With so many providers across Lincolnshire UK that provide care and support services, there is lots of advice readily available for family members on support tips, conflict resolution strategies, choosing the right care/support provider and looking after your wellbeing as a Caregiver, but- how do you have that first conversation? How do we go 'Mum. I think you need a Carer to come and help you'. For some people, this conversation can feel easy, especially if an elderly person needing support is receptive to having extra help at home, or looking at care options- but unfortunately this isn't always the case.
For some families, this conversation can feel like a very daunting and upsetting experience. To try and help alleviate some of these worries we've written up some tips on how to have that very first conversation, things to bear in mind and how to discuss putting care in place as a positive asset to improve the quality of someone's daily life.
1 - Terminology and Tone
I know, I know! Isn't it so frustrating to hear the word terminology come up again and again, if it isn't in the news it's in blog articles! Frustrating as it is having to constantly bear in mind the words we use and the way we phrase things, actually our tone and terminology can completely change the dynamic of a conversation and make it much more comfortable.
When we're suggesting the idea of having care and support put in place often the thing that feels most frightening for older people isn't the concept of being supported- it's the loss they feel of having their independence taken away. Feeling that they can't do things they know they could once do, and may feel they still should be able to do. It can also feel embarrassing to be at a point in life where tasks need to be done for them, particularly when it comes to personal care, cleaning, shopping and remembering to do things at certain times in the day. All of this can contribute to feelings of frustration, guilt and grief.
If we change the way we discuss needing care, and phrase it in an empowering way we can encourage our loved ones to be receptive to having extra help in a way that doesn't feel like a significant loss in the same way.
Instead of saying: "I've noticed you can't go to the toilet by yourself now, and your sheets have been soiled on lots of occasions- you can't live like this. You need help so I'm going to arrange a carer"
Try saying: "I'm really worried about your well-being. I want you to stay as independent as possible because I know this is important to you. I've noticed on a few occasions when washing your sheets they've had stains on them I haven't seen before. Perhaps we could look together at some support options that we could put in place for you so you can stay healthy and well. We could look through a directory together, see what services there are and what they do- you could tell me your preferences and choose one. I'll then arrange to put it in place for you if you like. In the meantime, is there anything you're struggling with you would like to talk about? Maybe there's something I can do to help so we can help you stay comfortable and independent while you make this decision"
Both of the above examples maintain that having support in place is really important. However the choice or wording in example 2 is much more positive and empowering- maintaining the importance of choice giving and maintaining independence. It talks about putting care in place in a way that doesn't dictate- but offers while expressing concern about the impact not having support has on the person's wellbeing and quality of life.
Remember-
Include the person in making choices as much as possible. If they can't make a decision can they instead tell you their preferences? Think about how you can include them at each stage. If you can't deliver their choice, can you offer a compromise that takes their choice into account- keeping them at the center of their care.
Validate the person's feelings and worries. Talk about care and support in a way that reminds them it is there to support them. Explain that their worries and concerns are valid and understandable. Offering empathy and understanding can go a long way in these conversations.
Keep calm throughout the conversation. Body language is really important; as is understanding the person's communication needs and preferences. For someone who feels anxious- they may not want to make eye contact, and that's ok- use distraction methods and provide space and time for the person to look away and take breaks between the conversation.
2- Choices and Inclusivity
There's very few things more upsetting to some people than being a strong, independent person who has been a beacon of support to others throughout their life, to be in a position where they now need to lean on the support of others. Coming to a place of needing care and support can be worrying, upsetting and frustrating. It can feel like a real loss of self, and lead to very valid feelings of grief.
It's really important therefore, to include as much as possible, the person in their own support decisions and choices. For someone who is reluctant to having care and support, they may be open to other types of services which over time will help them ease and adjust to the idea of having further support later on.
Offer to look with the person needing care, to go over different types of services together and take notes. Ask them what they would like help and support to look like for them. Offer suggestions and be receptive to their answers.
I once suggested to a person in need of personal care that they could have a home-help provider. They said no, they didn't want any form of care. That was their choice and their right- so I then replied with. "That's ok, that's your decision. Maybe instead with could look at different types of accessible equipment- we could see if we can find something that will help you to provide your own personal care, and instead we could see if there's a service that will wait outside the bathroom just to be readily available if you have an emergency. This way you will still have your privacy to wash and dress- but you won't be alone and without help if you fall and slip. This will help you to stay independent for longer in a way that feels comfortable for you".
Remember-
Choices allow for better communication which can lead to compromise so that you know your loved one will receive the best form of care that meets their needs in a person centered way.
