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We acknowledge the traditional owners of the lands on which this podcast has been produced and we pay our respects to elder’s past and present. Well, when you’re having somebody come in, you want to feel comfortable. You want to be able to trust them and, and work with them and be able to speak to them at any time, is just also respecting that professional boundary as well and not overstepping too much into someone’s life.
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Welcome to snack, the aged care podcast where we break down some of the big questions around what it really means to be person centred. I’m Dr. Andrea Petrovsky. I’m a gerontologist, and I’m passionate about hearing and sharing the real life experiences of ageing.
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Good care relationships are fundamental to person centred care. But there are boundaries in a professional relationship, and a range of individual things that impact the kinds of relationships people are comfortable with. So how do people navigate that in real life care situations? Today we talk to our guests about what good care relationships mean to them.
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Working kicking off today by hearing from Nola and Naomi, who all received support in their homes.
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Naomi, what are the most important things that carers do when they come to your home that helped create a good relationship?
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Well, Andrea, the first thing that they do is they walk through the door beaming just a huge smile is so happy, they love their job. So they just really come to it with a just a really open and willing kind of energy. So what are the some of the important skills? Do you think that care workers care staff need to have to create a good trusting relationship? Well, I think that the first thing is that they need to suss out what the person’s
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attitude is like, whether they’re timid, whether the outgoing whether they’re
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a whole flower. Yep. So there’s a bit of a combination of getting to know someone’s kind of care needs, and any any kind of health issues that they might have, but also learning how to read people. Yes, yes. That’s it learning to read people know, why is having a good relationship with the care workers who come to your home important to you, you want to be able to trust them, and, and work with them, and be able to speak to them at any time that they need help. Or if you need help, you know, little chat for a minute, is everything’s ready to go. And all the equipment is always in the same place. So I don’t have to go through the rigmarole of what she has to do or where to go.
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It’s all organised. And it all in a friendly attitude. So yeah, so there’s an ease and a familiarity and a friendliness about it. Not being interpersonal. I mean, not not wanting to know all the nitty gritties, about either of us, but being able to talk about, you know, a little bit how’s your weekend? What did you? Yeah, that sort of thing. It’s that idea of showing respect in both both directions from the carer to the client and the client back to the carer.
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Here’s a great example from Jude about the difference it’s made to her having a positive and trusting relationship with the care staff supporting her at home. We also talk to Jude about her own professional experience.
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Because your relationship with one of your current carers was quite instrumental in you getting a package, wasn’t it? Yes, yes. She actually, I had a really bad patch last year, where I was becoming increasingly immobile. And, you know, I was waking up every morning thinking, Well, what do I have to do to survive today? And so she actually said to me, I want occasion, my GP actually wanted to put me into hospital a couple of times with that, and I refuse to go.
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And the worker actually said to me, you know,
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it was fortunate that you would could still manage to shower yourself, because if you hadn’t been able to, I wouldn’t under the current arrangement, I wouldn’t have been able to shower you. And I think it would be a good idea if you applied for a package. Yeah. So that we don’t have that situation again, if your needs change, and you need more support, then you have access to that. She actually said you have deteriorated Jude in the time I’ve seen you. And I think because we had the relationship we did you know, I was prepared to hear that. She knows she knows that I have very good reason for being
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for not wanting to go to hospital or to
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go into residential care. And also, I think I think I also recognise her competency. Yeah. And I think that’s really important thing for our listeners to understand about that relationship of trust that actually makes it possible to get to understand someone, sometimes care staff do need to raise issues like we’ve been talking about, you know, especially if they see that someone might need some extra support.
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What is it that you’ve seen care staff do really well, to have those conversations and to do that in a sensitive way, I think back to when I was a worker. And I suppose sometimes it was really quite difficult, because, you know, I might have been sent into a situation which was really quite dire,
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and had never met the people before.
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So as a social worker, that was often really quite challenging.
