How can I be a better care worker?

Posted by pepes-peri-peri@reddit | AskUK | View on Reddit | 24 comments

Long story short: I went to uni and studied to work in pharmaceutical research, got a job and realized I much prefer working with people. Currently trying to get into paramedic science/cardiac physiology but NHS jobs (or moreso funding) are few and far between atm.

I've just started as a social care assistant in a nursing home. Personal care did initially shock me, but 3 shifts in and I'm not really bothered anymore. I do still feel a bit awkward and intrusive/guilty doing it. I don't dwell on it but find it extremely upsetting that some people are in such late stages of disease and there's photos of them on the wall smiling with their families. Life can be so cruel.

I am really enjoying the job. Especially finding ways in which I can connect with residents or find out what they done when they were younger and talk about that.

How can I be better at this job?

Dignity and respect is really important and I've noticed a lot of care workers will talk about residents right in front of them as if they are not there. I understand some don't have much capacity, but it's so wrong to speak about them as if they can't hear, or even just in that condescending baby talk tone. They're adults!

I have been helping with personal care when staff kept laughing and joking and flirting with each other and coming in and out of the woman's room while she was in a toileting sling. The door should have been shut as it would be for any other person going to the toilet. I regret not saying anything at the time.

I'm looking for advice on how to connect better with residents, activities to do with the kind of restless/bored residents, how to not feel guilty/awkward with personal care and what to do in situations where I feel other staff are being inappropriate. I don't want to cause drama/friction and it is a bit big-headed and bold saying something when I'm so new but at the same time I'm in my late 20s and they are mostly early 20s so I do feel like I could pull the maturity card.

(This may be making me come across as a cunt, I'm laid back asf and always up for a joke - but when it comes to certain things like this I'm happy to put a foot down)

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OhMai17@reddit

What a lovely question to ask ❤️
I have been a care worker in different settings for the last 10 years. It is incredibly frustrating seeing others do the things you are talking about, and the truth is that you can make a change.
I can see from your post that you already have it in your heart to be a good care worker, because you CARE, and that’s the best start.

Things I have learned and always try to do:

Always talk to service users like you would like to be spoken to. There is no need to be patronising. Yes, tailor your communication to each person’s needs, but always do it from a place of respect.
Person-centred and holistic care. Learn all about it. Live by it.
Some things you can do to provide individualised care:
Communication: Again, this is a big one. What does the person need? Would visual communication be better? Short sentences and time to process information? You work in a nursing home, so I imagine you work with a lot of service users with dementia. Background noise (people talking, the radio, the TV) can be incredibly distracting when you’re trying to help someone engage in a task. I appreciated this so much when someone taught me. It made simple tasks, like encouraging a service user to stand up from a chair, so much easier.
Dignity: Give your service users choices. With EVERYTHING. What food would you like today? Which shirt would you like to wear? Would you like to wear your jewellery today? Banana or apple for dessert? Which shower gel would you like?
Also think about capacity. Iris is 80 years old. Iris loves cake. Iris has full capacity to understand that cake might not be the best thing for her blood sugars, but Iris wants cake. She understands the consequences and has the capacity to make that decision. You can suggest something healthier, but if Iris wants cake, GIVE IRIS THE FUCKING CAKE.
Dignity during personal care: Make sure people are covered as much as possible. Keep doors locked and curtains closed. If you are assisting someone in the toilet, once they are safely seated, leave the bathroom if appropriate, or at least turn away if it is safe to do so.
When talking about service users, it is so easy to talk about them in front of them. Nursing homes are busy places and everyone is rushing around. Sometimes a simple acknowledgement can make a huge difference: “Hey Doris, we’re just going to talk about what you’ve been doing today, if that’s alright with you.” Not only are you showing respect, but you’re also setting an example for your colleagues.
Spiritual and emotional needs: Ask your service user or their family. Do they want to go to church on Sunday? Make it happen. Do they want to visit their mum’s grave? Make it happen. We used to keep a diary of important birthdays for family and friends and support our service users to choose a card, write it, and send it.
Did your service user love baking? Let’s go to the shop and buy ingredients. Let’s bake together.
Promote independence and ALWAYS ASSUME CAPACITY. Unless there is a reason not to, assume people can do things for themselves. Find out what support they actually need, rather than what others assume they need.
Advocacy. Advocate for your service users. Speak up if something isn’t right. If you see something that isn’t being done properly, say something. You have a responsibility to safeguard the people in your care.
Education. Pass your knowledge on to the people who shadow you in the future. Be the example you wish you’d had when you first started.

