Elderly, unsettled patients often fidget and pick at their sheets, clothes and skin. Twiddle muffs, cuffs, mats and blankets are an ideal solution– giving patients something to do with their hands. So the twiddle items, particularly the buttons, have to be attached securely.
I use embroidery thread, dental floss and linen thread to secure the item to the twiddle blanket, mat, muff and cuff. For buttons I will often finish off with yarn if I want to add in a colour. However, if you use thick yarn to attach a button the holes in the button will full before the button is securely attached.
If a patient pulls and tugs at a button, I do not want the thread to break or unravel. A loose thread is an attractive beacon for a patient who is restless and unsettled, and they will pick away at the loose thread. All ends must be well woven in.
How do I make sure that the item has been securely fastened? I get my husband Paul to do the safety test by pulling and tugging on the item.
My fear is leaving a pin or needle in a twiddle creation!
Assessing each twiddle muff, cuff, mat and blanket is an important aspect of the making, collecting and distributing of twiddle creations for recipients.
We want to prevent an agitated and confused patient pulling on a twiddle item and breaking the thread that secures the twiddle item to the muff, cuff, mat and blanket, or finding that drat pin or needle. The twiddle creation should be a simple and safe gift to calm the patient, not to cause harm.
So what to do? The creator should:
Make sure that everything is sewn on tight so they cannot be pulled off, and that there are no loose threads or hazardous parts like sharp objects.
Use unwaxed, non-perfumed dental floss which is very strong, or embroidery thread, to attach items like buttons to the twiddle creation. Finish off with coloured cotton or wool.
Have someone to do the final check by twisting and pulling the items, and checking thoroughly for pins and needles before any twiddle creations are handed over to the hospital.
I don’t like a lot of dos and don’ts, however overtime I have accumulated a lot of learnings to improve the safety of my twiddle creations.
I avoid using any item that could restrict a recipient’s fingers or hands. I like trying out new crochet stitches but once again I keep clear of lace work or stitches that promote gaps where finger or cannulas could become trapped.
I have found that some wool textures are unsuitable, particularly those with loose fibres that can be easily pulled out, as these can be a choking hazard.
While it is lovely to use any large pieces of ribbon, lace or velvet the material should be secured well to ensure that it stays attached to the twiddle creation.
Some creators incorporate old keys, key rings, nuts and washers. These should be assessed to see if they can harm the patient or even the medical staff. Nothing sharp or potentially sharp should be on the twiddle creation.
For safety reasons check that the following items are not used or present: sharp edges or points, pins, safety pins or badges, brittle items or items that might snap easily, items that have been attached with glue or adhesive backing or glue surfaces, items with screw-on backs, items which contain liquid, like glow-sticks, or water sealed in beads.
I love pompoms. They can be quite engaging but most of them fall apart. So check carefully if you use them to see if the strands can be pulled out.
I recommend that you don’t use any items that can be pulled to bits, such as plastic or paper flowers, feathers, paper and foam items.
Lastly, if you know where your creations are going, check with the place or organisation what they require. I have found that each place or organisation has its own set of rules. During Covid-19 many ask that you pack each creation in a plastic bag with your name and date of packing on it. It’s up to the organisation to remove the plastic bag prior to giving the recipient your twiddle creation.
At the Royal Melbourne Hospital these twiddle creations are gifted to the recipient and they take them with them when they leave the ward.
Our stories are linked to our experiences with the Royal Melbourne Hospital. Our dream is that wherever you are you might be able to be part of a project in your area. We would love to hear your stories so we can all learn from each other to help make hospital stays a comfortable experience for the elderly.
Making twiddle creations provides opportunities to involve friends and family members. An important aspect of our project is involving people in different ways. While crocheting and knitting is our preferred way of making blankets, muffs and cuffs, the twiddle items that are attached to the blankets, muffs and cuffs can come from many different sources.
For example, Paul, my husband, supports the project collecting interesting bits and pieces like discarded hair ties and ribbons found on the street and small items such as felt animals, buckles, snap fasteners, velcro from $2 shops. Some people like donating buttons, ribbons and zips. It still amazes me what you can turn into a useful twiddle item as long as it is safe for a recipient.
I have also received some knitted pieces in a variety of sizes which I could then turn into complete twiddle creations. What was so exciting about this, was that beginner and inexperienced knitters used different types of yarn to make these pieces. Everyone benefits and feels a sense of achievement and purpose.
Leftover granny squares become pockets.
Before starting a project many knitters and crocheters do a swatch, a small piece of crochet or knitting that checks the tension to see if their stitches match to the pattern’s gauge. These swatches are very useful indeed to attach to twiddle creations. Maybe you can persuade someone who does a lot of knitting or crocheting to give them to you.
See what you can collect to reuse. If you have time, have a read of my story about repurposing granny square blankets. You can help in so many different ways. It is such fun and a great activity to share with others in the making of these twiddle creations.
A couple of years ago our daughter, Mya, an emergency physician, suggested I have a look at making twiddle muffs for elderly patients admitted to the Acute Medical Unit at the Royal Melbourne Hospital. These patients were often distressed and restless at being in hospital. The nursing staff found that by giving the patients some sort of activity to occupy their hands and minds they became more settled.
The first twiddle muffs for the Royal Melbourne Hospital
Soon we were making twiddle mats, blankets and cuffs.
The nursing staff are the key to this project. They have a range of different activities they can use to help settle patients. When given a twiddle creation, some might reject it; others are intrigued and become engaged. This twiddle creation becomes their property and they take it with them when they leave the unit.
The question then was, how do we/you sustain this project? We will share ideas with you overtime and let you know how we are going. We look forward to our many discussions.
