One of the more unnerving discoveries on my journey in private care has been that caregivers can be very territorial. It makes me incredibly uncomfortable. Maybe it’s because I spent most of my career in facilities where there is a sense of unity and teamwork even when it’s felt begrudgingly. Circumstances force people to work together and even the most likely of partnerships tend to foster a sense of protectiveness as we work together with the common goal of providing the best possible care in such a flawed environment. Not so much in independent home care.
My first encounter with this was my very first family. God bless them, they were lost and desperate for help. Having not expected their family member to suddenly need to live there full time, they weren’t certain how to proceed. They were loving and trusting people with a strong desire to do this right.
That particular job landed at my feet at a time when I desperately needed a change. Now, I had never done home care so at first, I was eager to learn whatever I could from my co-worker. That eagerness faded quickly. Instead of being welcoming, she was…well, bossy. At first, I chalked up the differences in how she expected me to transfer my new client with the maneuvers I had learned in the facility with the change in environment, but I very quickly decided that as much as I wanted my new co-worker to feel comfortable with me, I did not feel safe doing transfers the way she preferred to do them and just like in facilities, within certain parameters, such tasks can vary from caregiver to caregiver. I tried to explain this to her to no avail. That’s how I learned to smile, nod and go about my business working my shift the way I see fit. Unless my client or her family complains, there is no reason to alter how I perform my job and I was told as much by the family who hired me. They explained that the other caregiver was under the mistaken idea that there was a hierarchy.
I’d been in this field long enough that it rankled me to be micromanaged by my peer, especially considering we worked on opposite days and other than showing me the ropes on my first shift, we had never worked together. She communicated with me in long notes that detailed what she wanted me to cook for our client, how she felt I should spend my shifts, what activities she wanted me to avoid and exactly where she wanted each cleaning bottle. Being a rookie at the time, I assumed she had worked for the family for a while. I had no idea that she only started the week before I did.
She was let go for reasons that I won’t go into, other than saying it had absolutely nothing to do with me. For the rest of my time with that family, I was the sole caregiver. The hours were insane. It was too much and I was awful at setting boundaries. I missed my old facility and I had renewed sense of gratitude for my former co-workers.
By the time I left that family for my current job, I had a much deeper appreciation for working with others and had chalked up my first experience with a co-worker in private care as a fluke…until I met my new co-worker.
She had been with the family for two years and is very…involved. At first, it was off-putting. I had to explain to her that I was not going to question my client’s doctor about her medication. That wasn’t my place. As a caregiver, one of my roles is that of an observer. I note changes in behavior, variations in blood sugar, mobility, mood, urine output, blood pressure, etc. but in no way do I attempt to diagnose. That is out of my skill set. I do not question how my client chooses to spend her money or lie to her about appointment times in order to “speed her along”. It is just not how I do things. For me, mutual trust is sacred in this field and I can’t expect my client to trust me if I am not being honest with her.
For quite awhile I resented my co-worker. She was doing this ALL WRONG! The responsibilities, job duties, and boundaries that were so ingrained in me from my years in facilities were being thrown right out the window! Because there are parameters that I was unwilling to cross, I began to feel a little insecure. I started second guessing myself, especially after she said that from now on, she would schedule the doctor appointments on her shifts.
I got myself in a real tizzy over that one. I vented. I wrote about it. I made certain to time it so that my co-worker’s and my path rarely crossed. I ranted to my friends that this lady thinks she OWNS my client and I didn’t feel that was right. I was reveling in all my self-righteous glory. I did everything but actually have an adult conversation with her about it. I was wrong.
One day, in the middle of a shift, my phone rang. It was my co-worker. She was calling to see how our client was feeling. She sounded nervous and apologized for calling in the middle of the busy time, but it was her only spare moment and she was concerned because our client had been sick.
A switched flipped in my head. Yes, I was uncomfortable about the way my co-worker micromanaged everything. Yes, I thought she was overly involved and territorial, but not once had I sat down and had an honest discussion with her about it. Not once had I considered that maybe…just MAYBE her attitude had nothing to do with me and everything to do with the well-being of our client. That had to change.
