HOW TO CARE WITHOUT TAKING OVER
The instant you see a loved one struggling to do an everyday task, your caring reflexes kick in.
All you want to do is help them, to make their life easier.
They might be taking five minutes to wash up a plate, or puzzling over the microwave buttons. It’s a lot of effort for them, and (to be honest) painful for you to watch. Wouldn’t it be better to do it for them?
Actually, sometimes the answer is no. As care professionals, we often see the effects of concerned relatives and others providing too much care. And while this always comes from a good place, with the very best of intentions, too much care can be as detrimental to them as too little.
The downward spiral of dependence
To understand why, let’s imagine our tea-making scenario from your loved one’s perspective.
For years, whenever someone visited, the first thing I did was to put the kettle on for a cup of tea. But recently, the whole process has become a rigmarole! Getting out of the chair, getting over to the kitchen, even filling the kettle — it’s all become such hard work.
When my daughter comes round, every time I was starting to get out of the chair, she’d say, “I’ll do that for you, Dad.” And before I could say anything, it was half-done. She moves around like a whirlwind —washing my plates up along the way, too. I couldn’t be bothered to argue about it, and it seemed less fuss to let her get on with it. And after all, I know that she likes to help me out.
So pretty soon, I’d settled into a new routine, where all my visitors were offering to make the tea — including the visiting care services — and I always said yes. Now I’ve noticed that when I have to do it for myself, it’s become more difficult.
In fact, the last time I made a cup of tea, I dropped a mug and made a right mess. I’ve been worrying about that a lot. So perhaps, all things considered, it’s better if I just wait for someone else to do it. I think my tea-making days are over!
Although our example is fictitious, this downward spiral is all too real and common for people receiving care – whether they’re getting older, or there are those recovering from an operation or health scare. By accepting help with a task, people in care can often lose the confidence and ability to do it for themselves. Then they need more help with the task, resulting in even less practice. It all adds up to a steadily increasing dependence.
Walking the fine line
Clearly, the best scenario is where someone receives support which helps them to stay as independent as possible. Yes, we want to make their lives easier, but (to put it bluntly) not so easy that they become de-skilled and dependent.
This same mindset extends to risk. Many of us have watched vulnerable relatives negotiating risky activities — climbing a stepladder, for example — with our hearts in our mouths. Our instinct is to lock away anything that could cause injury and forbid them from doing anything that’s not entirely safe.
But even when we’re starting to assume a caring role, it’s important to remember that our parents, for example, aren’t children. And although we’d want to protect all our loved ones, we cannot wrap them all in cotton wool. Risk is an inevitable part of an independent, grown-up life.
So how do you walk the fine line between caring and over-caring, between protecting and over-protecting? It’s far from easy, but our professionals have put together some ideas that we hope will help.
Four steps towards care that enables and re-enables
1.Discuss levels of support with the person you’re caring for
Good communication with the person you’re supporting can prevent a lot of false steps and misunderstandings. Be honest about your concerns, explaining that you want to help without taking over. Being open will encourage them to be forthcoming about what they really need help with, and what they’re comfortable managing. Being able to choose how much support they receive is in itself empowering.
2.Provide opportunities to choose
One of the hardest things about ageing is that our day-to-day options become restricted. The danger with providing care is that it further restricts the cared-for person’s choices. It’s all too easy for a busy relative (or even professional carer) to simply do what the cared-for person usually likes – without even asking.
Whether it’s choices in activities, food and drinks, or clothes for the day, providing a supported person with options can hand them back a much-needed sense of control.
3.If appropriate, discuss making clothing easier
When we’re children, being able to dress and undress ourselves is a milestone in our autonomy and freedom. So conversely, losing that ability through ageing or lack of mobility can be an unwelcome sign of losing independence.
Unfortunately, many clothes are completely unsuited to the abilities of the ageing body or for a body that’s not performing as well as it once did. Features such as buttons, zips, press studs and laces can be particularly difficult, making it impossible for some people to dress or undress themselves. However, a few changes can make a world of difference. For example, trousers with an elasticated waist, rather than a button, may allow someone to get dressed in the morning. If you notice that a supported person is struggling to dress or undress, it’s a conversation well worth having.
Also, consider how easy clothes are to access. Wardrobes stuffed with clothes or heavy drawers can provide as many barriers as the clothes themselves.
4.Encourage and facilitate physical activity
One big contributor to the ‘spiral of dependence’ is a lack of physical activity. When moving around becomes harder, whether suddenly due to an illness or operation, or due to the course of time, our natural tendency is simply to do less of it. This is turn takes its toll on our ability to move, as muscles weaken from lack of use and joints stiffen. Lack of activity is linked to many diseases, including Alzheimer’s and diabetes.
To break out of this cycle, you should – where possible – encourage and provide opportunities for physical activity. Of course, what this means in practice will differ greatly from person to person. For some, getting out and about on walks is entirely appropriate. For others, it may mean just moving around the house more.
Judging the appropriate level to support and encourage is tricky: again, discussion and sometimes negotiation are the key methods.
Professional care and independence
Home care services can be invaluable in maintaining a person’s independence. When home care workers are well trained and experienced, they become experts at judging the right level of support. It’s then that home care can become truly re-enabling, giving the supported person a new lease of life.
Unfortunately, whether through company policies or poor training, some home care can actually increase dependence and fragility.
When seeking any kind of professional home care, we therefore recommend that you ask plenty of questions about their policies in general, and specifically about how their service helps to promote independence.
Retain Healthcare is a leading provider of outcome-focused in-home care and support for elderly and vulnerable patients in the South West. Retain also recruits healthcare workers and provides high-quality healthcare training. For all enquiries, please contact firstname.lastname@example.org
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