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The care relationship – Paid care givers

November 19, 2012

I have written about care in earlier posts.  Today I am pondering the experiences of paid care providers in care relationships. 

I am an occupational therapist and some might consider me a paid care provider.  Most of the time, I feel like I am consulting not necessarily caring.  I watch with my “occupational therapy eyes”.  As I share my observations and my tentative hypotheses, I problem solve with children and their parents and teachers. 

I feel like I am providing care when I am doing an activity like massaging a young infant.  Touching another person to give assistance is what first comes to my mind when I think of care.  This is the type of care I would like to discuss today (though I am learning that care can go far beyond this physical activity).

I am curious about the experiences, thoughts, feelings, and opinions of paid care providers and those disabled people whom the care providers bathe, dress, and feed.  How do supervisors, disabled people, and the paid care providers themselves decide when the care is inadequate, satisfactory or exemplary?

I have read some blog posts about care and some academic articles and books about care.  I am learning that attentiveness to the specific needs of the care recipient is a necessary part of good care. 

Many people struggle to describe how it feels to give physical care and physical help to complete personal activities.  What are care providers thinking as they provide this care?  How do they check how well they are doing their job?

I would love to hear more about what paid care providers think and feel.  If you are a paid care provider and/or a recipient of paid care, please share your ideas with me.  What does someone like me – someone who doesn’t currently need nor give this type of care – need to know? 

I suspect that there is often not enough training or time to do as good a job as both people in the care relationship would like.  If this is true, what needs to change and how?  How do both people in the care relationship cope with these constraints?



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  1. Before my epilepsy prevented me from doing so, I was a dedicated carer to the elderly with dementia in a nursing home setting. I’ll do my best to answer your questions.

    I disliked the “factory conveyor belt” aspect of the job. Yes, you need to be able to work quickly, but these are people you’re dealing with – not objects. Trying to rush an elderly person who is already confused and might tend toward violence when provoked by being hurried is grossly unfair. I always tried to be as reassuring as possible whilst working as quickly as I could.

    Time should be allowed for a carer and a client to get to know each other. Nobody wants a brash stranger who doesn’t care about their dignity or feelings to be washing them roughly, toiletting them or dealing with highly personal care. I always observed new residents and learned (often the hard way) their likes and dislikes. As a result I became a favourite with some of the residents – including one lady who was known for violent behaviour. Speaking gently to her and reassuring her throughout washing, dresing, toiletting and bathing was all it took, but nobody else could get close to her. One afternoon my floor sister was amazed to walk into the dining room and see this lady waltzing me around to “The Blue Danube”. I’d been wiping up after lunch and the lady had heard the tune on the radio, wandered in, kissed me, said “I love you” and started whirling me around! The floor sister had never heard her laughing before, and she had the laugh of a carefree young girl.

    There is annual in-house training, but new carers are very much thrown in at the deep end. I was shown a video of what not to do and expected to get on with it – and consequently I was often yelled at for taking too long or not getting something quite right. This definitely needs to be addressed for the sake of both the carer and the client. There aren’t enough dedicated people who want to do this job as it is, so the last thing the industry needs is for people to be frightened off by the physical demands.

    My way of caring often didn’t make me popular with my superiors, but I was there for the clients and not for them so I honestly didn’t care. I still managed to get things done quickly and my clients were always some of the happiest. If a floor was short-handed it was always me that they asked for (but never got because my floor sister wanted me with her). I was never off duty in my mind, and once saved the life of a client who had been out with a friend and didn’t want to return to the home by stepping out into a busy road and persuading him to go with me. His wife and son both thanked me but – in spite of them speaking to the home manager – that was all the acknowledgement I recieved.

    It can be a heartbreaking, difficult, thankless job, so one thing I truly believe is that homes should weed out the carers who are only there for the wage and make sure that their staff is as dedicated to their cause and their clients as possible.

    • Thank you very much for sharing your experiences and your ideas. You raised a couple of points that I’d like to respond to. It seems really important that supervisors and management in general are supportive of paid care givers. Care givers also need to receive care even if it isn’t the same type of care that they provide. Thank you for reminding me of that. You also touched on the fact that sometimes care recipients can be verbally or physically aggressive. I suspect that happens when care givers are not told enough information about the care recipient and when the care givers are unable to be fully present and attentive to the needs of the care recipient. Though it is after the fact, I am grateful that you were able to be attentive to the needs of your clients.

I look forward to hearing your thoughts!

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