My Reality of Domiciliary Care

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Status: Finished  |  Genre: Other  |  House: Booksie Classic

This is my story of working in Domiciliary care. I started writing this for self help purposes after suffering a mini breakdown due to the stress and pressure of the job. I would now like to share it with others in order to bring awareness to what carers go through on a daily basis. I would also like to bring solace to fellow carers, past and present, by sharing my story, the laughter and the tears. The sadness and the joy. The ups' and the downs'.

ACKNOWLEDGEMENTS

 

I would like to thank all the lovely and inspirational people I have had the privilege of looking after and the amazing, wonderful people I have had the honour of working with.

 

Thank you all!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INTRODUCTION

 

So, to introduce you to this narrative and to me…. I have worked in Domiciliary care for about 5 years, I have a Level 3 Diploma in Health and Social Care and I have worked for several different Domiciliary care companies across the area and worked my way up to supervisory positions.

I decided to write this to share my experiences of this job, and of the profession in general. I wanted to share the good experiences, the not so good experiences and convey the reality of this profession, as well as taking you on my own personal journey through my time working within care.

 

Although this job is rewarding and fulfilling, and you get to meet a lot of different people, some of which are inspirational, and you get to make a positive impact on their lives. It is also an extremely hard job, and you are often treated quite badly by service users and their families as well as your own office staff. The poor pay, the long hours, the constant demands of both service users and office staff can really take its toll on carers both physically and mentally.

 

I am writing this hoping to share with you the emotional rollercoaster that a carer goes through. The demands, the abuse and the tears of laughter and sadness, providing relatable stories to carers, and bring attention to others of how this amazing profession needs help in so many ways in order to continue being able to provide the crucial service it does.

 

I hope you will enjoy reading my story and that it serves the purpose I would like it to.

 

 

 

 

 

 

N.B The facts and figures in this book are correct at the time of writing, however, may change in the future.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BEFORE CARE

 

Everyone gets in to care for different reasons. For some it is because they had a loved one receive care, for others it is a career change, and for some people the perceived flexibility of the job is attractive around children and other family commitments, and for some poor misguided few they think the job will be easy and it is all about tea, cakes and cosy chats (I do literally LOL at those people)!

 

For me, I wanted a career change. I wanted to work with people, helping them and having a fulfilling and rewarding job role, supporting them to remain independent in their own homes.

I came from being a Veterinary Nursing Student, so although a different background, caring is caring right?

 

People generally want to stay in their own homes, they feel safe there, all their memories are there, everything is familiar to them.

I sure as hell would not want to be turfed out my own home and sent to a strange place where I did not know any one simply because I needed a bit of help with things like my personal care or medication for example.

I think most people have at some point experienced being temporarily handicapped – a broken bone and struggling to shower?

Or, pregnant and having to wrestle to get your socks on?

These are everyday impossibilities for a lot of people, so how rewarding it must be to help these people to achieve these tasks and more.

So, what better job is there than to enable that to happen for people every day?!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GOING FOR IT….

 

Looking for a job in Domiciliary care is not hard to do, they are everywhere!

All offering different rates of pay ranging from £8 - £9 ph. with varying mileage pay of between, 17p per mile to 25p per mile, and some offering travel time/mileage and some not. But all offering flexible working hours.

Sounds pretty good huh?!

 

So why so many jobs being advertised?

Why such high care staff turnover?

Why so short staffed?

Humm….??

 

Although it is not hard to find a job in Domiciliary care, it is a relatively lengthy process to go through before you can start working; to break this process down for anyone who is not familiar with it:

  • Application form and CV sent.
  • Telephone screening interview
  • If successful, face to face interview
  • Documentation, ID, DBS (Data Barring Service), references check.
  • Training (some provide paid training, and some do not)
  • Shadowing

You are then are ready to go.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TRAINING

 

The training offered in Domiciliary care is often quite variable from company to company, some training taking a few weeks, and others just a few days.

The training I have encountered, to be fair, has always been quite thorough and comprehensive.

 

Within Domiciliary care there are many regulations and legislative bodies in place regarding every element of care being delivered – manual handling, medication, infection control, safeguarding, health and safety to name a few.

The reason the training is so in depth is because Domiciliary carers must abide by the laws, legislation and regulations set out by these various governing bodies, for example:

  • Medication Regulations Act – which lays out strict laws on what carers can and cannot do regarding medication, remember carers are not medical professionals! We can only follow the advice and guidance from those who are medical professionals i.e., prescription labels.
  • Manual Handling Operations (MHOR) – which states what equipment we can use and how to use it and the techniques we can and cannot use for both the service user’s safety and our own.

If we are found to be breaching any of the laws and regulations, or if anything goes wrong because we have not done our job correctly the consequences can be severe!

I do not want to bore you with all the politics and bureaucracy of it all. It is just to explain things from a carers point of view.

 

Although there are all these regulations etc. in place, and every Domiciliary care companies training that I have attended has taught about these things and taught to the standards they have laid out. It is hardly ever policed or enforced out in the community, so a new carer will undergo the training, be shown the correct way to do things to minimise the risks to both service user and themselves, explanations of the do’s and don’ts and why’s, and then when out in the community, for some, not all, the training will go out the window, and all the condemned techniques and bad practise comes out to play.

They either forget their training dos and don’ts and/or they feel pressured by the service user or their family to carry out tasks and manoeuvres they know they are not allowed to do. Or, they may not have the confidence or the heart to explain to someone that they cannot do that, or sadly some carers just think it is quicker and easier to drag lift some poor elderly chap with osteoporosis up his bed rather than taking the time to place a slide sheet.

 

What some people do not realise is that as a carer you are covered by the company’s insurance, so if anything goes wrong it will only cover you if you have abided by the correct procedures and techniques, and it only covers you to do certain tasks. Otherwise, you are personally liable.

Furthermore, some of these people are fragile and by drag lifting someone you can cause dislocation of the shoulder or skin abrasions, even degloving (which is when the top layers of a person’s skin are pulled away from the muscle and bone underneath it). This has been known to happen, so not only are you putting a vulnerable adult at risk of injury, but you will also be personally liable for it because those injuries could only happen by a carer not having carried out correct manual handling techniques.

 

Unfortunately, however comprehensive the training is, it does not really prepare a newbie carer for the reality of dealing with service users in their own homes. Some service users can smell a newbie carer from 5 miles away and will try all the tricks to get them to do things from begging, guilt tripping, the old chestnut of ‘I won’t tell anyone if you won’t’, to of course abuse, insults and shouting.

