Private companions learn new ways to engage with frail clients through dance movement

Private companions learned new ways of engaging with their frail older adult clients in a four-week workshop led by The Dance Exchange and offered at Baycrest Health Sciences this past November. 

Guided by instructor and dancer Shula StrassfeldGuided by instructor and dancer Shula Strassfeld (at centre in photo), the weekly one-hour class inspired private companions (PCs for short) to think about using music and physical movement as a way to have a different kind of conversation with their client, connect in a new way with the person they’re helping, regardless of the cognitive impairment, mobility limitations (most are in wheelchairs), speech and language difficulties, and multiple health issues related to aging and disease.

Dance movement workshops for PCs is unique to long-term care in Canada. “Baycrest is on the cutting edge of this arts-based learning for private companions,” says Strassfeld.

The PC role is filled primarily by women, hired by families to provide companionship to a frail family member and assist with their daily living activities (such as brushing teeth, dressing and bathing). They typically provide this support in the client’s own home or in hospital, long term care or community day centre settings. PCs are considered an extension of the client’s family by the healthcare facilities they work in. Many have Personal Support Worker certificates and some have nursing credentials from their countries of origin.

With relaxing music playing in the background, Strassfeld teaches her class to use dance movement and gestures as a way to introduce themselves to each other and to their client. The clients are part of the workshop, and if they are able to, are keen to participate.

PC Angheline Siobal (left) dances with her client Blanche Schmit. PC Larcy Alba at far right.

PC Angheline Siobal (left) dances with her client Blanche Schmit. PC Larcy Alba at far right.

It may be a wide sweeping arm gesture that evokes a welcoming hello or a wave of the hand like the Queen, a small finger movement, or two arms reaching up to the sky. There is no wrong way to use dance movement as a new communication tool, Strassfeld explains to her group of 16 PCs who are sitting beside their clients in a large circle, inside a spacious room with floor to ceiling windows that provide lots of natural light.

“Small movements are just as important as big ones,” she says in an encouraging tone. The PCs are a bit shy at first to create their individual dance movement, but soon the hesitancy gives way to more confidence and a spirited session of trying out their creative movements with each other and most importantly, with their clients.  

Strassfeld asks the PCs to imagine one of their favorite places in the world and create a physical gesture to express that feeling of bliss. One PC stretches out her legs and wiggles her feet as if sitting on the sand and splashing in the waves. The PCs take turns expressing through movement their own special place. There is a lightness in the room, lots of smiles and laughter. Those clients who are awake in the class take in the sounds and smile. Some try to move their own limbs while sitting in wheelchairs and are encouraged by their PC. “C’mon my lady, you can do it,” says one PC. “Hi mama, let’s see you move your hands,” says another.

Melissa Tafler“Dance is a way of communicating with their client, sharing stories and having a different kind of conversation,” explains Melissa Tafler, coordinator of the Arts and Health program at Baycrest. “This is about spontaneity, a different way of being with their client.”

The physicality of dance, of moving one’s body in a creative way to express a thought or feeling, can elevate the relationship between caregiver and the one receiving care – moving it away from ‘I’m here to help you today’ to ‘I’m here to connect with you today’.

“We know that the arts have the ability to tap into places where deeper thoughts and emotions reside,” she says.

Strassfeld leading her PC group Strassfeld leads her PC group through another exercise called “mirroring” and plays a familiar show tune to get everyone in the mood. The PCs place their chair directly facing their client. They hold their client’s hands and move together in unison slowly, so that one person will lead and the other will follow. Even clients who are sleeping in their wheelchairs can be gently engaged in this manner, Strassfeld reminds her class.

“Every opportunity for the private companion to sit facing their client creates a different, or more equal, power dynamic,” notes Tafler, who quietly observes the class from just outside the circle.

Another exercise has the PCs making a shape with their body and arms and coaxing their client to make a similar shape. The PCs then gather in a circle without their clients and partner up to make their own dance movement shape and hold the shape for a short time. Strassfeld explains that they can use the shape game in their regular day when dressing their client. “As you put a sweater on your client, you can say, ‘Let’s stretch our arm, that’s shape one. Now let’s bend our arm (as the sweater sleeve goes on), that’s shape two,’” she says, modeling the dance movements along with her class.

Strassfeld moves to her computer, which is hooked up to small speakers, clicks on the iconic show tune, “Give My Regards To Broadway”, and asks the PCs to have a dance party with their client. “Do whatever feels good,” she says.

“This makes life a little more exciting each day,” says one PC as she moves to the music and talks with her client.

PC Angheline Siobal agrees with her colleague. “This is exercise for the client and for us too,” she says. “It helps remove some of the stress from our day and helps us to bond in a new way with our client.”

In this class, it is evident there is much tender affection between the PCs and their clients. Still, the companionship role can be stressful at times given the health issues in the individuals they’re caring for, including responsive behaviours related to dementia.  It is not an easy job, and the daily routine of providing companionship and assistance to someone who may be very frail and mostly non-communicative can sometimes feel monotonous and wearing.

“The work you do is hard,” Strassfeld acknowledges to her class of PCs. “It’s important to take some time for pleasantness in your day. If you continue to do these movements with your clients, the happier they’ll be and the happier you’ll be.”

There is a waiting list for the next Dance Exchange workshop for PCs at Baycrest.

Story and photos by Kelly Connelly, Marketing and Communications, Baycrest Health Sciences in Toronto. It will be published in an upcoming edition of Caregiver Solutions magazine. Baycrest’s Arts in Health Program involves leading the development and operationalization of initiatives that integrate the arts across clinical programs, education and research in health and aging.  For more information visit www.baycrest.org/culture-arts-innovation or contact Melissa Tafler at mtafler@baycrest.org.