Every so often you will arrive at a placement where you immediately recognize that things are just not right. By this we mean that there is too much ‘pushing and shoving’ to get the client from ‘a to b and back again.’
Often this may be the case in clients with advanced dementia, although it can happen in many different situations. Dementia is a more likely area where you may see this because of the nature of the disease and the lack of short-term memory which is a byproduct of the disease.
Now, as a new incoming live-in carer you will very likely be more aware of things of this nature because you are seeing things from an outsider’s point of view.
The reason why other people may not notice things changing is because things are familiar and people who are too close in the situation may simply move with the changes – whether they are right or wrong.
So, let’s imagine you arrive at your placement to find that during the handover, the outgoing carer has to literally heave the client up and into a wheelchair, or onto the commode, or anywhere they need to be. What on earth should you do?
It’s tricky..
It truly is a tricky situation. First and foremost, you need to take care of your own back. If you are injured with excessive heavy pushing, shoving, shunting – whatever you choose to call it – it is only you that will suffer in the end.
No one is going to pay you when you are laid up while a back injury heals, not the family nor the agency. You will be left on your own.
This is a good starting point and if you are in any doubt about whether the method used is acceptable and safe, ask yourself if you would be happy with your smallest/shortest friend trying to perform it.
What do you do?
If you are with an agency, the first thing is to contact them and explain your side. You can expect them to reply with a comeback that it is handover day and always difficult, you may want to hang on for a few days until your client is more settled again.
While this is extremely annoying because it almost sounds as if you are not being believed, there is a modicum of truth in this. Many clients do get disturbed on handover day and it can be stressful for many clients.
You may choose to wait those extra days to see if things change. On the other hand, if you feel deeply that things are not right, then standing your ground may be a path to take.
Explain that as an outsider you see things a little differently and be prepared to give very clear examples of this. Do not be vague and do not be critical of the other carer. Rather state your side that moving and handling has turned into pushing and shoving, which is wrong.
If you receive no joy from discussing things with your agency you may want to approach the family. This may or may not work as again, they have probably only received good reports from other carers and not had any reason for concern.
It is worthwhile discussing with them that there are better ways to move their loved one around, and you should have an idea of how to do this before you speak to them.
You may have noticed that things may be easier if there was a standing hoist available to at least lift your client off the bed when they obviously have issues with standing by themselves.
You may feel that climbing into the bath to shower is simply dangerous and there are different ways to bathe your client.
Get your ducks in a row
You can expect a certain amount of negative reaction if you, soon after you arrive, start to complain about the way things have been done before – sometimes for years.
Have your reasons ready. It is a good idea to always say that ‘this is incorrect because….’. Never a good idea to simply say it is wrong, this is a surefire way to get people’s backs up and foster hard feelings.
Tact and diplomacy
This is a good idea at all times, whether you speak to the outgoing carer, the hourly carer who covers your break, the family, or your agency. No one likes to be told that they are in the wrong, even if they are, so remain calm and polite as you put your point across.
Final thoughts
There are two ways that this situation will go, namely they listen to you, take your advice on board and change things for the better, or they simply choose to ignore your advice and suggest you ‘get on with your job.’
At the end of the day, you will be faced with two choices yourself – to stay (and hopefully change things) or to leave as soon as you can.
Think twice about the latter because agencies do not look kindly on carers who walk away from placements. You should at least give them some time to replace you.
Hopefully favorable changes can be made to help your client. If not, and after much discussion you are still not taken seriously, then ask yourself whether your own health is at stake and worth the risk of staying and possibly being injured.
It’s never an easy choice but it is an important one, so think seriously before you decide what to do.
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