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Because you don’t know them, you don’t know what their fears are, and so forth. So these, these people who are coming in, I think,
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the workers, I think a frontline workers,
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often with some very fragile people. So Were there particular as a professional as a social worker, Were there particular strategies that you developed around being able to have those difficult conversations with people? I think it was always accepting the cup of tea. And, you know, and lead them into a discussion about what what is making life really difficult for you right now?
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What’s stopping you from pursuing the things that are really important to you and I, and I think that’s an important thing to actually recognise that you’ve got no idea what somebody might be passionate about in their lives. Yeah. And you know, all you can do is actually work with them.
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And listen to the person understand where they’re coming from, and what makes life worthwhile now
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and try to preserve it.
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Now, of course, there are often other people involved in the care relationship, and that includes family carers and other family members. Angela supported her parents over a number of years as they receive support at home, and then move to residential care. Here’s what Angela had to say about what she experienced and observed as a family carer.
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So one of the things that we hear a lot in our conversations with people using care services and family carers is around trust. What is it in your experience that makes for makes a good trusting relationship so important?
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Well, on one occasion, mom had someone come in as a
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carer, whilst the other one of the others was on holidays, and she did not like her at all. And when the lady said, I’ll go upstairs and get the clothes, Mum just didn’t trust her to go up there and only get the clothes. Yeah. And that makes for a terrible atmosphere. Just awful. And then, you know, when I arrived, and mum said, Oh, well, can you go and check upstairs to see if she hasn’t taken anything? And I felt terrible. Yeah. Was that just because it was someone that she didn’t know? That’s right. She didn’t know her at all. Yeah, she was just coming in for two days. Do you have any sense of Is it a lack of familiarity and feeling that, you know, having someone different just made things too difficult? Or was there something that that person did that was different that made them not click that she didn’t sort of gel with mum,
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she was sort of, she didn’t have that friendly thing. But she knew that she wasn’t there forever. So therefore, she didn’t have that same.
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Same attitude, I didn’t know. And also because my mother could be quite critical. And so if she’s sort of, she started off with on this person’s only going to be here for two days. And, and you know, the reality of the work is that there are going to be times when, as a professional carer, someone’s going to be going in to cover someone or better off, you know, even if it’s just going in for the first time and not knowing whether it’s going to be a regular thing for you going into that person. And maybe he won’t gel with everybody.
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But they just have to do the best they can and Yeah, well, and I guess it’s about really for our listeners, it’s about understanding the reality of what that feels like for people. Yeah.
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You know that that sense of vulnerability about having a stranger in your home.
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In previous episodes, we’ve mentioned services that particularly support family and unpaid carers and see a lot of the kinds of issues that can arise between proof
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Additional unpaid carers. We spoke with Sam who’s a service manager for railways Karen gateway on the east coast of Queensland, and has also been a professional carer and a family carer herself. We asked Sam about the biggest issues they see arising in their service. There are a lot of hidden carers that we come across within the railways care gateway programme. And these are people who have provided support to their loved ones or to neighbours or to friends for quite an extended period of time. And they’ve never really connected with the idea that they were a carer and they had something really value to offer not only to their loved ones, but to the professional workers who were being introduced into their care arrangements. So sometimes their knowledge or their skills or their experiences with that person receiving care can quite often be dismissed. I think sometimes, even as professional care workers as I’ve been myself, we can become quite desensitised to the nature of our work. And we’re quite often rushing from house to house on shift and not really taking the time to be present, particularly with family carers and kind of acknowledge what they’re going through when support workers or professional paid carers aren’t in the home. Quite often paid or professional services are only introduced in a home when a carer, you know, experiences burnout or their own health issues or things are not going so well at home.
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Sometimes carers are just totally in a state of overwhelm. And the idea of strangers being in their home or helping their loved ones with really personal tasks can be quite, quite distressing.