It takes quite a strong person to be able to stand there calmly and stick to your guns, and often as a carer you are facing these situations alone.

 

When I used to train carers, we used to try and role play real life situations to try and help prepare them and give them a few ways of dealing with those situations that they may find themselves in.

 

I went to a customer once who I had never been to see before, so as I always did, I introduced myself and quickly familiarised myself with his care plan and began to commence his care.

The gentleman did not have a recliner chair and was struggling to bring himself up to a standing position, I offered to help him stand which he accepted, and I began to assist him with one of the sit to stand techniques, he immediately got annoyed with me and shoved me away and held his hands up for me to pick him up (yes, to actually pick him up off his chair). I explained that I cannot do that but there are other ways I can help you to stand.

After a while and using his frame we made our way over to his stair lift and up to his bathroom, carried out his personal care, dressed and backdown stairs using his stair lift. Once at the bottom, the gentleman expected me to again pick him up off his stairlift, again I explained I cannot do that, but I can help you in other ways if you are struggling. The gentleman began shouting at me prompting his wife to come over who also started shouting at me about how I was useless and if I cannot pick her husband up off his stair lift then what is the point in me going there and then kicked me out of their house.

 

All I could do was apologise, explain my position, leave and report it to the office.

 

Another customer I used to visit regularly had a fall the one morning. I checked her over to make sure there were no obvious signs of injury – bleeding or respiratory distress etc. I made her as comfortable as I could with cushions and blankets and then rang for an ambulance. Meanwhile, the service users’ friend arrived and immediately began shouting at me about how I should have picked her up off the floor and made her comfortable in her chair. I tried to explain that unfortunately I cannot do that for risk of causing injury or exacerbating an unseen injury. Nor can I go against the advice of the 999-call team (who had told me not to move her).

The friend continued shouting at me to go away if I am going to be useless, and that I should be ashamed of myself for wasting the time of the emergency services.

 

Again, all I could do was apologise, explain my position, document it and report it to the office.

I will add that the friend did apologise to me afterwards, but carers are only human too and being spoken to like that and treated like that is upsetting.

 

Not every service user, their friends and families are like that some are lovely and understanding and accepting of what you can and cannot do and appreciate of everything you do for them. But sadly, some are not like that and the training does not always prepare you for those people.

 

Domiciliary care does also involve what is called palliative care which is caring for someone at the end of their life. People who are sadly passing away and want to pass away at home.

This obviously is an extremely distressing time for loved ones and training does not prepare you for this part of the job at all.

Providing care for end-of-life patients requires a great deal of sensitivity and the family often, and understandably, require a sympathetic ear. It can be very emotionally draining and heart wrenching for carers in these situations especially if you have grown close to the family over time.

 

I fondly remember a gentleman I used to visit who was receiving end of life care and lived with his lovely wife.

The one morning I went to visit him as usual. However the office had failed to inform me that he had sadly passed away the night before and not taken his call off my rota. I knocked and walked into their house as normal calling out ‘good morning’ to be faced with his grieving wife and family sitting in the living room. Immediately I realised what had happened and I apologised and explained there must have been a misunderstanding our end and to please accept my sincere apologies and deepest condolences.

 

Mix ups like that you would think are rare but unfortunately, they happen too often. Regarding that poor family, they received another visit off a carer that same evening. Despite the office having been informed the night before that that gentleman had passed away, and again in the morning from myself. They still failed to amend the rota and inform the carer due to attend that evening that it was cancelled.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SHADOWING

 

Shadowing is when a new carer completes training and accompanies a carer out on calls. This gives a newbie a chance to meet some of the service users and put in to practise what they have learnt in training, but under supervision.

Newbies are supposed to shadow more experienced and trusted carers. However, often, newbies are sent out to shadow inexperienced carers. This leads to bad habits being picked up and becoming the norm, as well as misinformation being spread as facts.

These misguided and misinformed inexperienced carers go on to become misguided and misinformed experienced carers, perpetuating the cycle of bad practise and misinformation.

 

Having new carers shadow you is a big responsibility; you are in a position of trust. You need to lead by example, show the correct way of doing things, instil good practise, be available for correct advice and guidance and support.

I was lucky with my first shadowing experience when I started in Domiciliary care. I had a very experienced carer who was happy to share her experiences with me and pass on invaluable knowledge and wisdom. I remember this carer giving me her personal phone number so if I ever needed help or support, I could ring her.

I was taught and shown good practise right from the start and had the confidence instilled in me by her from day 1. Even to this day I have drawn on some of her words of wisdom in this job.

She has become a trusted and respected friend.

 

However, during another shadowing experience when I started working for another company. I was partnered up with an inexperienced carer and we were on our way to see a lady for her bedtime call. This carer was giving me the rundown of her bedtime routine and said we leave her medication out for her to take when she wants.

Now in Wales, to leave medication out is in fact illegal, so I explained this to this carer and said I will not be having any part in leaving her medication out.

This carer went on to tell me that we must as this is what everyone does and what the service user expects.

 

This carer had no idea that in Wales leaving medication out for a service user to take as and when they feel like it is illegal, and the reasons why it is illegal, and yet she was placed in a mentoring role.

 

(To clarify the reasons behind why medication cannot be left out: people can forget to take it and depending on the medication it could prove fatal if someone forgets to take it. Some medication is time critical and so needs to be taken at certain times, this could be because of the medication effects on them or the reactions it has with other medication that the service user might be taking. Furthermore, as a carer we must log each time a service user takes their medication (this medication log is a legal document), but we cannot log it if we have not seen them take it. Therefore, if anyone needed to see the medication log i.e., a Paramedic or GP then we have no record or timeline of what medication has been given and when.

There is also the potential risk of an overdose. If a service user has forgotten to take their left out night-time medication and then morning medication and they decide oh dear it is ok I will take it all together with my lunch time medication. You have an overdose.

Also, what about grandchildren and nieces and nephews visiting that service user, and they see what looks like sweets left out and takes them.)

 

There are all these risks associated with leaving medication out and that is why it is illegal in wales. We have a duty of care even if the service user does not see or understand the risks. We must take the responsible approach.

 

It is during the shadowing stage when it can go wrong for new carers. New carers who have no experience in Domiciliary care soon start to realise what it is all about, that it is not all cups of tea, cakes and cosy chats. The demands that are made of you, the tight rotas and constant changes being made, and how some service users can treat you quite rudely and disrespectfully.