So I asked her if she would like to see a movie and hang out and she agreed. After biting the bullet and swallowing my pride, I addressed my concerns and admitted my insecurities and asked her what she thought might be a possible solution. It turns out, part of the reason she was so territorial was that there were many caregivers over the years who were not so great. High turnover and missing meds caused her to be cautious and protective. I could understand that. She opened up about her own insecurities like this bring her first and only caregiving experience. We began to learn from each other. I won’t tell you that things are always sunshine and rainbows between us all the time now, but it’s been much much better. True growth in this field stems from an openness to be honest and a willingness to begin from a place of understanding one another. That is how we stop resenting one another and learn where we can best serve the needs of those in our care. There can be no teamwork when there is no interest in understanding the other members of the team. This was a lesson well learned.
“So what do you think, Alice?”
That was my reaction the first time the family for whom I work asked me my opinion. Having worked in a facility for so long, I’d honestly forgotten what it was like for someone to value what I think about a situation.
Every move this family has made has been done out of love and concern for their family member. Their only agenda is to see that my client is well cared for. Physical therapy, occupational therapy, in home nursing, speech therapy and even a physical trainer are all a part of her weekly routine. Being that I am private care, I accompany her to her appointments and have witnessed first-hand the difference in the quality of care when a loved one is in the office advocating for a patient vs a resident in a facility to whom no one is accountable. The contrast is astounding.
Working privately for a family has been much more of a collaboration than I expected. This is new for everyone involved and we are all learning together. My client has been doing remarkably well considering all of the change in a relatively short amount of time. I attribute that to the love and consistency that this family has shown her. They are INVOLVED and that makes all the difference. They take her to church and shopping. They have learned how to transfer her safely. I’ve shared some tips on redirecting and calming her when she occasionally becomes agitated rather than over relying on PRN meds. I’ve stressed the importance of self-care and explained that dementia is a family disease that inevitably affects the family unit as a whole. In turn, they have been open about her story and life experiences, their family dynamic, their hopes and concerns. It’s a much more intimate and open relationship than I experienced in the facility and it’s based on solid communication and mutual trust.
The hours are long, sometimes thirteen hour shifts, but I’m finding that to be useful; almost a crash course in getting to know one another. Often, we all eat together as we share the details of the day. They have made me feel both valued and welcome. All of this adds to a solid, warm and collaborative relationship that is mutually beneficial for everyone involved.
You know you have to take this leap, Alice. You KNOW you do, not only for your financial responsibilities but also for your mental and emotional well-being. Sigh. I knew this. And I was excited about the opportunity that practically landed in my lap. Excited, yes. But scared and sad too. After nearly eight years of working with my folks, I am taking another job. Instead of taking care of more than twenty people, I will be caring for one. I’m so accustomed to running and routine that this is a big change for me.
My ability to get to know and connect with my residents is where my strength lies. I look forward to actually having the time to spend one on one with someone; to get to know her on a deeper dimension than the facilities can provide due to time constraints. I’m excited to put into use much of the training that was a lost cause working in a facility that was often short-staffed. I can actually use music therapy and appropriate forms of redirection. Together, this client and I can plan our day; I can actively encourage her to engage in the development of a routine that suits her rather than trying to get her to follow one that is easiest for me.
It is a wholly unexplored area of long term care for me and I think there is much that I can learn from the experience. It will be trial and error as we get to know one another and I adjust to the different pace. That is actually a benefit though. This will be a new adventure for us both.
Ah, but I am not overstating it when I say that it breaks my heart to leave my folks. I know logically that they will be ok. I also know that I’m not actually LEAVING them. The facility is only four miles away and I’m already making plans for fun visits. It will just be a new dynamic to our relationship. We will meet as friends rather than caregiver/residents.
My difficulty stems from love, but also from my reluctance to let go. My reluctance to trust such a broken and flawed system to care for them properly. It’s MY issue, not theirs. It is true that I need to take this leap. To deny that would be a disservice to myself. It is equally true that taking this position affects more than just myself. To deny that would be a disservice to my residents whom I’ve formed such close bonds with these past several years.
Change is the one constant in life and I’ve been walking through my fair share of it lately. Though most of these changes have been very positive, it is my nature to cling tightly to the familiar. There is no room for growth in holding on to fear. Letting go is never easy, but that doesn’t mean it’s not the right move and I look forward to exploring and sharing this new chapter with all of you. I believe this period of one on one caregiving will hone my abilities and help me become more well-rounded, both of which I will be able to use for future endeavors in the world of Long Term Care.