Working in a care home and seeking views/advice

[DaisyUnderTheSun]

Hi all!

I've just started a new job as a carer in a care home and I really love it. But it's very strange that there are no relatives/visitors, and so I can't talk to family members or get their perspective. So what I'm really asking is - what do you think I need to know about caring for people with dementia and what would you want to say to me if it was your relative?

Thanks guys!

 

[May30]

Hi,
I would say focus as much as you can on the things they can do rather than the things they can't. Try to see the person through all their difficulties. And find the little things that make them tick. My dad loved animal programmes and I tried to get the home to put them on for him but they never did. He had a little musical instrument set and I was the only one who used it with him. It's the little things that really matter and would keep his spirits up.

 

[Lynmax]

Could you phone the relatives to get some information about a residents interests? Although I was not able to visit the home before mum moved in, I have had many phone calls with the carers and manager about what mum likes to do and possibly more importantly, what she does not like.

 

[DaisyUnderTheSun]

@May30 Thanks for your reply, I'll be on the lookout for things like that. It's difficult when there are no family members to tell me those details, but hopefully one of my colleagues will know. I know exactly what you mean though - I was putting the telly on for someone the other day, and because they're non-verbal I had no idea what they like to watch

 

[DaisyUnderTheSun]

@Lynmax I hope I'll be able to talk to families on the phone, I think at the moment I'm considered too junior, but I'll see if I can persuade the seniors to let me. Can I ask, do you think it would be appropriate to stop by during a window visit to introduce myself? I don't want to butt in or take up the precious allotted time if it wouldn't be welcome.

 

[lemonbalm]

@DaisyUnderTheSun . You sound as though you are going to be a tremendous asset to the care home. I'm sure your warmth and compassion will be a great help. I would say that patience, kindness and respect are the main things which you no doubt already already have. Something which has disturbed me quite a bit in care homes I have been in is lack of respect and raised voices. it's probably not intentional. I know that hearing is often an issue in care homes but I do wince when a carer shouts "do you need a wee?!!!!" to a resident. I think the "toileting" side of things can be very distressing and degrading. If you can find a way to communicate with each resident without having to raise your voice, particularly if it's to ask them if they need the loo, that would be really good. Watching out for signs that they need the loo is important too, as being too late can cause a lot of distress and loss of dignity. Those carers who can do their job without resorting to raising their voice really stand out, to me anyway.

 

[Sarasa]

Hi @DaisyUnderTheSun , glad you are loving the job. It must be tricky at the moment as in normal times you'd be meeting relatives all the time when they visit, and if they are anything like me would be wanting to let you know what things my mother liked, and be very happy that you would be interested in finding out. I think with introducing yourself maybe hold back for a while until you know the residents better, and have asked other carers their opinions.

 

[Shedrech]

Hello @DaisyUnderTheSun
It's good that you are enthusiastic about your new career... maybe shadow some of the other staff so you pick up the home's practices and some tips... watch and listen carefully so you begin to appreciate how individual each resident is... ask your colleagues about anything you are unsure about... approach residents slowly (no surprises or abrupt movements) smile a lot and use a calm, clear voice, speak a little more slowly than we normally do and keep things simple and straightfirward, face each person so they can see you are talking to them
In my dad's care home each resident had a file which gave background information and up to date details eg about meds and nutrition... staff were expected to familiarise themselves with these and speak with the longer serving and more senior staff who all knew the residents well

Please don't take it upon yourself to call family members without permission from your line manager... be aware that seeing a call was from the care home immediately made me worry... it takes time and experience to know how to handle calls well... maybe ask to listen in on some as part of your training
Same with visits.. speak with other staff about how these are organised... given that family hardly get to be with their loved ones at all right now, I'm sure your colleagues are careful with both resident and visitor
Have a chat with your line manager and ask for some things you're unsure about to be included in your ongoing training

there's a lot being discussed on DTP so reading around the threads will help you appreciate the carers' perspective and how the members here deal/cope with situations