New carers also worry about time management – how long a call is and everything they must do within that time frame, and then getting to their next call on time.

 

An average 30 min am call will involve:

  • Getting the service user up
  • Washed (either shower or strip wash)
  • Dried, possibly creams applied, dressed and incontinence pad/pants changed, possibly empty night bag and attach leg bag.
  • Hair brushed, teeth, lifeline on, hearing aids. Watch, jewellery, glasses
  • Made comfortable with blankets, cushions, tv or radio on
  • Provide breakfast.
  • Provide medication.
  • Leave drinks accessible.
  • Empty / clean commode
  • Tidy up, make bed, open curtains.
  • Fill in paperwork.
  • Clean up, wash up.

(slight variations depending on the individual needs of the service user. A double handed call will be different)

But this is daunting for some one new to the job.

 

I have always been honest with new carers when they have shadowed me. I have shared some of the wisdom that was shared with me coupled with some of my own experiences. I have always tried to treat a new carer how I wanted to be treated and how I was lucky enough to be treated.

However, sometimes care just is not for everyone, and not everyone completes their shadowing.

I have had some new carers walk out part way through a shift or complete the shift but not turn up for their next day of shadowing.

 

 

 

I had this lady shadow me on a double handed run, (admittedly, to have a shadower act as your double hander is tough and not what I see as fair on a shadower. Too much pressure and too much expected of them. They should be just observing and taking part slowly as and when they feel ready to. However, this was the situation we were both in. We were coming to the end of our morning calls where we would then go into our lunch calls.

We left this lady’s house and headed back to our cars. The shadower looked frazzled and unhappy and I could see where this was going. I tried to cheer her up a bit and quell some of her uncertainties about doing this job. We both got in our cars and drove to the next call. I got out of my car, but she didn’t get out of her car. I went over to her and asked if she was ok, she said no she can’t do this and wanted to leave. I explained that she is my double, and I can’t complete this call without her, can she at least please stay for this 45min call and then if she still doesn’t think this job is for her, she can go. She wasn’t having any of it and left. I contacted my office and explained the situation and they said make her stay. I said I can’t she’s already gone. They said I’ll have to do the call on my own as they’ve no one free to send to help me.

So, I did and gosh that was hard and quite scary trying to complete a double handed call on my own!

Another reason a shadower should not be relied on as your double.

 

However, I do not blame this lady at all for having left. It was a tough morning for her.

 

I think the minimum number of hours usually expected for someone to shadow is 6 hours. However, that is not set-in stone, so if someone is already experienced, they can shadow a lesser number of hours, but equally if someone is new and does not feel ready to go out alone after 6 hours then they can shadow for longer. You do usually get paid for your shadowing time the same as a carer does.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ON THE ROAD

 

I will never forget my first day going out into the community alone. Training complete, shadowing complete, and I was still bricking it!

 

My first customer – an elderly lady. 30-minute call. Help her out of bed. Assist with personal care. Tidy up. Make her breakfast and give her medication.

Sounds pretty straight forward, yeah?

An hour and a half I were there as she did not like each of my attempts at making her porridge. After the fourth attempt, I had finally got it to her liking, and I left.

 

I quickly learnt that firstly, you do not get paid for running over your time, and secondly, service users waiting for you can be very unforgiving when you are late.

 

Going solo in the community is exciting, but it is also scary, a lot of the time you are on your own with a lot of responsibility and although the office staff are at the end of the phone, they are not there with you in the situation. If you work care in rural areas, then you cannot guarantee you will even have a mobile phone signal.

 

I was given a new customer to go and visit in quite a remote rural location. I vaguely knew the area but not well. I had a shadower with me too. I asked her if she knew this area, but she didn’t either.

Sat Nav got us to the area but not to the house, so we drove around for a little bit looking for this house, but we couldn’t find it. We decided to ring the office for further guidance on where this house was. Oh, our phones had no signal at all!

Nobody around to ask.

Ok, plan B, we drove back out of this little village place until one of our phones got a signal, we then had to pull over and ring the office and then drive back into the village to look for the house. OMG we still couldn’t find it!

Right, back out we go to where we got a signal, rang the office again, and back we go to the village. Yay, we finally found this house lol!

 

I attended a double handed bedtime call. It was our last call of the night. A 30-minute call, using a hoist and commode to transfer a gentleman from his chair in the lounge through to his bedroom, change into pyjamas and into bed.

All was going well until we got into his bedroom and was ready to hoist him into his bed – the hoist stopped working. Every carers nightmare!

We did all the usual checks – battery charged and connected properly. Wires connected properly. Emergency stop button had not been activated. Everything checked out.

At this point the service user’s wife was becoming agitated and started blaming previous carers for not having placed the battery to charge properly. We knew that was not the case as the battery was showing full charge, but his wife needed someone to blame.

We made the gentleman as comfortable as we could, well, as comfortable as anyone can be whilst sitting on a commode.

We rang the emergency helpline number on the hoist and explained the situation. The company said they will send someone out but could not tell us when that will be. We also rang the 101 service who said they too will send someone out with specialist equipment to help the gentleman.

We also informed the on call of our situation who agreed we had done everything we could. The service user is safe, his wife is present, help has been notified and, on their way, so we can leave.

By now though his wife was quite concerned and expected us to stay the night until someone arrives. We explained we cannot do that for many reasons and apologised. We tried to comfort her and reassure her as best we could, and she reluctantly let us leave after several hours of us being there.

 

The problem with the hoist turned out to be a faulty battery and it was replaced by the manufacturer.

 

As a Domiciliary carer you never know what you are going in to when you arrive at a call, you must be ready to deal with every eventuality.

 

A friend of mine who is also a carer told me a story once of a gentleman she visited who turned out to be a bit of a sexual deviant and would not let her leave his house. He cornered her in his kitchen and the only thing she could do was climb out of his window.

 

Do not get me wrong, Domiciliary care itself, and by that, I mean the job itself, is great, and you get to meet some lovely people, but sadly, you also get to meet some quite rude and unpleasant people too.

 

One lady I used to go and see treated you like a servant from the Victorian era. She would shout at you to hurry up with things, refer to you as girl and click her fingers for your attention.

Once you had served her food you had to go and stand in the corner of the room quietly with your hands clasped in front of you until she next clicked her fingers at you.

 

I think all carers can understand and accept being treated badly by someone and dealing with challenging behaviour from someone if there is a reason like cognitive impairment i.e., dementia. But when it is only plain rudeness and disrespect it is really hard to deal with and can be very disheartening.

