Seeing the person
Pam
Pam lives with dementia and likes to do things at her own pace. In this scenario, Pam is distressed and not ready to engage with care tasks but the care worker is on a tight schedule.
The Experts-by-Experience Viewpoint…
This scenario presents a common dilemma in care work: having a lot to do, but not wanting to rush people.
Our Experts by Experience Panel (EEP) felt that patience, kindness and acknowledging that Pam is feeling stressed is paramount. Care workers need to help Pam to feel at ease. For example, sitting with Pam and asking questions about the photos on her wall, simplifying words and speaking clearly and putting on some relaxing background music (to ease her anxiety) would be good things to do in this scenario.
The EEP suggested rushing Pam to get dressed would likely give a bad reaction and if the care worker raises their voice this could be perceived as intimidating. Leaving Pam in her nightclothes would be a ‘last resort’ – the EEP hoped that puzzling out some way to put Pam at ease would make it possible to help her with dressing.
Roger
You visit Roger, who has dementia, to keep him company whilst his wife, Jean, goes shopping. Roger is increasingly quiet and you are starting to find the visits difficult.
The Experts-by-Experience Viewpoint…
Our Expert by Experience Panel (EEP) understood that this scenario must feel difficult for care workers. However, they also felt strongly that Roger must still be given the care worker’s full attention during the visit. So whilst it might be tempting not to engage fully with Roger, since he seems to give so little back, this would not be good for his welfare.
The EEP suggested that chatting to Roger about a range of topics was important, and that this might include local events. Care workers should be patient and trust that this social stimulation is still helpful for Roger, even if he cannot express it. The EEP also suggested that chatting with Jean when she came home to get her advice about how care workers might engage with Roger in future would be a good idea.
Lázsló
Lázsló is introduced in this scenario as a friendly and chatty person, and despite his memory troubles, is clearly comfortable striking up conversations in social spaces. It is possible that Lázsló has made a mistake about this couple’s identity, which could be linked to his memory difficulties, although this is not obvious.
The Experts-by-Experience Viewpoint…
The panel decided that Lázsló’s independence and autonomy were paramount, and the danger in this scenario is that Lázsló might be accidentally undermined by the care worker. The panel said that Lázsló must not be given the impression that he has ‘done something wrong’ by simply engaging in friendly conversation. The couple he is talking to appear puzzled, but they are not in any way alarmed. So, simply allowing Lázsló to finish his conversation would be an appropriate action. Joining him in the discussion could also be appropriate.
It would also be okay to distract Lázsló as long as he was not led to think he was causing a problem. Telling Lázsló he is causing alarm, or suggesting he is confusing people, would not be suitable, and could make Lázsló lose confidence in his social abilities. Divulging Lázsló’s memory difficulties would be a breach of trust.
Vera
Vera likes to be clean and tidy but is struggling with personal hygiene at the moment.
Vera gets a great deal of comfort from her doll and is unwilling to be separated from it.
The Experts-by-Experience Viewpoint…
In this scenario, Vera’s hygiene is important to her, but finding a way to do that without leaving her distressed is key.
The Experts by Experience suggested that asking Vera if she would like to bathe with her doll would be the most appropriate option. Doing so acknowledges the comfort the doll provides whilst also meeting Vera’s care needs.
Separating Vera from her doll is not taking her comfort into consideration and risks further adding to her distress.
Deciding not to bathe Vera means that she is left with poor hygiene, which is not how she likes to be.
