidence sources to back up my knowledge, but most of them proved to be lodged in my brain and were utilised on the day. I do not yet know when the results are due to be released, but I am guessing that it might be in a couple of months’ time. Fingers and toes crossed – how will I bear the suspense? I will be very scared on the day that the marks are released.

mental capacity act       mental health code      mental health act manual

Hungry for yet more learning, I am now looking forward to starting the final semester of Year 2. The module is called Nursing Practice and Decision Making, and I am already acquiring some of the texts ready for some preparatory reading. There is still a small part of Semester Two remaining, and I am particularly looking forward to some specific learning regarding dementia; as this is a topic that is personally very close to my heart. Additional to my university learning, I have also secured myself a day on an Advanced Dementia student seminar next month, which I am greatly looking forward to. I have also just become a Dementia Friend too.

dementia friends

Reading books is good for your mental health

Happy Birthday, Shakespeare

shakespeare

Today is William Shakespeare’s birthday; to be more precise, it is his 450th birthday!  Reputedly, as well as being born on the 23rd April, Shakespeare also died on the 23rd April.  In just a couple of years, 2016 is set to mark 400 years of the date of his demise.

Many people first encounter Shakespeare’s work during their school days, and often may have struggled with the unfamiliar and archaic language.  A Mid-Summer Night’s Dream, Hamlet, Macbeth or Romeo and Juliet are the usual contenders for purposes of study.  While the language is somewhat different from our contemporaneous vocabulary, it remains compellingly enigmatic with its iambic pentameter, its rhyming couplets, quatrains and soliloquys.  Shakespeare’s work, for me, is a thing of beauty, and many authors – be they playwrights, poets or novelists – can never hope to match the Bard in his sheer productive quantity of plays and sonnets.  Shakespeare was prolific with his mighty pen.  If in doubt, just take a look at the Complete Works of Shakespeare, and you will be faced with a heavy and cumbersome volume of text.

If Shakespeare is not your thing though, there is a fantastic array of reading material in our libraries, bookshops and on the Internet.  Whatever your taste, there has got to be something to suit – fiction or non-fiction.  I personally favour the literary classics, especially Thomas Hardy, and I also love Scandinavian crime fiction, especially Henning Mankell and Jo Nesbo.  Reading books is good for your mental health.  It is healthy to be intellectually stimulated, to escape, to learn and to imagine.  To promote this positive pursuit further, it is a special reading occasion, today and tonight.  To find out more, please read on…

books

World Book Day and World Book Night

In honour of the Bard, today is also UNESCO’s World Book Day and World Book Night.  World Book Day first began in 1995, and was launched as a tribute to authors and their books, and to encourage the reading habit as a pleasurable pursuit, with a particular emphasis upon engaging the young.

Every year, a World Book Capital is chosen for a period of exactly one year, and the 2014 choice is Port Harcourt in Nigeria.  The city is intent upon improving literacy rates amongst its young people, and as Irina Bokova, UNESCO’s Director General states: ‘books are our most powerful forces of poverty eradication’.  Education, as we know, is often key to building our future prosperity.

For more information, go to http://www.un.org/en/events/bookday/

To support and advocate the ethos of literacy promotion, World Book Night is literally spreading the word.  Tonight, many free books will be handed out, by community book givers, at public events and places all around the world.  The event is run by the Reading Agency, and here in the United Kingdom, the twenty books for distribution this year are:

Getting rid of Matthew by Jane Fallon

The Boy with the Topknot by Sathnaw Sanghera

Today everything changes by Andy McNab

Vengeance is mine inc. and other stories by Roald Dahl

The Boy in the Striped Pyjamas by John Boyne

Four Warned by Jeffrey Archer

Black Hills by Nora Roberts

Tales of the City by Armistead Maupin

Confessions of a GP by Dr. Benjamin Daniels

Rivers of London by Ben Aaronovitch

Hello Mum by Bernadine Evaristo

The Recruit by Robert Muchamore

Theodore Boone by John Grisham

The Humans by Matt Haig

Geezer Girls by Dreda Say Mitchell

Whatever It Takes by Adele Parks

Gorky Park by Martin Cruz Smith

After the Funeral by Agatha Christie

The Perfect Murder by Peter James

59 Seconds: Think a little Change a lot by Professor Richard Wiseman

For more information, go to http://www.worldbooknight.org/books/2014-book-list

You might just be one of the lucky ones, and end up being given a book.  Books are your own personal ticket on a journey to another world.  You can travel to virtually anywhere you want to!

