The recent focus on reducing restrictive practices in order to deliver restraint free care to the people using education, health and social care services has predominantly focused on paid carers (such as teachers, nurses and social workers) and their employing organisations.
However, many people who present behaviour that might be challenging live at home so it is important that we do not forget the needs of all those ‘unpaid’ carers (the husband, wife, son, daughter, brother sister, friend, neighbour) who equally need advice, guidance, support and training on this contentious and emotive subject.
An Unpaid Carers Perspective
A colleague, who is also an unpaid carer for a family member who has dementia, recently shared an experience which powerfully illustrates the the kind of understanding, help and support unpaid carers need if positive differences and improved outcomes can be achieved:
As a carer I recently attended some training about dementia for family carers. About half the people there were family members of people newly diagnosed and needing some basic information on how to prepare for role as unpaid carers. I think they got what they needed.
The other half were more like me – and every one like me with more than a couple of years caring under our belts (so almost by definition for people caring for loved ones who have moderate to advanced dementia). When asked what we wanted from the day, we said we needed advice on how to deal with difficult and/or challenging behaviour of various types – sometimes from the person we care for and sometimes, some of us admitted, from ourselves. There is a lot of advice available and which often boils down to:
- Remember they don’t mean it
- Don’t take it personally
- Stay calm
- Don’t get into conflict
- Walk away
Perhaps these hints and tips are easier to follow in a care home or hospital and perhaps there are times this advice is easy to follow at home, but maybe, we need examples of what to do that in real life.
Can you just walk away if someone is going to pee in a public car park in full view of children?
Can you avoid conflict if someone is about to put paint or soap in their mouths? or if someone has just swore or used derogatory language to a shop assistant?
How do you walk away when some one has been incontinent and needs personal care but are refusing your help?
How do you stay calm if someone is doing something against medical advice which may be detrimental to their well-being? and . . .
How do you not take personal comments . . . you know. . .personally?. . . how does a wife of 30 years not take it personally when her husband ignores or doesn’t recognise her, around the whole dynamic of their relationship and how it is changing. How does a son live with a father regularly telling him “I thought I had a wonderful son . . . but I was wrong”
There are no easy answers but it is important that both paid and unpaid carers work collaboratively to find ways of helping people work out some answers.
The Restraint Reduction Network aims to bring together organisations, paid professionals and of equal importance, unpaid carers and users, to share their experiences learn how to make restraint free care a reality. The role of unpaid carers and users to deliver restraint free care and support is paramount as they typically know and understand the people who need to access and use services best.