The ageing process brings about many changes in people, not only the obvious physical changes, but the less visible changes to mood and the psyche. Perhaps the children and grandchildren live far away, perhaps the beloved spouse has passed away, and perhaps the reason for low mood and disinterest in life has its roots in some other factor or combination of factors.
Depression affects people of all ages, and we all know how devastating this condition can be. An older person who lives alone or who feels cut off from the vibrancy of a previous life may easily become disinterested in participating in daily routines. It may not even be depression; dementia can lead to changes in behaviour and mood swings which can be baffling and frustrating to the carer.
Most live-in carers have experienced the situation where the client is unwilling to participate in normal, everyday activities, from getting up, to washing, to eating and everything in-between. It can be tempting to fall into the way of thinking that it is that person's right to decide about whether she or he wants to do certain things and to use that as an excuse for not trying to encourage the person to get up, have a bath and so forth. Of course adults have a right to decide on all matters affecting them, regardless of their mental capacity, and the live-in carer needs to be respectful and sensitive to this. However, we need to draw a distinction between an intermittent caprice, which we are all entitled to, and a habit which begins to threaten the well-being of our client.
If Mr S wants to stay in bed until mid-afternoon some days, that is fine. However, when this sort of withdrawing behaviour starts to become habitual, we need to become proactive in finding ways of acting in the best interests of the client, without impairing their dignity and autonomy. This is where knowing your client comes in handy. You could use an activity or hobby that the person enjoys to encourage them to get up, or the weather (I appreciate that in the UK this might call for some creative interpretations!)
Even something as simple as the suggestion that you need help with a task, such as tidying up a room, could be a way of encouraging participation. Remember always to use suggestions in a positive way and to avoid asking questions. For example, “Do you want to go out to the pond and feed the ducks?” could quite easily elicit a definite 'No’, whereas “We haven't been down to feed the ducks in a while, I think it would be nice to go down after breakfast and take a walk around the pond. Last time we went the baby ducks were so adorable, I'm sure they've grown a bit since then”, is more likely to engender a spark of interest. Keep your voice light and relaxed and try to evoke a sense of the enjoyment and benefits to be derived from the activity. Paint an inviting scene with your words, your tone and your facial expressions.
It may take several different attempts and suggestions and there will be days and moments where nothing you suggest has any affect at all. Do not give up. Giving up is not in the best interests of your client’s health, both mental and physical. Do persevere and don't think you have to go it alone. Talk to your carer colleague; it may be that she/he has some ideas or an approach that works well with the client. Engage the family or friends of the client and keep the channels of communication open with your care manager. Most care managers have been carers; they know what it's all about and they will have useful advice.
Laetitia Hannan is one of our very own Professional Carers who has worked with The Good Care Group as a Relief Carer on the Senior Care Team for over 3 years. Laetitia strongly believes in providing an outstanding service to the clients she cares for and provides a fascinating insight into the role of a carer. We hope that you enjoyed this blog as much as we did and find it both interesting and useful. If you have any comments or questions please feel free to leave below!