Minutes: Monday 1 May 2017 @ Lithgow Library Learning Centre Venue: Lithgow Library 157 Main St, Lithgow

Chair: Sandra Hemming (Canterbury Bankstown) Minutes: Sally Meakin (Canterbury Bankstown)

Attendees: Sandra Hemming, Sally Meakin – Canterbury Bankstown, Natalie Conn, Melinda Short – Bathurst, Georgia Lewsley – Blue Mountains, Susan Bradley-Hoy – Burwood, Annette Chaplin – Camden, Bernadette Stephenson, Robert Swan – Campbelltown, Kylie Streeter – Canada Bay, Mary Ryder – Hornsby, Alison Kim – Lithgow, Fiona Dunn – Macquarie Regional (Dubbo), Fiona– Midwestern, Julie- Anne Jones & Caryl Collins – Penrith, Anne Chestnut – Ryde, Laurie Popple – Wollongong

Apologies: Greg Roberts – Canterbury Bankstown, Samantha Hamilton – City of Sydney, Helen Jack & Kayo Magill – Hornsby, Alina Brulinski & Sonia Campion – Ku-Ring-Gai, Marian Gray – Manly, Julieri De Florio – Northern Beaches, Michelle Drummond – Bayside, Sherryl Charley – Singleton, Oriana Acevedo & Mylee Joseph – SLNSW, Sarah Murray & Susan Hyde – Willoughby

Dated 6 February 2017 (Willoughby) Mary Ryder (Hornsby) Laurie Popple

• Lithgow Home Library Service is 4 years old
• the total geographic area the service covers are the towns of Wallerawang, Portland and Lithgow.
• total of 60 HLS clients 20 individuals (own home) and the balance in institutions.
• there are 4 nursing homes in the area and 2 retirement villages
• growing population means there is a need for volunteers to sustain the service.
• deliveries are done monthly using a council car
• Kim dedicates approximately 10-16 hours a week to HLS
• Bathurst Library suggested that Lithgow utilises E resources to support HLS demand
• Dubbo Library is now able to resource share due to the amalgamation which is a positive outcome for the Home Library Services involved
• external volunteer organisation was suggested also to assist with managing volunteer secondment

Subject: Dealing with Death and Dying.

• in primary and community health care, nurses, aged care workers and community nursing staff aim to maintain clients independence to allow them to remain in their own homes.
• many of these people are aging clients that have a variety of health issues
• a growing cognitive decline is apparent with increases in dementia and related illness
• palliative care team deals with mental health issues of clients facing declining health
• amongst health care professionals the following 5 stages of grief are studied to deal with the varying emotions experience by clients.
• this theory was introduced by well known psychiatrist, Dr Elizabeth Kubler-Ross to assist people with the emotions they experience when they are diagnosed as terminally ill or have lost a loved one.
• the 5 stages are as follows:

1. Denial - The first reaction is denial. In this stage individuals believe the diagnosis is somehow mistaken
2. Anger - When the individual recognizes that denial cannot continue, they become frustrated, especially with those around them. Certain psychological responses of a person undergoing this phase would be: "Why me? It's not fair!"; "How can this happen to me?"; "Who is to blame?"; "Why would this happen?".
3. Bargaining - The third stage involves the hope that the individual can avoid a cause of grief. Usually, the negotiation for an extended life is made in exchange for a reformed lifestyle. People facing less serious trauma can bargain or seek compromise. For instance: "I'd give anything to have him back." Or: "If only he'd come back to life, I'd promise to be a better person!"
4. Depression - "I'm so sad, why bother with anything?"; "I'm going to die soon, so what's the point?"; "I miss my loved one, why go on?" During the fourth stage, the individual despairs at the recognition of their mortality. In this state, the individual may become silent, refuse visitors and spend much of the time mournful and sullen.
5. Acceptance - "It's going to be okay."; "I can't fight it; I may as well prepare for it." In this last stage, individuals embrace mortality or inevitable future, or that of a loved one, or other tragic event. People dying may precede the survivors in this state, which typically comes with a calm, retrospective view for the individual, and a stable condition of emotions.

So how do we deal with our feelings when working with clients and their issues?