 

[DaisyUnderTheSun]

@lemonbalm Thank you very much, it's so sweet of you to say that! Luckily I have some experience with speaking clearer, not louder for people living with hearing loss - my mum has had progressively worsening hearing so I know the drill. (She's just gotten her first hearing aids, and the things she can hear now are hilarious. She thought her hearing aids were broken the other day because there was a weird crackling sound - turns it's been years since she heard the sound of leaves crunching under foot!) I'll keep in mind what you said about toileting too - I suspect there's such a loss of dignity involved in pad changes, being hoisted onto the commode etc, that carers forget that it's also degrading to have your toileting needs publicly discussed.

 

[DaisyUnderTheSun]

@Sarasa Thank you for your reply. The more I do this job, the more I feel the absence of relatives. I can't ask them what their loved one likes or dislikes, or encourage a resident to interact with someone who I know won't lash out, or have someone there who can spare a minute to tell me whether someone is behaving differently that day. And I'm still feeling my way for which carers I should/shouldn't model myself on, but the best people to model myself on for each individual resident would be the people who have loved and cared for them for years. It's very, very frustrating and upsetting and it breaks my heart. Praying for a vaccine every day ???

 

[DaisyUnderTheSun]

@Shedrech Thank you very much for your long reply, that's all really useful. It's so difficult at the moment to convey to residents that I'm smiling with my mask on - I've been smiling so widely to make my eyes crinkle that my jaw hurts as well as my feet!! I've been trying to read the details in care plans too, but often they just don't have the level of detail I need

That's a good idea about asking to listen in to a call with family as well. I feel like interacting with families is a whole extra skill set that I'm missing at the moment. It's a shame that getting a call from the home always made you worry. In a perfect world, families should be told about the good things and bright moments, not just falls and deterioration. I'm sorry that happened to you, even if I'm not surprised by it.

 

[Weasell]

I wish you well in your new job

My advice is To use your eyes, not your mouth.

If you see things that puzzle You or you wish to improve then, silently put them in a diary. Return to that diary at some time in the future and you may realise why things are done as they are?

If you think this is your vocation, then a target of six months is not very long to stay fairly quiet and learn through observation.
Your desire to do your best for the people you support is so lovely, but the role you are in is holistic. Be careful your enthusiasm does not cause friction. If the staff team feel you may
‘ show them up’ this can cause problems. Communication at all levels is essential.
If your colleagues like you, you get little tip offs of useful information that they will never bother give a team member they don’t like.
Remember in many care settings the staff cause far more problems then the residents.

People with dementia can act in a stupid way , but many are ‘ not stupid’. I have known some that will specially wake at the crack of dawn to ensure that it is me that washes them!
I simply think ‘ if it was my mum’! I always think that is a great way to see what is right.
If I can suggest a route for your enthusiasm ?
Try to study distraction techniques, done well they are invisible and so powerful.

 

[Shedrech]

you misunderstand @DaisyUnderTheSun
I had an excellent rrelationship with all the staff at dad's care home ... we shared the good, the bad and the downright ugly, had a laugh and chatted a lot
BUT any carer here will tell you that the instant knee jerk response to any phone call, especially with late stage dementia and no doubt in these troulbled times, was 'is this THE call...' ..... the staff calling would always first say 'nothing to worry about ...' before they went on to discuss whatever was needed

and I'm sorry @Weasell good staff training is for all, not just staff who are liked ... in dad's home new staff were largely chaperoned for some time and more established staff shared good practice with any and every one
your "Remember in many care settings the staff cause far more problems then the residents." is, apart from the many not being 'most or all', a horrible generalisation

 

[jennifer1967]

training and observation. how to do moving and handling safely for you and the resident as it will hurt your back if you dont do it properly. i have the effecte which arent nice. read the residents folder[ there was a person who hated the door closed.] the other is that families dont always know some things of residents as the residents have never told them. i miss the work but i miss the residents and their families more. you are part of a team.good luck