A lot of people assume Domiciliary care is just about looking after elderly people with dementia, and although that is a large part of it, it is not all of it.

Domiciliary care is about helping anyone who needs it to stay in their own homes, so that can be people with MS, Cerebral Palsy, or people who have been victims of accidents and been left paralysed, amputees, acquired brain injuries or cancer patients.

In Domiciliary care you can also help people who are at the end of their life and have come home to pass away.

 

Nobody can really prepare you for doing this job. Training cannot prepare you, it can simply teach you the legislative side of it, the paperwork side of it and how to use the most common place equipment such as slings and hoists and slide sheets.

But what you must learn yourself is how to deal with service users and dealing with your own emotions.

If you are lucky like I was, you will have a brilliant mentor who will give you brilliant tips and tricks and pass on invaluable knowledge that admittedly may not make sense at the time but will soon become clear during your time as a carer.

My mentor was always completely honest with me about this job too which I appreciated. She never sugar coated anything which helped me subconsciously mentally prepare for going out alone.

I always tried to expect the unexpected and be prepared to deal with anything.

 

I remember it was my second day in the job out on my own and I went to see a lady for her morning call.

She got up and began independently washing herself while I made her bed.

Next thing she just collapsed in her bathroom, unconscious and struggling to breath.

I rang 999 and tried my best to reposition her to improve her breathing which luckily worked.

I stayed with her monitoring her until the ambulance arrived.

 

The poor lady had suffered a TIA (Transient ischaemic attack), which is a mini stroke to you and me.

 

Another example is regarding a lady I used to visit who had severe dementia.

As I arrived, I could smell burning as I approached her back door. I went in and saw her picking up lots of little black bits from her kitchen floor. I looked around to figure out where the burning smell was coming from but nothing obvious.

The lady was quite cross about the mess on her kitchen floor and didn’t know where it had come from.

I tried to calm her down and offered to make her a cup of tea. I filled up the kettle and went to connect it to the electric base to boil, the kettle wouldn’t connect on to the base. Confused I lifted the kettle up to look underneath it and saw there was no base. I took a closer look at the cooker and realised the poor lady had tried to boil her electric kettle on her electric cooker, hence the burning smell and little black bits.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CROSSING BOUNDARIES

 

As a carer you are constantly walking a very thin line. It is a constant balancing act of ethics, regulation and legislation, laws, professionalism and duty of care, while at the same time being human and keeping your emotions in check, and always remembering to cover your arse!

Any Domiciliary care company will tell you to always cover your arse. This is because sadly carers are the first people to blame when something goes wrong, or when something goes missing, and when you are working alone in people’s homes you are vulnerable to accusations, not just by the service user but by their families too.

Carers are easy scape goats. We generally work alone, and we are not considered professionals like a doctor is or a social worker, so as soon as a piece of equipment stops working properly – the carer broke it, they were not using it correctly. Something goes missing – the carer took it. The service user refuses personal care – the carer is lazy and neglectful.

As a carer you must document everything and know what your insurance will and will not cover you for and always inform the office of everything so they too can document it for your own protection.

 

I went to see a lady once whose shopping we used to do.

The one day I went to see her, she had lost her purse and was blaming the carer who’d been to see her the previous day, saying she had taken it home with her.

I looked everywhere in her house for this purse and could not find it. I documented everything and informed the office.

A few weeks went by and still no purse, and this lady was still blaming this carer for having taken it. Until the one day her purse showed up. It had fallen down the side of the seat in her son’s car.

No apology though.

 

I do not think most people blame carers out of maliciousness, but we are an easy target and, it is important to remember that service users with dementia or Alzheimer’s genuinely forget and become genuinely confused and scared.

 

What some people do not realise is as well we cannot force people to do anything, all we can do is encourage, explain and support, but if someone is adamant about not showering or even washing then we cannot force them. All we can do is respect their wishes, document it and report it to the office.

It is not a carer being neglectful, it is a carer doing their job properly and following regulations surrounding the care of vulnerable adults. If a carer did force care on to a service user, then he/she would be facing charges of abuse under the safeguarding act.

 

One of the hardest boundaries to not cross is that of being professional and becoming too personal with a service user, and even at times their family.

Visiting the same person every day, and with some people several times every day, you both get to know each other. They build up a trust with you and can end up confiding in you, although this is a great honour and privilege, you have to remember you’re not there to be their friend or replacement family member. You’re there in a professional capacity and in a position of trust to do a job and make decisions that are in the service users’ best interests.

Please bear with me as I try and explain this because I know how it sounds…. harsh right?!

 

But if a carer crosses the boundary from professional to personal than that carer can no longer do their job properly and is making it harder for themselves and their colleagues and is also being selfish.

This is because as a carer you are dealing with vulnerable adults and have a duty of care to them, and by remaining professional you are better able to be objective and can better meet the needs of the service user, and better recognise things that are wrong because you are not being clouded by your own personal feelings.

A friendship or other personal relationship is by nature selfish because it becomes about you and your needs. You inadvertently develop expectations from that person because your mates…. Right?

Moreover, as a carer, service users are not your friends, not YOUR service users and not your adopted gran. They are vulnerable adults who are trusting you to do what’s right by them.

 

Furthermore, it is making the job harder for yourself and your colleagues because once you have become over familiar with someone it is a lot harder to say no to them if you need to. You will start finding yourself in situations like:

 

SERVICE USER

Oh dear, this is such a big tablet for me to swallow. Could you just break it up for me please?

 

CARER

Oh, well I’m afraid I can’t. We’re not allowed to do that. I am sorry.

I’ll get you some more water to help you swallow it.

 

SERVICE USER

Oh, now dear come on. You know I won’t tell anyone. It’ll be our little secret. It’s what friends do isn’t it.

 

It is an awkward situation to be in. The carer now risks upsetting the service user especially as the service user thinks they are friends, but if the carer breaks up that tablet, he/she breaks the Medication Regulations, as well as risks hindering the efficacy of the medication.

It may not seem like a big deal, breaking up a tablet, but understanding pharmacokinetics; tablets are in the form they are to allow them to be absorbed by the body in certain ways and at certain times. So, by breaking up the tablet you are essentially disturbing how that medication works. Reducing its effectiveness and generally lessening its efficacy.

Moreover, as soon as that carer breaks up that tablet once the service user will expect it every time and off every carer that goes there.

It is far easier in the long run and much fairer on your colleagues and service users to keep things purely professional right from the start.