• TALKING about the problems is VERY IMPORTANT. Internalising will only lead to problems.
• Talking is the panacea to enable a good outcome for all.
• We have a duty of care, or a social responsibility towards our clients.
• When looking to refer a client for assistance with the above issues we should try contacting the following:
• the GP
• the carer
• the case worker
• community nurse
• NSW health
• When joining clients we should ensure we have contacts (ie phone, email) for at least one of the following:
• Family, doctor, carer, case worker
• Any ongoing issues should be referred to managers of care organisations. Staff should ask their own managers to make contact with these organisations.
• Try talking to clients to see if they are open to discuss issues and offer suggestions where possible.
• Or you can tell the clients you will make some enquires about what is available for them and then give them that information so that they can make any decisions about referral.
• Refer clients to services you are aware of and give them options to help improve their situation.
• The relevant NSW Health, for your area may be able to assist and you can try contacting either the Community Health Department or the Central intake number

Other relevant organisations for referral include the following:

• My Aged Care
• ACAT (Aged Care Assessment Team)
• Community Aged Care Workers (within your own council)
• Social workers (local hospital if the clients has just been sent home)
• Various aged care private organisations where the client is already registered with them, ie Benevolent Society.

Staff who do not feel confident to talk to their supervisor , manager or colleagues should consider utilising the EAP (employment assistance program) counselling services

A general discussion followed the talk, identifying the issues staff face when dealing with aging clients and clients with disabilities. Some of these issues included the following:

• witnessing poor living conditions in either individual homes or institutions
• seeing the deterioration of clients
• dealing with emotional outbursts from clients (sadness, grief, depression, sorrow etc)
• external factors such as cockroaches, smoke, needles, odours, personal hygiene of clients, medical conditions (ie wearing a colostomy bag) wounds etc, and clients in various stages of undress
• hazardous areas
• unclean library materials

There were various reasons raised as to why clients are distressed, some of these included the following:

• their declining health,
• loss of a loved one or pet,
• partner or family members health,
• threat of being placed into care and as a result reluctant to declare their problems for fear or being ‘put in a home’
• loneliness and fear

All staff present at the meeting agreed that dealing with angry clients, clients who are developing or demonstrating mental health issues, those who are depressed, emotional (ie in tears) etc places pressure on HLS staff and that can take its toll if staff don’t talk about what they have been dealing with.

Sally Meakin (Canterbury Bankstown) suggested that she would be happy to listen and talk to other HLS staff experiencing difficulties dealing with client problems. HLS staff are the best people to provide support to one another because they have firsthand experience.

BREAK FOR MORNING TEA

See attached presentation

Due to time constraints the remaining agenda items were combined and priority items were discussed

• A number of promotional idea and programs were discussed.
• The need for more visibility in our community. Working alongside existing pop up libraries or creating our own opportunities to present programs and outreach, particularly in areas where there is a strong ageing population.
• there is a trend in some public libraries, to move away from putting promotional material up to inform existing clients of services and programming.
• there is also a need to embrace partnerships to do cross promotion and ease the pressure on staff resources
• suggested we consider inviting community groups to the library for events and encouraging them to host their meetings etc in the library. It is a good opportunity to present our services and programs. It may also allow these groups to then promote our services and programs to their clients. This may allow us to reach a broader audience.
• we should be training all staff to engage our senior clients and determine their needs for both Readers Advisory and relevant services and programming. This is a useful way to enlist help from all library staff to aid in Seniors promotion.
• A 5 week program on brain training and the 5 stages of health, that showcased tai chi, using apps, coding for seniors, U3A etc proved very successful. Other libraries have trialled similar ‘healthy ageing’ talks which have also been popular, taking a positive approach to ageing.
• A Ukulele group at Lithgow has been enormously popular, as was a cooking demonstration for seniors at Campsie Library in conjunction with the Maggie Beer Foundation. Lifestyle programming for seniors helps to engage our active seniors and allows us an opportunity to familiarise them with our regular services and programming. Any event involving seniors is a great opportunity of promotion and outreach.

• Blue Mountains Library services do not have a Home Library Service.
• Staff offer a delivery service based upon need to individuals when required.
• They are looking for grants to establish a permanent HLS
• Georgia Lewsley from the Blue Mountains has provided her email glewsley@bmcc.nsw.gov.au if anybody can provide assistance in regards to possible grants, establishing an outline, setting up procedures, policies etc.

CLOSE OF MEETING 1pm followed by a tour of Lithgow Library.

NEXT MEETING: 7th AUGUST, BANKSTOWN LIBRARY 10am-1pm