Wednesday, 24 September 2014

Carepartner Wednesdays--Connecting with Staff


You dreaded this day.

You knew it would come. You saw it coming. You probably put it off too long.
Now it's here.

It's moving day. Your family member is moving into a care situation.

You've spent month visiting, asking questions and trying to figure out what the best place would be. This one is new and looks beautiful, but the staff seem to patronise the residents. That one is older and a bit run down. The other one seems good, but the waiting lists were too long. That one cost too much. You looked talked to others and struggled, and finally made the best decision you knew how.

You waited. Finally, the call came.

Now your family member is settled in, is adjusting and you should be breathing a sigh of relief.

Except...

You have some questions about the staff.

They don't do things the way you would, there are things you don't like, and details are getting missed. Some days, you are more stressed than when you were full-time care partner. Why can't they get it right? What happens when unfamiliar staff are on? How can you be assured your loved one is safe and well cared for?

We refer to the "daughter from Florida" syndrome. She (and it's almost always a "she") lives out of town, and feels guilty about that. When she flies in for a visit, she creates havoc, finding                    fault with everything, questioning every routine and activity, and makes everyone's life miserable--often including her own family member. When she leaves, everyone breathes a sigh of relief.

I was that daughter, once. My Dad was staying at an interim home until the new home he was to move into was open. We arrived to find him slumped in a wheelchair, drugged out of his mind. They put him to bed, but we kept trying to rouse him. He stirred but didn't respond. I marched to the nursing station and demanded to see his chart. I recognised (but ignored) the looks I got, and leafed through the list of his medications. The nurses began to talk about "periods of aggression," which was the reason he was drugged. I thought, "I'll show you aggression." I was furious, and back then, I didn't know what I know now about non-medical interventions.

This story has a good ending. We stood around his bed, calling to him. My sister kept saying, "Ann has come from Ontario to visit you." After several minutes, he raised one hand without opening his eyes, and muttered, "She shouldn't have spent the money." My sister and I grinned at each other. Dad was back. Within a few weeks, he was moved to the new facility, and things were much better.

In this case, I had good reason to question the staff, and this wasn't a carefully chosen facility, but a holding place until the other was finished. But I recognised, even as it was happening, that I was being "the daughter from Florida."

Giving up the position of primary care partner to another (or several others) is tricky. There is relief, but there can also be a sort of jealousy, and the conviction that no one else can do it quite right. Also, because someone you love is deteriorating and you feel out of control, you may well try to control what you can (such as what drawer the sweaters are put in, and what they are eating.)

For many years, I've been a staff member, and worked with families to ensure they feel comfortable about leaving their family member in our care. Here are some suggestions from both sides.

1. The staff is not the enemy. Get to know them as people. Show an interest.
2. Evaluate. Ask yourself, "Does this really matter?" Maybe it does. In that case, make sure staff know what you would like. Maybe it isn't important to anyone but you. Drop it.
3. Communicate. If you want people to do something, tell them in the nicest way possible. Be kind, but also be thorough. Make sure everyone gets the message. This may mean talking to a supervisor, writing a note--whatever gets the message across.
4. Go higher. If you have made every effort to get a message across and are not happy with the results, speak to a supervisor.
5. Give praise. Praise is the oil that keeps the wheels turning well. They will always turn, but with praise, they fly! Don't forget to tell a supervisor when someone has done well.
6. Volunteer. There is no more popular family member than the one who helps out. You can join in regular activities, go on trips, take people outside. Your loved one will be a part of this with you, making it a win-win.

There is one exception. If you suspect abuse in any form, take it immediately to the highest authority.
Abuse, even in language and attitudes, is never acceptable and shouldn't be tolerated for a minute.

We have families who, after their loved one has passed away, have come back to serve again with other residents.

They know they are among friends.


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