I think as a carer it is easy to forget you are part of a team, although you spend a lot of time working alone, you are still part of a much bigger team. Whatever you do for a service user, that service user will expect from every other carer, again by keeping things professional and within the boundaries makes your colleagues job easier too.

 

I have literally lost count of the number of times I have been to service users over the years and have been asked to do stuff I should not be doing and the look of shock on their faces when I explain that I cannot, and they reply with…. ‘Well, so and so did it’, or ‘the other carers that have been here did it’, and I have had to explain why we cannot do it.

It is not team work to leave your colleagues in those situations and it is not fair on the service users to be left confused and not knowing where they stand.

 

I have been asked to:

  • Shampoo and cream a leather sofa.
  • Climb a ladder and clean the guttering out.
  • Carry out DIY jobs.
  • Look after the grandchildren while they have been visiting.
  • Do the school run.
  • A colleague of mine was asked to clean the bathroom floor on her hands and knees with a toothbrush.

The list goes on….

 

Being a carer is not just about helping people and doing things for them. It is also about promoting their independence when you can, helping them to do things for themselves, even if it means it will take a bit longer.

With some people yeah you will have to do stuff for them, but with other people they can do some stuff for themselves and you are just there to assist if needed – steady a shaky hand or loosen something for example.

Too often it is easier to take over and remove some one’s independence rather than stepping back and promoting safe independence.

No one wants to lose their independence, and by preventing someone from doing something like washing their own face, it is just removing something else from them when they could have already lost so much.

People are in danger of giving up sometimes, and the more they lose and have taken away from them, the more risk they are of depression. The more they realise they can do and can keep control of the more their confidence grows.

Like I said earlier being a Domiciliary carer means walking a fine line and having to balance a lot of things.

 

Confidentiality is a big thing too in Domiciliary care and is never really taken seriously.

The GDPR (General Data Protection Regulation) and confidentiality is to protect service users from having their personal information shared. However quite often I discovered service users who knew information they should not know about other service users. I appreciate that some service users will become curious to who else we go and see but it is down to us to remain professional and respect and protect the rights and privacy of the vulnerable adults in our care.

To think a service user will not remember what you have said to them or will not share it with anyone else is a big mistake because I guarantee you, they will. I used to hear about everything carers used to discuss with service users.

They may not remember what they had for breakfast that morning, but they will remember what confidential information you told them weeks previously!

 

A lady I used to visit couldn’t remember one thing from the next. But this one day she asked me how another one of our service users are. She asked after her by name and when I said, ‘oh I’m sorry I don’t know her, I’m not familiar with that lady’. (Obviously, I was but I didn’t want to get into a discussion with her about another one of our service users – confidentiality!) she then proceeded to disclose this lady’s address too clearly trying to jog my memory. When I enquired with her as to how she knows of this lady she told me the new girl who has just started with us asked me if I knew her and how to get to her house as she was lost.

 

Astonishing what information people can remember!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rotas, Availability and Wages

 

OMG! This is a minefield, and to be honest, I do not even know where to start…. I guess I will try and start by explaining the structure of the office set up. Ok, so there are variations and different companies have different titles for job roles, but the duties and responsibilities are still the same, so:

  • Branch Manager (self-explanatory)
  • Care Co-ordinator (devises the rotas)
  • Field care Supervisor/Keyworker (looks after the carers and helps the care co and manager)

(Some branches will have several care co-ordinators and supervisors and others will just have one each depending on company policy and branch size).

 

The care co-ordinators job is hard and relentless, it does not matter what you do there is always someone who is not happy. Either the carers are not happy because their rota does not fit their availability. for example, a carers available hours to work may be 7am – 2pm and they have been rotared in till 3pm. Or the service users are not happy because their lunch call is supposed to be 12.00 and yet it’s been rotared for 1pm.

Being a care co-ordinator is a fine juggling act and a real skill to get right. In fact, I do not think it is ever possible to get it completely right.

You must know what carers you have got available for each day and what service users you have needing calls. In order to try and break it down for you:

 

Monday

X3 am carers 7am – 2pm

X2 long day carers 7am – 10pm

X2 pm carers 3pm -10pm

 

Tuesday could be completely different though as could Wednesday and Thursday etc. As a care co you then must fit those carers availability with the call times of your service users taking in to account length of calls i.e., 30 mins, 45 mins 1hr etc. with travel distance between calls i.e., 10 mins travel, 15 mins travel because neither company nor carer wants to be travelling 45 mins or an hour between calls.

 

The best travel time I had once was to travel to my next call in 10mins when it was a 45min journey. Just not possible lol!

 

Hopefully, you are still with me and following me with this?

Now, on top of that, there is always sickness to throw into the equation. A carer rings in sick and cannot do their run (shift), or their car breaks down, or childcare issues, or road closures.

Someone must cover those calls; those service users cannot go without a call!

It is the care cos job to find cover. Either split the calls up and divide them out to existing working carers. Or ask a carer whose day off it is to work and cover those calls. Or do them yourself. Or ask the supervisor to cover them, if they are even able to, as the supervisor will already be doing a multitude of other things.

The service users may not get the exact call times they want but they are still getting a call.

(in my experience the weekends are always the worst to cover calls. Always sickness come a weekend.)

Service users do not understand how hard, in fact near impossible it is devising a rota, and why would they, it is not their problem to understand it. So, when a carer is late, that carer will get an ear bashing for it and yet it could be because of traffic, road closures, poor driving conditions, additional calls added to their rota which he/she is desperately trying to accommodate, or that he/she has been called in on a day off and has got there as quickly as they could.

It could even be because the previous service user that carer had been to see fell ill and needed extra help causing the call to run over, or the service user had a fall and they had to wait for an ambulance.

 

The longest time I had to wait with a service user was 5 hours for an ambulance to arrive.

It was a double handed call. We both arrived, and the lady was on the floor after having fallen out of bed. We checked her over, made her as comfortable as possible and rang 999.

This was a 30-minute lunch call, and we were both due to go to another double handed call straight after but obviously we couldn’t leave her alone. The office had to find another carer to meet me at the next call while my current double stayed with the service user.

I then went back to my colleague after.

 

You never really get a break as a carer. Even when your shift is over you can get a call, ‘oh I need cover can you please pick up three extra calls’, or it is your day off and you will get phone calls and texts asking you to cover calls.

You can go to bed say Monday night with your first call starting at 8am and then wake up Tuesday morning and your first call now starts at 7am because another carer has rung in sick late Monday night and the on call has had to cover her calls and changed the rota.

