Free Health Essays - In providing care for another person, it is always helpful to know about their past life
Definition of carer and client relationships
The goal of caring is that the client feels empowered, develops a greater understanding of his or her illness, learns to live with the illness in a more satisfying and resourceful way with a greater sense of well –being and that these gains are enduring.
The relationship between the carer and client is influenced by personal experience, beliefs of friends and family, the papers, the television, books about counselling or psychology, spiritual books, novels and prevailing views at work. The characteristics expected from carers are a willingness to listen, warmth, confidentiality and equality.
It is important for the carer to see the world of the client from their point of view, trying to understand their meanings and their life in a sensitive and gentle way without trampling on their personal images and meanings, but it is also important to define boundaries by creating space both for the client as well as for the carer.
Prejudice and its influence on care
Knowledge about a client’s past can help to structure the nature of interaction and can give the carer a deeper understanding about attitudes and experiences of the client. The roots of prejudice and oppression are very deep and can influence the attitudes and behaviour of the carer and the person being cared for. Differences in color, class, gender, religion, culture or sexual orientation can be translated into prejudices.
Prejudice has been defined as ‘an attitude that predisposes a person to think, feel, perceive and act in favourable or unfavourable ways towards a group or its individual members’. There are many inequalities which oppress both individuals and groups restricting their freedom to live fulfilling lives. If carers think that everybody is the same, then they become racist and sexist, since they deny the culture, religion, history and biology that make us different.
Penny Coleman portrays the life of gay, lesbian and transgender elders living in Greenwich Village, New York during a time when homophobia, sexism and violence were rampant. Senior citizens of every sexual orientation face innumerable physical and social problems. The reminisces of these senior citizens about the society they lived in and their own responses to it helps the reader understand the complex emotions and lives of an oppressed group, but it is important for the carer to clearly define boundaries between knowledge about the user’s past that could be relevant to define the nature of care and that which serves no purpose towards the care but could bring out an uncontrolled situation that both the carer and client are ill-equipped to handle.
Setting Boundaries
The client may confuse the nature of his or her relationship with the carer to be an emotional one and may disclose information about his or her past that is more than what is required in a purely professional relationship. This kind of disclosure can create in the client a belief that the relationship is deeper and more intimate than necessary and may demand similar confidences or obligations from the carer.
If a client is reminiscing about a past negative experience, it can bring out high levels of negative emotion. The client may become uncommunicative, moody, tearful or even angry with the carer for bringing up past issues and for witnessing the client’s distress. Heightened responses like guilt, inadequacy, fear, anger, sadness or hostility have to be resolved and may precipitate underlying mood or emotional disturbances. Healthy limits have to be set and the agitated client should be redirected to help deal with the problem more objectively
The carer itself may have to confront moral or legal dilemma by becoming aware of his or her client’s past. It may also affect the perception that the carer may have about other significant people in the client’s life. Relationships, feelings and reactions to family members often depend on the past history with these family members leading to confusion, stress and guilt.
Most of these reactions and responses are understandable but if they bring out feelings of disgust and shock, then the carer must take the time out to resolve these feelings that could significantly affect future care relationships with the client and his or her family.
It is not always possible to find immediate solutions but it is useful to bring in the professional nature of the relationship as a reminder to the client and also as an opportunity to stop or change the emotional response. It is especially important for the carer not to take on an emotional relationship in a client who very little other confiding relationships. The balance is between whether the client would benefit more from a professional input from the carer or an emotional relationship.
It is difficult to be warm, caring and empathetic within narrow professional boundaries especially with clients who cannot themselves define these boundaries. Clear communication on what is required for the duration of contact, what information would help and what measures can be taken if these limits are overstepped, can help to define clear boundaries. Sometimes it is helpful just to listen as long as the client is able to keep extreme emotions under check, but if a situation goes out of control, the carer can intervene and stimulate a brainstorming session to understand what triggered the situation and how it could be avoided or handled in future.
The carer is in a position of power over the person who is receiving care, but it would be helpful to remember that this position of power is present only on one dimension and that they are equal in all other respects.
Conclusion>
Many older adults will reminisce about significant events and people in their lives – it is a way of re-living and re-experiencing their lives. The caregiver can use this to build a better relationship to bridge the past and present to gain a better understanding of the person’s values, needs and resources, but this reminiscing must be directed by the carer to enable a fruitful relationship that ultimately helps the client to become empowered and more able to live with his or her illness in a satisfying and resourceful way.
References
Sanders P (2002) First steps in counselling: A students companion for basic introductory courses. PCCS Books
Leathard A (2001) Health Care Provision: Past, present and into the 21st Century Stanley Thornes Ltd.
Coleman P (2000) Village Elders University of Illinois Press
Fletcher L and Buka P (1999) A Legal framework for Caring : An introduction to law and ethics in Health Care PALGRAVE Publishers Ltd
Law Commission(1995) Mental Incapacity Law Commission 231. London HMSO
