Care worker challenges & how to overcome them

Getting a business off the ground and making it a success is a challenge for anyone, especially when the service you provide is as personal as supporting someone in their home. Let’s look at some of the solutions or strategies you can consider if you strike a problem.

You and your client just don't get along. Sometimes people simply don't click. As a professional, you could do the job regardless, but if you think it's causing too much stress or tension, consider:

• sitting down and having an honest chat with your client, to see if there are things you can both do to improve your relationship
• finishing your work with that client. It may be better for you both.

You and your client work well together, but you can't relate to their family or friends. Your client's loved ones may be anxious about their wellbeing, and protective of them too. As a consequence, they can sometimes be demanding. It may help to:

• Understand the position they're in and consider ways in which you can reassure them of your commitment to the support you’re providing
• Speak respectfully, politely and warmly, even when you’re tempted not to
• Ask how can you work more positively together so you can all be part of the solution.

Your client’s family disagrees about their care arrangements. At times you may find yourself in the middle of family disputes. If this is the case, behave in a professional manner – do not involve yourself or take sides. If someone begins a conversation with you, have a reply ready such as, “I’m sorry, but I need to let you and your family deal with this issue. It’s not my place to get involved, which I'm sure you can understand.”

You’re expected to do more work than you can complete in the time you’re paid for, or you feel overworked. Right from the start, be clear about what you can and can’t do. Realise that if you choose to ‘go the extra mile’, a client or their family may come to expect that as normal. In this case, there may be a lack of clarity about your role, or the true value of what you're doing may not be understood. Ask to review your job description and the agreed number of hours with your client or their family members. Discuss your responsibilities and expectations. Be clear about what you can and can’t do in the available time. If you need to renegotiate any of these elements; be clear about your boundaries. Do this informally or schedule a time to talk about your role, how it might need to change, and whether funding/hours need to be increased.

Your client is behaving badly. Everyone has bad days. But if your client is regularly uncooperative, it can be stressful or even unsafe.

• Commit to speaking respectfully, kindly and politely.
• Speak calmly, clearly and directly about what's needed, what's okay and what's not; a prompt, calm, measured and objective response to any complaints can help.
• Watch your own body language. These links may be helpful:
  www.bodylanguageexpert.co.uk
  www2.aaos.org/acadnews/2002news/b16-7.htm
  www.kevinhogan.com
• Treat the person as if they're being cooperative, no matter how resistant they are; this can often encourage cooperation.
• Remember what position your client is in; understanding them better will create an opportunity to address any underlying issues. What are they facing emotionally and physically? What might be behind their resistance or poor behaviour? Could it be:
  • Fatigue or pain
  • Physical or mental illness or a learning disability
  • Irritability as a side effect of medication
  • Frustration about the situation they're in
  • Worry about their health
  • Feelings of disempowerment, embarrassment, fear or anxiety
  • Lack of understanding about what's expected of them and why
  • Resistance to their privacy being invaded
  • Denial that they need help
  • Cultural differences
  • Bad previous experiences when receiving support
  • Disinhibition due to their condition (for example, dementia or stroke) or the use of alcohol or drugs
  • A history indicating a lower tolerance for stress or higher likelihood of aggression.
• Ask them what they're feeling concerned about and really listen to their reply; show them you take them seriously.
• Ask questions that indicate that you want them to be part of a solution. Such as, “I understand that this isn't working for you. What would be a more useful way for us to do this for you?" 
• Suggest a visit to the person’s GP to rule out a new health issue.
• Keep a log of any concerning incidents, clearly describing what happened and when, so you have well-documented evidence should you need it.
• When accepting jobs, learn all you can about conditions such as dementia – sometimes they do cause aggressive or inappropriate behaviour.
• If, after your best efforts, the relationship becomes unworkable because of the client’s behaviour and attitude, you could:
  • Speak with their family, if relevant or appropriate, and agree together to work on solutions
  • Decide to finish your work for that client and give them notice as per your initial contract terms. 

You feel unsafe at work. You have the right to feel safe at all times from verbal, emotional or physical abuse. If you find yourself feeling uncomfortable or unsafe, discuss this with your client directly and/or their family members. Be clear about what is and is not acceptable, and that if such behaviour continues you will not be able to stay working for them. Violence of any kind needs to be a deal-breaker. 

When scheduling visits to a potentially unsafe client, make sure someone knows where you are, and keep your mobile phone handy. Maintain your personal boundaries. You could also consider doing a personal-safety training course.

You become unwell or injured and need time off. Your health and wellbeing is relied on in the work you do, but of course you're only human too and there will be times you can’t work. If this is the case:

• Communicate this to your client and/or their family as soon as possible, so they can make other plans. Keep in touch with them about when you will be well enough to return to work, but don't go back too soon or you could relapse or pass on a contagious illness to your client.
• Do all you can to look after yourself and maximise your recovery, such as seeing a doctor or physio.
• Consider forming a relationship with other support workers in your area, so you can provide cover for each other in times of illness or injury. Discuss with your client how you might manage 'shared care' at busy times or if you become ill.

Your stress levels are rising. Assisting others can be draining and distressing at times, often depending on two things: the health and situation of your client(s) and what’s happening in your personal life. Care provision means continually attending to someone else’s needs, but those in support roles often need to set time aside to deal with their own health, so don’t put it off! These links may be helpful:
Stress management
Ministry of Health
Southern Cross: Stress

Your client has or develops a condition you know little about. Do all you can to learn more. Speak with them and/or their family about any new expectations and to gain information. Consider contacting organisations directly linked to their condition to find out more about their needs, such as the Cancer Society, Arthritis NZ, the Stroke Foundation, or Alzheimer’s NZ. If you feel unable to provide the support they need, speak honestly to your client and/or their family – don't try to give something you're not able to safely deliver. You may need to request extra training or feel you should conclude your work so someone better qualified can step in.

Your work is unacknowledged. Many support workers and people in caring roles don’t receive thanks or appreciation for their hard work. Try to think about it like this: you know, without a doubt, that you're making a positive difference to someone’s quality of life – if someone notices, that’s a bonus.

You're experiencing ‘lone-soldier syndrome’. Some people who work in support roles can feel it’s all up to them and at times this may be overwhelming. But you don’t always need to solve problems alone. Be proactive and lean on others in the wider support team: family members, the doctor, other professionals and relevant organisations, and other workers doing this type of job. 

You've been accused of something. There may be times when a client unjustly accuses a worker of stealing. This is more likely when it comes to certain health conditions, such as dementia. You can see how vital it is in these instances to have the best relationship possible with the client’s family and close friends, and to have gained a reputation for being scrupulously honest and trustworthy. Look to them for assistance to work this issue through. Be open and transparent. Seek legal advice if necessary and use your own network for emotional support. Always keep records and receipts for your protection, plus a log of any incidents or comments that concern you.

Need help or have questions? Contact the Customer Engagement team on 09 887 9777 or by email at hello@mycare.co.nz