As a carer you can do an 8-hour shift and not get a break as travelling between calls is considered your break.

 

I was on a double handed run this one day. Myself and my colleague had a lunch call cancelled so we thought yay we can go to the shop grab a sandwich and have a well overdue wee. We got back to the car and her phone rang asking us to go back to one of the service users as she had had an incontinence accident.

We headed straight back there leaving our food and the first thing her husband said to us when we arrived was ‘where have you been? what took you so long’? we explained we came straight away as soon as were asked and he replied with ‘well you should have got here sooner, your other customers should have to wait as this is more important’.

 

Unfortunately, there are service users who really do think THEY are the only people that should matter to you and THEIR needs are more important than anyone else’s.

 

I used to visit a gentleman who used to often say to me that he doesn’t care about my other service users and that my duty of care remains with him so I will stay for as long as he decides.

Quite often I used to have to say to him ‘I appreciate you may not care about my other service users, but I do care, and I am sorry, but I need to leave now.

I will be back later’.

 

Domiciliary care jobs are always advertised as being flexible hours and to some degree they are. However, rarely is your availability respected unless you are very firm about it and even then, you will always be asked to pick up more calls. Everyone has their own style of asking, some people will ask you very sweetly and nicely, some will guilt trip you in to working more and others will demand it and even add it to your rota any way and not take it off.

The thing is once a call has been added to your rota you are duty bound to attend. If you do not attend, then you can receive a POVA (Protection of Vulnerable Adults) otherwise known as safeguarding. This can affect your DBS as a neglect issue. So, some office staff will do this knowing you have no choice but to attend otherwise face a safeguarding investigation.

 

The rota and working hours of carers is hard and stressful. It is hard for the care co and the carers. Quite often carers are working with no breaks and for 15 hours a day.

A lot of carers, myself included, have worked 12- and 15-hour days for 12 days straight and still been asked to pick up calls on a day off.

Another quite common place practise which I have seen countless times regarding rotas and availability is what is called stripping. This is when a carer hands back their run (shift) due to sickness or car issues or whatever and does not pick up extra calls on their days off. The office staff will strip their rota as a punishment, so that carer will have no calls for a week or two as punishment. As a carer you only get paid for the calls you do, so if you do not have any calls for a week or two that is no money for a week or two.

This practise is a way of bullying a carer in to doing more work and picking up more calls.

 

Although the job adverts always seem like a good deal with pay and flexible working hours, the reality is far from that.

Just about all Domiciliary care companies pay you minute by minute on a clock in/out system. You use your phone to scan a bar code on the customers file when you arrive and when you leave.

So, for example you could have a 45-minute call and for whatever the reason you complete all care in 30 minutes then you only get 30 mins pay.

There is a lot of reasons a call can be finished early:

  • Service user does not want care that day.
  • Family present and will do it.
  • Friends visiting
  • Service user gone or going out.
  • Medical appointments
  • Additional time allocated to service user for when they are having a bad day.

Obviously as a carer you are aware of this and always try to utilise your time wisely, but we cannot force care on to somebody or interfere with appointments.

Furthermore, you soon learn when you have outstayed your welcome. Most of the time once you have done what they want you to do they want you to go. They want to be left alone to watch TV or go out or have their food etc.

Bedtime calls are a classic example of this. Once you have done what you need to do and made a service user comfortable in bed they want to be left alone to go to sleep or relax in bed.

 

I used to visit this lady who had a 30-minute bed call. She had the same routine every night and once she was comfortable in bed with her TV on and food next to her, she just wanted you to go, so you finished 5-10 minutes early.

 

As a carer you cannot win with pay, you either do not get paid for running over your time and you do not get paid for finishing early.

 

Mileage sadly does not cover the cost of fuel either or wear and tear on your car.

Basically, you can do an 8-hour shift and take home 4 hours pay, so in order to take home a reasonable living amount you must work 7am – 10pm 7 days a week.

 

I have done this for a long time, and it is not physically or mentally sustainable.

 

Working in Domiciliary care is long hours and low pay.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GOING FOR PROMOTION

 

As I have previously said I was a care supervisor.

It involved a lot of further training to learn how to use the computer systems and I had to undergo additional training in order to be a manual handling trainer. This was because this new job role involved not only carrying out care calls but also to:

  • interview new carers, sort out their documentation and train them up,
  • look after the existing carers,
  • share the on-call duties (which involves being at the end of the phone for if a carer needs you outside of office hours and be ready to go to them if needed too)
  • amend rotas when needed,
  • adhere to office compliance with paperwork and phone calls,
  • carry out random spot checks on the carers,
  • conduct new business (which involves carrying out risk assessments and taking on board a new service user)

This could easily entail 12 to 15-hour days with may be 2 to 4 days off a month and on those “days off” you could be on call or covering sickness. You would think the pay would be good though wouldn’t you, it was not, it was the same as a carer.

Although I enjoyed the role. The workload and the hours were simply too much for one person to sustain doing for any length of time.

 

Every Domiciliary care company has their own office set ups. I have worked for companies where their keyworkers do not carry out the training or the recruitment, they have a separate trainer and recruitment worker, and so the key workers are there to look after the carers and service users.

However, Domiciliary care companies are always looking to save money and so by employing one person to carry out all the above jobs and pay them the same as a carer is a great way of saving money. Most key workers or supervisors are on the same pay as a carer despite working longer hours and managing more responsibilities.

 

 

 

 

 

 

 

 

 

 

 

 

 

THE FATE OF REALITY

 

This is a hard chapter to write, probably the hardest one to write. As I wrote at the beginning of this book, this is my own experiences of Domiciliary care and my own observations and this chapter is all about the effect this job had on me and what effects I observed it having on others too.

 

The poor pay and the number of hours I had to do to earn any kind of a liveable amount of money took its toll on me plus the constant workload and pressures became too much. I was constantly working and neglecting myself and my family. Yet despite the number of hours I was working the money was basic, so I still also had the financial pressures too. The amount of work and responsibilities I was trying to keep on top of was too much for one person which became too stressful, and no time off.

In the end it all caught up with me and I ended up ill with exhaustion, anxiety and depression. I ended up going off on the sick which added more pressures on me as statutory sick pay is not enough to live on but because of how ill I was I could not continue with my job anymore.

It was during my time off that I realised a few things:

  • why there is such a high staff turnover.
  • why there are so many care jobs available.
  • I just cannot work these hours anymore.
  • I cannot see this profession changing but nor is it sustainable as it is either.