Hope this helps ❤️

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Loudlass81@reddit

Can you come and be MY Carer...having trouble finding anyone that would be the type of Carer you are...

AbjectGovernment1247@reddit

Talk to them in the same way you would talk to your grandparents, assuming you had a good relationship with your grandparents. 😄

Ask questions about them and their life before the care home, their likes and dislikes and be willing to share things about yourself. It's amazing what stories you'll hear.

Additional-Guard-211@reddit

I am training to be a social worker, and honestly I just want to say it really sounds like you have the necessary attributes to be a social worker. If ever the other thing doesn’t work out or whatever, please look into consider this.

I work with children so its hard for me to actually answer your question, but what I do know is relationships are the key here. Relationships with the people you support, their families, their professions, other professionals, colleagues etc is the most important thing.

Stand up for them in situations where their dignity is being impaired by other staff's behaviours.

As someone likely to lose all OUTWARD capacity (bit like locked-in syndrome at the end of my illness), I can tell you we as those who NEED personal care appreciate the staff that DO advocate for us - and I'm sure your resident's families would too.

I STILL have an issue of Carers REFUSING to respect my need for dignity as a trauma survivors despite still having full mental capacity AND more than able to speak up for myself. It makes me shudder to think about how they're treating those with LESS of those abilities than I have, if they ignore MY dignity so frequently.

They acted like me needing to have the toilet door SHUT when it faces my GLASS front door was too much effort, and would get angry with me for refusing to allow them to pull down my trousers if the door was still open. I've even had one Agency DUMP ME as a client simply for insisting my dignity was met during toilet visits.

Also - music from whatever era the residents were in their teens & twenties. The amount of ways music unlocks people never ceases to amaze me.

ueberryark@reddit

Thank you for caring. A couple of book recommendations for you...

Contented Dementia by Oliver James

Beyond the Facade by Eileen Chubb

Also look into your organisational structure and identify who your safeguarding lead is at head office (you should be able to find out online but they should also be communicating this to you regularly).

Environmental-Cut779@reddit

Talk to them as your providing care; “shall we jut do this Doris” , alright Doris are you happy for me to just help was you bottom. Doesn’t it feel much better now your all washed and on clean clothes, I know it makes me feel better ; your already looking at it from a person centred approach. Which is a brilliant start, tell em about your day, ask how they slept, all of this stuff, so when your doing a hand over you could say so I help Doris do x didn’t I and then we brushed your hair and made sure you had a nice drink “ your making them part of it

Source work in adult social care but not on the ground

asmzi101@reddit

Some of the best carers I’ve met are the ones who have a balance between encouraging healthy choices whilst also respecting the person has capacity to make poor choices. Don’t want to get washed? Want to have cake for dinner? You can encourage the better option but always remember they are the one in charge of their own life.

Sounds like you’re really good at this job already.

deg1388@reddit

I say be the whistle blower. People deserve dignity and respect. Anyone out of line needs to be dealt with by management. Unfortunately these bad habits get passed on from staff member to staff member. It just takes one to say, no thats not good enough. We have a 2 person per resident policy. You are more likely to do your job properly if someone is there to witness everything.

Tay74@reddit

It shouldn't even require being a true "whisle blower", the organisation should have a way to raise concerns. I wouldn't go rogue before trying to solve things using the organisations official channels

I work in the admin side of inspecting care organisations, you get some shit places that won't listen to feedback from within or outwith the organisation, but there are also plenty of places that do want to treat those in their care right, and want to run a high quality, above board organisation, and those places will often listen to employees and make changes if they are told something isn't working

carolomnipresence@reddit

Whistle blowers never fare well, and Managers are all about the owners' interests. Confront the behaviour personally, politely and firmly. They'll know they're in the wrong.

Also ... I find simply playing music or singing with them is an instant uplift.

grafter83@reddit

I could say so much in response to this post- literally could talk for hours about the principles of care and how passionate I am about them, but I don't have the time or patience to write it all out lol.

The most important thing I will say to you in response to your post is that being the best care worker you can be involves courage and the bravery to speak up when things feel wrong. This is very definitely not always easy, and socially you may pay the price. I can't lie, work wise you may pay a price too- I once was involved in a very serious whistle blowing case and ended up mysteriously not being booked for many more shifts by the agency I had successfully worked at for several years- even helping them facilitate staff training through that time. This should not happen legally but with a zero hours contract it's very easy to get away with...it also shouldn't happen morally as it discourages future whistle blowing- did I suffer very negative effects from that situation? Yes, absolutely. Would I do it again knowing what happened last time? In a heartbeat, wouldn't even think twice about it. I couldn't look myself in the mirror otherwise.

