The example just shown highlighted the importance of ‘positive feeling’ in support work. The HOPES research noticed that support workers built a relationship so that the older person felt they were ‘on their side’. Establishing yourself as helpful and trustworthy person was found to be extremely beneficial when delivering care.
One support worker noticed that a family carer was struggling to wash and dress her husband, but she was very reluctant to have care workers do it. Possibly, she felt threatened by having formal carers take over, and that it might be a sign of failure. The support worker recognised this, and tried to re-frame her role as being a little bit of help, not as replacing what she was doing
I said: “I’m not here to take over, you’ve been doing fantastic all this time, it’s just a bit of support, that’s all, that will help you look after him for…you’re doing it 24 hours a day, seven days a week”. So it’s also letting her know that I completely understand what it’s like and “I’m here to help: let me help you”.
Being ‘on their side’ meant validating their experiences, and demonstrating active listening.
So, I would sit down for ten minutes, have a good chat with her, let her have a good rant. She’d rant about [name of a care worker] coming in. She had big issues with [name] coming in, and I’d let her talk to me about it. I would just validate those feelings, because I would say to her, “it must be awful”, listened to what she was saying, “yeah, I would feel really crap about that as well”, and just validate what she was saying. So, she felt like she was being listened to and heard.
Some caution would be needed when doing this. This support worker was careful to validate the service user’s feelings, but without getting into a dialogue about what the care worker might have done wrong.
Activities: When things go wrong
The HOPES research also heard from some homecare workers who were having difficulties engaging with older people with mental health needs. There were some clues as to how they might have approached things differently.
How might this homecare worker come at things differently?
“Oh gosh, I’ve just thought of one really resistant person. Oh, this one lady, she definitely doesn’t like me. I have never done anything wrong, but maybe I think it’s because I’m one of these people that – when I know somebody needs the care – I will say: “you really need to do this”, or, “you really need to do that”. And, she does not like that at all.
She has cellulitis on her legs and sometimes needs cream. She’s gone through four different brands of the creams that the doctor’s prescribed because she says that it’s really itchy. I’m not joking, she will literally be shaking, saying “it’s so itchy, it’s so itchy”, and it’s literally just E45 cream!
I’m not saying that she doesn’t feel those things, but she’s one of those people that once she gets something stuck in her mind, she doesn’t want to do anything. Like, if you offer her something for tea and she doesn’t like it, she doesn’t want anything else, she will throw the plate down, she will say, “get it away from me”. She’s very stubborn.
How was this older person labelled?
Was this care worker “on their side”?
How might this care worker have approached this differently?