 

During my time in Domiciliary care, I met a lot of carers, some who had been doing it for years and some who were new to it, and those who had been doing it for years all suffered from either physical or mental health problems or both.

The common mental health problems I came across effecting carers were stress, depression and anxiety.

It was during my time off that I started to be able to think more clearly and I knew I could not go back to working for that company anymore. I could not cope with the hours or the workload. I could not neglect my own family or myself anymore.

It was a risk leaving with no other job to go in to, but I knew it was a risk I had to take because the alternative, which was to stay, would not end well for me either. It just seemed that whatever I did was never enough, they always wanted more. Whatever I gave was not enough, they always wanted me to give more and yet there was no more of myself to give, hence why I fell ill and why I believe a lot of carers fall ill.

There is also such a condition called carers fatigue also known as burnout.

 

Anyway, I handed in my resignation, focussed on getting better and applied for a carers position in another Domiciliary care company. I decided to be completely open and honest with them right from the start. I told them all about my experiences up to that point and the effects it had had on me.

I got the job and went into it with a positive attitude and a newfound strength.

As I was a carer now and not in an office roll my workload was less and I could just concentrate on the service users and the care they needed from me.

I was working full time hours and enjoying the job. I had a much healthier work life balance and was in control of my anxiety and depression. However I was not earning anything like enough money to cover my living costs (which were by the way modest and the basic costs someone must pay to simply be alive).

I worked out that in order to earn enough to cover my monthly bills I would have to work the same hours again that I was previously – 7am to 10pm at least 6 days a week which again is just too much and not possible to maintain in a long-term capacity.

 

I tried again with another care company, but it was not any different – low pay and long hours and the begging phone calls to pick up calls on days off takes its toll on you. How can you relax on your day off when you have someone begging you to work or guilt tripping you into picking up calls!

I realised through my own experience and that of others who I had chatted too over the years that this is Domiciliary care. The only way to cover your living costs in this profession is by sacrificing your own health and your family to work ridiculous hours.

It was a bitter pill to swallow and a hard realisation to accept.

 

During my time in Domiciliary care, I had many chats with managers and, also working in an office roll gave me an insight into the managerial side of Domiciliary care.

Not only do managers have their role of running the branch etc. they do the on call- and pick-up calls too when needed. Managers and office staff are also put under huge amounts of pressure to get what is called “hours”. This refers to the number of hours each week that service users need care calls.

There are always far more people needing home care than there are companies able to provide the service. So, managers are constantly under pressure to either employ more carers or get existing carers to pick up more calls so they can take on more hours.

Due to the amount of stress managers are under they themselves can fall ill or leave and those that stay sadly are not always able to offer much if any support to their carers due to their ridiculous workload and pressures that they are put under.

 

I have also noticed that people’s expectations of carers differ somewhat too; some people are truly lovely and appreciative and reasonable, but others sadly are not.

Peoples’ unreasonable expectations add to an already pressured and stressful job.

The thing is carers care. They want to please people. They want to help people. They want to do whatever they can to make someone happy and comfortable and so I think that makes them a target for some people to take advantage of and place unrealistic expectations on them.

Carers are not superheroes; we do not have magical superpowers that enable us to do things that other people cannot. We are just human like everyone else. But I also think carers find it harder to say “no” as well because of their giving and pleasing nature.

All this creates a recipe I think for carers to easily be taken advantage of guilt tripped and pressured in to doing things they should not.  

  • Carers are not medical professionals; we are not a doctor or a nurse. We are First Aid trained but we are not qualified medical professionals. We cannot stitch wounds or replace a catheter.
  • We are not an emergency service either. We provide an important service to vulnerable people, but we are not an emergency service. You cannot expect to call us out at 2 o’clock in the morning to change your bed clothes or your incontinence pants.
  • We are not modern-day servants. We are more than happy to help you in any way we can, but we are carers not modern-day servants.
  • We are not cleaners or chefs. Just because our job role can involve a bit of hoovering or making an omelette does not mean we are professional cleaners or chefs. If it is a professional cleaning service you need, or a professional chef you need then you need to hire those specific service providers.
  • We are not tradesman; we cannot sort out your electrics or fix your plumbing problems. We cannot enter your loft spaces and tackle vermin issues. We cannot lay new carpet for you either.

 

These are not fair or reasonable expectations to place on carers and unrealistic expectations like these can place a great deal of stress and pressure on carers. Carers trying to please people in ways that they simply can’t; they are not trained or qualified to do, or its simply not humanly possible to achieve.

I find it quite cruel at times when this happens; people trying to take advantage of the kind caring nature of someone, or even guilt tripping them in to risking their own life in dangerous driving conditions, or to carry out a dangerous task because they do not want to pay a skilled tradesman to do it.

Carers have this massive pressure placed on them to drive-in all-weather conditions, on all terrain and at any cost and it really is another unrealistic expectation that people have.

 

I remember one winter when I was working for this company. A message went out on our private group chat; the manager was asking more carers to work and pick-up calls as we were short staffed due to the snow and ice on the roads. One carer he was calling upon lived in a very rural area that had suffered heavy snow and she couldn’t safely travel. This manager kept on asking her and tried guilt tripping her and then told her she has a “duty of care” to their service users and therefore could be in trouble if she doesn’t pick up calls.

I will never forget her response, she replied with:

 ‘I also have a duty of care to myself and my family. I am not risking my life and leaving my children without a mother and making my family suffer my loss to drive in unsafe conditions. Nor am I risking the life of other innocent people trying to drive in dangerous conditions.’

I was sat in my car reading the messages going back and forth on the group chat and when she replied with that, I applauded her!

 

Carers do care and they will do everything they can to reach some one, that pressure they place on themselves plus the added pressure placed on them by their managers,

and the service user and sometimes the service user’s family means many a time a carer will risk their own life driving in dangerous conditions.

I myself have driven through flooded roads, closed roads and even on icy mountain roads, all of which have been stupid and dangerous undertakings, but all with the desperate intention to reach someone.

Carers do not have all terrain vehicles, and nor do we have military style training and driving abilities with access to an army of advanced survival equipment and resources to tackle all weather conditions. Therefore, to expect us to be able to reach people in flood water and snow and ice, I believe, is very unreasonable.

 

I have come across some good managers in Domiciliary care that really care about the whole profession and their carers. They value their carers and want to look after them but unfortunately, they can’t change how this profession is. I have also come across some not so good managers who just see carers as expendable. They know they can be easily replaced. They just use them and abuse them and when they leave just move on to the next one, because there is always a next one.