Including them in decision making gives control back to the person involved and in need of support. This helps promote independence and reaffirms that you have their best interest in mind. It builds trust by demonstrating that you aren't taking the decision away from them, or trying to manage their care for them- that you trust they can tell you what they need and, that you will respect their preferences and take them into account.
Compromise is important. It may be that the person needing care doesn't want someone to do personal care because they're a very private person and the want to retain that independence. However, it may be that the risk of harm is too high and therefore you need to insist that they have someone who can help keep them safe. There are lots of different ways to meet and ensure someone's safety in the way that they want so be willing to look at different ways this could be provided. Even if after exploring different options you have to make the call and insist on a personal carer being in place, showing a willingness to compromise and look at different options will help build and maintain trust and optimism when discussing care.
Give reasons for the choices and alternative options you suggest, why they're needed and what the main goal is. This will help keep you both open to new suggestions and it will also reaffirm the priority of putting care solutions in place- whether it's to maintain some one's safety, alleviate pressure on family care givers or to help someone keep their quality of life. Giving reasons behind the decisions you make will reaffirm that the priority is the person, you have their best interest at heart and it will also help them to consider new ways they think they can keep themselves safe which will encourage them to include themselves in their care.
3- Body Language and Impartiality
When you are worried about your elderly loved one it can feel frustrating when they aren't receptive to having help. Emotions can become high- especially when they come from a place of worry. Remaining calm, open minded and impartial will help to maintain a positive environment to have the discussion. It will also help to look at things from the perspective of the person you are trying to help.
Remember, they may say things you disagree with, or that feel hurtful- but they may not be intended this way. Keeping an impartial stance will allow you to pick the issue apart and look at the issue behind it; to ask questions and come at the situation from a solution focused approach.
If someone says: "You don't care about me. You just want to send me to a home so you can have the house"
Perhaps underneath this, they are saying: "I feel like you aren't asking me what it is I need. My choices and preferences aren't being taken into account. If I have to leave my home I will lose something really valuable to me, a home I've built my life and memories into. I don't want my independence taken away"
It could be helpful to respond with: "I'm really sorry you feel I don't care about you. I do- in fact it's your safety and wellbeing I'm worried about, it's the most important thing to me. Is there anything about having extra help that worries you that you'd like to talk about? It's as important to me that you're happy as it is that you're safe- how would you like us to help you stay safe and well, we can look at support options that will help you to continue to live at home if you aren't ready or wanting to move to a permanent place of care"
It's ok to feel upset during these conversations, and it's ok for the person needing care to be upset too. Sometimes, even the most patient of people will struggle with conversations like this. Don't beat yourself up if you do struggle. You can always take time away from the conversation and approach it again when you feel calm and ready. Alternatively, there are lots of services that can help have these conversations with you, which can be a really good way of having an impartial voice to keep things focused on finding a solution that works for everyone involved.
4- Care Planning and Involving
Sometimes a good way to start the conversation of care, is to build a care plan by involving the person in need of care and look at areas and times they struggle. We have a really good template available here.
This can be used to identify care needs and gaps that could be filled by certain suppliers and services. This can also help the person in need of support to think about different ways they could look at retaining their independence through the help of providers. For example; If you work on a Thursday 3-9pm but your loved one struggles to do their laundry and that is their preferred day, you could suggest that a home provider can help with the Laundry so they can maintain their independent routine without having to wait and work around you. This then helps them to live their life the way they want to, and remain in control of their routines which will continue to promote their independence in the week.
While planning out things that could help, you may find the person needing support begins to enjoy the idea of how their week could look with extra services in place here and there. They may even identify new areas and feel more comfortable to discuss other things they are finding difficult to maintain day to day.
5- Self Care and Seeking Professional Advice
Being a care giver is difficult, and emotionally challenging. No matter how resilient you are always take time to look after your emotional well-health. It's ok to feel stressed, frustrated and fatigued at the amount asked of you in a care giving capacity. To be a beacon of emotional support and to also come to terms with the idea your parent, grandparent or loved one needs help is an incredibly emotionally difficult situation to experience.
There are professional services available to support you and help you maintain a healthy sense of self. Organizations such as Mind, Age UK, the NHS and local wellbeing hubs and community initiatives can be a great resource to ensure you stay supported during this difficult time.
Don't be afraid to reach out for professional advice if you are finding the conversation too much, or if you would like help signposting services and care solutions and ideas to help put things in motion. Many providers like ourselves are here to help, and we all want what's best for the person involved. Consultations are a good way to seek professional advice and we always offer our consultations free so we can point you in the right direction and answer questions you may have before committing to support calls. Navigating care can be a minefield. We're always here to help. You can find out more about the support we provide at www.farrowfriends.co.uk/get-support