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And so we feel like that that team approach between paid workers and family carers in the home and really clear, open, respectful conversation can help reduce some of the carers fears. Yeah, so what are the key things you think professional carers need to know or to think about as they’re developing their approach to how they communicate with family carers? I think it’s really important for family carers and for professional pay carers to have a real approach of mutual respect. I think there’s a lot that can be learned from each other and a lot of support can actually be
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of benefit when family carers and support workers in the home are working together ultimately for for the good of the care recipient, that it also helps to maintain the family carer in their role when they’ve got additional support, or they feel connected with the professional staff that are in the home. So key workers and support workers are really an integral part in terms of connecting carers with other supports and services that also help to sustain them in their caring role. I think it’s really important that you can’t have conversations like that unless you’ve been present, unless you’ve been friendly, you know, you’ve built a little bit of rapport.
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We also spoke with Diane who has experience as both a provider and a recipient of care. Diane particularly raised the issue of professional boundaries, and shed some examples of where things can start to go wrong. A client offering their worker somewhere to stay when they were having trouble finding a place to rent or clients and staff meeting socially as friends introducing each other to their families on a social basis.
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These are the kinds of situations professional advocates can come across. So we spoke with Naomi, who’s an advocate with ADA, Australia, and also has experience working in the care sector in a social work role and as a support worker. So Naomi, what are some of the issues you see around professional relationships between clients and paid carers? That’s a really good question. And it’s one of the reasons clients we find cancel services or request a different worker. Sometimes what we see is workers caring so much that they can sometimes become over involved. And this can really result in blurred boundaries.
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Sometimes, workers may start over indulging information about their personal life and start seeing the client as a friend.
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What clients often feed back to us and I guess, to me and other roles, is that they enjoy having a worker who is professional but friendly, rather than a worker who acts as though they are friends. Yeah, it’s important distinction, isn’t it? That’s right. And that’s that’s really the cost of that professional relationships. So clients often find workers can also come across as though they’re rather be somewhere else. But we do have those polar opposites where you know, there’s either too involved or not under involved
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And sadly, often clients don’t want to speak up for fear of upsetting the worker and causing issues with their services. Yeah, because professional boundaries obviously help protect everyone involved. But why are they so important for person centred care, it’s important so that the relationship is one that is built on trust and respect. You know, it’s important to remember that when, you know, workers are providing services, that they’re being done in a client’s home, so in their space, so even in residential aged care, it’s still their home, and it’s still their space. And that’s a place where they should feel safe. Yeah. So in order to provide it to ensure its person centred practice, workers can do this by judging or assessing how the client is in their presence, and how they react to
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their workers behaviour and the service. Another is to simply ask the client for feedback and asking for feedback is so powerful, because it lets the client know that you care about the service you are providing to them, and that you also care about their opinion. But if you if you do find that you are struggling, or you just want to sort of reach out, it’s great idea for workers to speak with a trusted member of the team, or their manager to sort of really work out what’s okay to discuss
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with clients, particularly in tricky situations. And it also helps to ensure that workers are respecting their own professional boundaries.
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We’ve heard quite a few examples there of what our guests think makes for a positive and safe and respectful relationship. Some of the things we’ve heard reflect what we’ve been hearing in previous episodes being friendly, enthusiastic and genuine, empathy, mutual respect, working together. But we’ve also heard today about the importance of respecting boundaries, the limits to friendliness, and where those lines might be. And remembering that each person you’re with is an individual with their own ideas about the level of friendliness and sharing they’re comfortable with.
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What’s really come through in these conversations is the importance of both of those aspects in developing a relationship of trust that’s so important in supporting people. Well.
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That’s today’s snack. Thank you so much for joining us and a big thank you to our guests for sharing their insights and ideas. If you want to find out more, you’ll find some great resources and other good stuff on our website Kota QL de.org.au. You’ll find links in the show notes. And please don’t forget to subscribe wherever you get your podcasts to make sure you get the next episode as soon as it’s out. Until next time, thanks again and goodbye from the codec Queensland team. This podcast is part of the homecare workforce support programme, which receives grant funding from the Australian Government