Educate yourself as much as possible about the principles of care and the ethics involved so that when your gut tells you this is not ok, you are able to speak out with certainty, and also explain the 'why'. This may be enough to make some other carers stop and think about their actions in the future- it absolutely won't matter to some others though and those are the ones you are going to need the courage for lol. Bad practice can be a result of a culture within a care setting, and good carers may end up doing things they shouldn't as they really don't know better/understand the 'why'.

Being brave is also important as you may be out into situations where you are asked by the organisation to do something above and beyond your scope of practice (happens more than you may think) and then you will need to advocate for yourself and stick to your guns.

Being a carer isn't just assisting with the Activities of Daily Living, it's being a voice for those who may not be able to advocate for themselves anymore...sorry I have gotten on my soap box a bit here, this is a subject very close to my heart! The fact that you are on here making this post shows that you are coming into this with the best intentions, and is a great attitude to have, I am sure you are a lovely carer.

retailface@reddit

No real advice for you here, but it sounds like you're doing a brilliant job so far. We need more carers like you, who see their clients as people rather than a list of things that need doing. Thank you.

Be ordinary and kind, do be a c*t when other carers are inappropriate, remind them that they are in a position of privilege in what can be routinely embarrassing and sometimes distressing parts of resudents' lives, to be able to access and help those people. Doing that can be a lonely business, but there will be some there who will be supportive, and the residents and their families would if they could, and indeed sometimes may actually thank you, if they're sufficiently aware. Ordinary and kind (oh, and don't trust the Managers).

Lynliam@reddit

I looked after teenagers with severe disabilities and had to do personal care. What helped was knowing there interests and talking about that while doing the embarrassing stuff as a distraction and it seemed to work, we got into a routine. And I enjoyed learning about there books, games, films etc

One thing I tried really hard to avoid was saying "how you doing" or "how are you" as a greeting. It really annoyed them as they felt it was sering the disabilities first. So I stead I'd try "what's new with you" or "what have you enjoyed doing this week". Focusing on everyday stuff rather than the meds or doctors or health bit. They got fed up of constantly having there health issues a main topic of conversation among people

CatsChat@reddit

I like that as an enquiry.

I think you have excellent instincts. A good place will find ways to respect people’s dignity. I did a student placement on a brain injury ward and another in a dementia unit and was so impressed by staff talking to the patient as they did things, saying where they were going to wash, handing the patient a washcloth to do what they could, staff keeping the patients ‘bits’ covered for dignity with a towel or sheet apart from when staff (or patient) were actively cleaning that area.
It’s difficult to challenge anyone when you are the new person. Maybe one way to make a difference might be to direct conversation to the patient yourself when you are with them, include them in the conversation? ‘What do you think, Malcolm, should Karen dump the guy she is seeing? Now we are just going to sponge your arm…’

princewinter@reddit

The best thing you can do, is exactly what your instinct is which is make sure everyone ELSE is doing their job properly. You hear horror stories about abuse in care homes and honestly it's one of my biggest fears. But the only thing that can stop that is people who do the job because they love it and WANT to do it properly.

It takes people like you.

MissCaldonia@reddit

You have the best attitude for this, I’m no expert but did work in an elderly persons care home when I was young. I’d say the fact you are treating them as the person they were is invaluable and actually talking to them even f they are talking about something that happened 60 years ago. Regarding the toilet situation, can you just say ‘let’s shut the door shall we? ‘ in a breezy way until you find your authority or get promoted?

Kiloyankee-jelly46@reddit

It sounds like you're off to a good start by treating them with dignity and empathy. My aunty has carers and the ones she likes best are the ones who remember the little things, and do certain things without her having to ask for them, for example setting her up with a cup of tea and setting a mug up for her for when they're gone and she's making her own teas. She also really likes it when they're nice to her cats, who are basically her whole world at this point due to her low mobility.

Upper_Paramedic_2043@reddit

Based on the care my father received when he spent a month in a care home I’d say treating everyone as a human being is a good way to start. Get to know your patients and what their individual needs are. Never leave them sitting in soiled clothes or berate them for any mishaps. If the patients like you then you’ll go far.

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