Books on Prescription

Many people who experience common mental health problems, such as depression, anxiety, obsessive compulsive disorder and eating disorders, can be helped further in their recovery through some medical reading.  Thirty self-help books in the Reading Well Books on Prescription scheme have been specifically chosen by health professionals, to address sufferers’ problems through the process of CBT – cognitive behavioural therapy.  In very simple terms, CBT is designed to encourage positive attitudes, and to displace the more negative ones.  It is a way of re-training the mind.

Books on Prescription schemes have been operating for several years across selected parts of the UK.  From June 2013, the Reading Well Books on Prescription titles were extended to include libraries within England, and should now be helping readers to understand and self-manage their conditions more effectively.  A growing wealth of evidence supports the efficacy of the books, and the English scheme is supported by the Department of Health’s Improving Access to Psychological Therapies Programme, the British Association for Behavioural and Cognitive Psychotherapies, the Royal Colleges of GPs, Nursing and Psychiatrists, and is also compatible with the NICE guidelines.

For further information, and to find out which books are in the scheme, go to  http://www.booksonprescription.org.uk/books

Welcome to my Thoughts on becoming a Mental Health Nurse

My name is Amanda Butler, and I have just started my second year as a Student Mental Health Nurse in Manchester. I am not your average eighteen to twenty something student; I am what they call a mature student. I have tried various career pathways in the past, including IT and teaching, but it is only now in my early middle years, that I have actually really found what it was I was looking for.

Like many things in life, it was a couple of major events that allowed me to reach my turning point. I lost both of my maternal grandparents to dementia – Alzheimer’s and Vascular dementia, respectively. I had been exceptionally close to both of these lovely gentle people, and I knew that I had to do something to help similar people, and their families, who were suffering with dementia. The disease is very cruel and often completely changes peoples’ personalities. The decline is progressive and it can be emotionally painful to witness.

The first part of my plan was to start a new job as a Care Manager in a residential care home which had a dementia community. The work was really tiring, both physically and mentally, but I found that I really enjoyed it and achieved enormous satisfaction from it. The residents were so trusting, so generally helpless and grateful for the workers’ efforts. I loved to hear the residents’ stories; they were an endearing and interesting combination, of both accuracy and confusion. It was impossible not to feel attached to these lovely vulnerable people and to care for them, with compassion and commitment, like you would your own family member.

After 12 months experience of working full time as a carer, I applied to various local universities for a place as a student nurse. I applied for the mental health branch, without a degree of hesitation, as I knew that I wanted to help not only people with dementia, but all those individuals with debilitating depression, bi-polar, schizophrenia and so forth. I feel strongly that sufferers of these conditions have been stigmatised and discriminated against for far too long. More mental health professionals are desperately needed to bring about the necessary changes, and I want to be one of them.

I found the university I was looking for in May 2012. Upon arriving, I received the slightly disappointing news that all the places for September 2012 had already gone, but today we would be competing for March 2013 places. This news was initially unwelcome, but when I thought about it rationally, it didn’t really matter if I got my place on the course; I would just have to be more patient!

The other students that I met that day were really friendly, and I was impressed with the facilities that were provided on campus. I had already passed one hurdle by being selected for an interview, but before that took place I was presented with two tests to tackle in numeracy and literacy. The literacy one was fine, as that is my favourite subject, but I was really nervous about the numeracy test, as mathematics has never been a natural strength of mine. Looking back, it did not go particularly well, as I never had enough time to complete all of the questions. I had revised beforehand, but I know that I was very slow in completing my calculations.

The face-to-face interview however, I feel, went well, as I found the interviewer easy to talk to. We comfortably chatted about our common interest in mental health issues, and so I felt really positive when I left to go home. I eagerly awaited to find out if I had been successful, and after about two weeks the good news appeared on my on-line UCAS account. I was going to be a Student Mental Health Nurse. I was going to make a difference. I was absolutely ecstatic and didn’t know how I would wait until March!

It is now April 2014 and I have completed my first year of training, and I am officially one third of the way to becoming a registered Mental Health nurse. The tutors say that the second year of our training tends to be the hardest, as it is still quite a way until the end of the course, the academic work steps up a level, and our mentor’s expectations on placements will be slightly higher because we are second year students. I am ready for the challenge however. I never expected it to be easy, and I am raring to go. Welcome to Year Two!