Aug 282011
 

“Unreasonable” residents

“Unreasonable” residents

Being in residential care, we often get labelled as “unreasonable”. We get told it’s “unreasonable” to want the toilet at short notice, “unreasonable” to expect assistance to access the community, “unreasonable” to want to get up at a certain time, etc. etc.

Whenever and wherever there’s communal living, and particularly where there’s communal care, there obviously has to be a certain amount of give and take and consideration of other residents to oil the social wheels. But in “care land“, (a different place with apparently very different social rules, norms and expectations from the rest of humanity), there’s a lot more expected. Unreasonably, in my opinion.

Sometimes these are quite extreme – e.g. being told it’s unreasonable to want to go to the toilet instead of using the bed (video, see V Elman’s story), or to have a comfy bed and be able to get out of it occasionally,

One memorable Christmas day, a care worker told me it was “unreasonable” to want a shower. It wasn’t fair on the other residents, as staff should be spending time with them, unwrapping their presents. This last one shows a relatively common element: psychologically blaming residents for being “unreasonable” to other residents.

Today was a minor one – staff strongly implied it was unreasonable of me to get up early so I could go to Church, and that it was particularly unreasonable for me to expect to get up at my own normal pace, as the people who normally get up at that time were waiting and being inconvenienced. (I should immediately point out that of course I didn’t take this lying down [pardon the pun] and that the situation has since been largely resolved; also that whilst my experiences are common it’s worse in other care homes and it’s not all care staff…)

 

Why are residents “unreasonable”?

It’s my experience that residents are branded as being unreasonable for the following main reasons.

  1. For perfectly reasonable behaviour that would be expected outside “careland” e.g. wanting to get up in time to meet commitments, to go to the toilet
  2. For “being unreasonable” as a very understandable reaction to the situation they find themselves in – common example: residents wanting the toilet several times an hour as it’s the only way to get attention or stimulation; residents “playing up” to get a reaction out of boredom or frustration, “challenging behaviour”
  3. For “being unreasonable” / manipulative, as the only way to regain some control in this very disempowering situation e.g. raising the stakes / threatening complaints to the Regulator  so that I can have a shower on Christmas day!
  4. Because they are unreasonable wankers. You get them in all sections of society.
(By the way, in case you were wondering, I think like most people I’ve been every one of the above at various points, though I’d like to think the first is the most common! Some tend to one of the reasons more than others…)

Scrabbling for resources

What particularly gets me about this situation is that residents are routinely blamed and labelled as “unfair” for daring to use scant resources that other residents need. It is very rare the scarcity of such resources (esp. staff time!) or the management responsible are identified as the culprit!

The illustrious home in which I live (far better than most…) charges £1,000 per week for me to live here. This is based on a costing model assuming I need over 40 hours of care (I use the word advisedly) per week. Anybody who knows me would know that’s ludicrous, I’m fiercely independent and don’t need anything like as much support as they charge for. Yet if I (somehow) were to receive all the care hours paid for, the following would happen:

  • The home would cease to function as a viable unit. Particularly if all the other residents were to get the care they paid for! The total would be several times the actual staff hours employed.
  • I would be accused, once again, of being unreasonable, demanding, and unfair on the other residents.

It does lead reasonable people (and the Council, who are doing an enquiry!) to wonder what, precisely, us residents get for the money.

 

J’accuse!

Given the above, it sticks in my craw that over the years staff and management have accused me many times of being unreasonable, to other service users’ detriment, including:

  • being responsible for another resident attempting suicide through jealousy of the staff attention I receive
  • intimidating and making staff scared of me and my complaints, such that they jump me up the queue above other, less articulate / empowered residents
  • unreasonably disrupting handover and jumping getting-up queues so that I could be up in time to meet voluntary commitments
  • putting my need for the toilet above their need to complete paperwork
  • wanting a bath on another resident’s bath day on returning from a week’s camping.

I could give hundreds of such examples.

I don’t generally think this is the front line care staff’s fault.  In most cases, I find that they are a hard-working, caring lot, doing their best for people whilst working in difficult circumstances, with inadequate facilities / resources / time / staff, huge responsibility, unsociable hours, poor pay and very little recognition. It’s no wonder things occasionally snap.

 

It’s all different in Care Land

But why, in care land, is staff’s inability to meet every residents’ wants or needs reinterpreted by staff (some) and management (some / many) as residents being unreasonably demanding and unfair to other residents? In many other high-paying service industries the Customer is king and customer services would be shocked at any such suggestion being made.

Imagine staying in a hotel charging £1,000 a week. A chambermaid accuses you of being unreasonable and unfair for having a lie-in, delaying her and affecting other residents’ room cleaning services! Reasonable people (and faceless sales droids) might rightly complain at such treatment and perhaps suggest there aren’t enough staff to do the job in a more “reasonable”, customer focussed fashion.

 

Sod that!

Next time staff accuse me of being “unreasonable” or selfish for wanting assistance I may suggest they are being unreasonable by not providing what I’m paying for. In other words, they should take their blaming emotional blackmail and put it where the sun doesn’t shine.

But given the impossible situation the staff are in, I would be being unreasonable…


With grateful thanks as always to Crippen / Dave Lupton Cartoons: www.crippencartoons.co.uk for his wonderful cartoon!

  4 Responses to “Unreasonable Residents or Unreasonable Management?”

  1. It’s experiences like this that make want to quit my (care) job. You describe all the challenges I face on a daily basis and *I can’t do anything about it*. There have been occasions where one resident has had an “accident” because I was helping another resident in the bathroom and I simply can’t get to that person in time to take them to a toilet. Other days when my 2nd person (for a few hours so we can get out during my 12 hour shift) has called in sick 20 minutes before we’re due to start, so I can’t take my residents out. At all. Even to another home nearby to visit friends. I get to come home to my animals and my boyfriend – when do my Dudes get to see a face other than mine or night care’s?

    That and the fact that, after 6 years and an NVQ3, I’m still only worth a smidge over minimum wage…

  2. I can well appreciate your frustration, Doug. I wonder whether it would help to make staff imagine themselves in your position? For example, ask them to think of something they like to do regularly that is very important to them, then to imagine that they couldn’t do it – couldn’t go out, couldn’t meet their friends, couldn’t even get up without help from others. How would they feel stuck in bed bursting for the loo, told to wet themselves (research has been done on this with nurse volunteers using plain water, and they were very distressed), even denied the chance to get clean on Christmas Day?! Surely opening presents comes second to basic hygiene and comfort. Opening presents also a job that could be done by people other than care home staff, if they are available – such as volunteers. Maybe you could type something and put it up in your room.

    • Thanks Vivien!
      Bringing it home isn’t easy is it – that’s my concept of “careland”: what some staff accept as reasonable / “the way things are done” / what should be accepted in “careland” is entirely different from what they would expect in their own homes / lives!
      When I moved flat I removed all notices, in an attempt to make it feel less like institutional careland, and in the experience that the staff who tend to behave in an institutional way tend not to read or digest such literature. But Crippen’s cartoons are more immediate and provoking – perhaps I’ll stick some of those up!
      And as for residents who haven’t the ability to challenge such practices, or who have internalised them such that they don’t recognise them as unreasonable – well, God help them, because nobody else does.

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