I have also come across some lovely service users and their lovely families:

 

It was during the Winter when we had quite icy conditions and I was due to visit a lady earlier than usual as she had an appointment. I received a message from her son asking me to take care on the road and to not rush to them. He went on to say that if I can’t make it for the time needed, I’m not to worry he will sort it out, but he doesn’t want me rushing taking risks on the road.

 

I was so unbelievably touched by this message. I was speechless. Naturally, I did everything I could to ensure I reached them for when they needed me, and I made it too. I was still touched though by their concern for my safety and their compassion, selflessness and understanding of the current situation.

It so happened that this lady’s son used to be a driver and worked on the road for years, so he knew the pressures drivers faced driving in bad weather.

 

Learning all this and realising that I must accept the reality of Domiciliary care (the good and the bad) was hard, but I had no choice.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TIME TO LEAVE

 

This was what I believed was my time to leave Domiciliary care. It was sad, but I could not work within this profession any more with how it currently is, and nor can I change it either.

To be honest though I had no idea what I was going to do, obviously I needed a job but what?

Do I go into residential care?

Start my own business? But what?

Emigrate?

Retrain/qualify in something? But again, what?

I had absolutely no idea what I was going to do. All I did know was working for a Domiciliary care company was not an option anymore and my mental health was too important to risk jeopardising again for anything.

It was sad because I love this job, but I cannot keep working in the way the companies and it seems the industry expects.

 

I decided to write this book while I rethought my life/future, hoping to provide comfort and solidarity to some and awareness to others of the reality of Domiciliary care.

 

An amazing job, but an impossible way to earn a living!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMOTIONAL UPS AND DOWNS

 

Being a carer comes with its own emotional turmoil that I think a lot of people outside of Domiciliary care do not realise, and those inside of Domiciliary care, and who are new to it, do not expect.

You really do not know what each day will bring, and what each call will bring.

Through the course of a day, and for arguments sake, say 12 calls, you not only come across rudeness and disrespect thrown at you, and attitudes of servitude directed at you. You also come across great sadness and fear, feelings of helplessness and guilt that you cannot do more for someone.

You can walk in on someone who yesterday appeared fine, and today, is in desperate need of immediate medical attention.

Yesterday you were laughing and joking with this person, and today they may not make it through.

People tell you that you must learn to switch off and disconnect yourself, but carers are only human too. Carers do this job because they care, it is hard to just switch yourself off and disconnect from vulnerable people in a desperate situation.

You do end up taking it with you.

You go to your next call trying to act as though nothing has happened when really all you want to do is cry, or talk to someone, or just be on your own for a while to process, or just have a cwtch off someone.

You cannot always ring your office as there is either no time, or they are too busy to worry about how you are feeling over what is considered to be an “occupational hazard”.

“these things happen. You know that”.

So off we go on to our next call, all smiles and acting as though nothing has happened ready to deal with whatever we face when we get there and no one to talk to about any of it.

We cannot just hand back our next calls and go home. There is no counsellor to talk to and you do not even always have a colleague with you if it is not a double handed call.

 

I remember a colleague of mine, who is also a friend. She visited a service user we both knew one morning and sadly found her dead on her bed. She had choked on her own vomit.

We don’t know how long she had been like that.

She rang an ambulance and attempted CPR, but to no avail and the paramedics pronounced her dead.

It was an horrific ordeal for this carer and she was offered no break to process what had happened. No support off the manager or company and had to carry on with her next calls for the duration of her shift as though nothing had happened.

 

As a home carer, you are also trained to look out for signs of abuse. There are many kinds of abuse such as:

Financial abuse (illegal or inappropriate use of an elderly person’s funds and/or assets)

Physical abuse (a physical act that results in harm or injury)

Sexual abuse (any sexual contact with no consent)

Emotional abuse (verbal or non-verbal behaviours that cause mental anguish and anxiety)

Neglect (failing to provide for or meet the needs and obligations of an elderly person)

Abandonment (leaving an elderly person whom you have responsibilities towards)

Self-neglect (an elderly person who exhibits behaviour that causes themselves harm)

We cannot act upon suspicions of abuse, all we can do is record it (when appropriate, as sometimes it would not be safe or appropriate to the service user for us to record it), report it to our manager and then continue to monitor the situation whilst feeding back.

It is extremely frustrating when you know there is abusive behaviour being committed and yet there is nothing you can do. All you can do is listen, monitor and report back.

 

You witness behaviours such as shouting and pushing. You sit and listen to an elderly vulnerable person express their unhappiness about being told that they are a burden and how they never thought their old age would be so controlled by somebody else.

You want to make their situation better. You want them to have the final part of their life their way, the way in which they hoped it would be. You want them to pass away one day happy.

You continue to listen to them, and you listen to the excuses they make up trying to justify the behaviour exhibited towards them knowing that there are no excuses. You nod your head and agree trying to show understanding. You try to create that safe space for them so they can open up to you and feel like they have some one on their side who cares and who they can talk to and trust.

You ask the family if they want help. Maybe they are tired and struggling?

Maybe they genuinely do not realise how damaging and abusive their behaviour is?

Maybe the family needs guidance and support?

Additional help is turned down by the family. The family knows best.

As you say goodbye to the service user to leave, you are sure you see anxiety and sadness fill their eyes.

 

You report everything back to your manager and continue to your next call wondering what will happen. Knowing you are powerless and have left a vulnerable person being shouted at for things they can no longer control, being pushed as they can no longer move quickly enough anymore.

Hopefully, this person will be ok. Am I doing enough, or is there more I can do? What else can I do?

 

Its emotionally tough as a home carer and I think that this is another element of home care that is brushed under the carpet and ignored.

No home care training ever prepares you for any of this.

 

 

 

 

 

 

 

 

 

 

 

 

A NEW BEGINNING

 

Whilst working at one care company, I met this other carer who started with us and she shadowed me, and we got on well. We kept in touch after I left, and it was whilst writing this book that she contacted me and asked if I had a job and was still working in care. I explained my situation to her, and she said she had started working home care freelance, and she wondered if I would be interested in working alongside her as she needed help. I must admit I was a little scared to go it alone in home care, but I had nothing to lose at that point and I love the job and I needed money and I know we worked well together so I thought – yeah sure let’s go for it!

It worked well for us and before we knew it, we had chosen a name, set up a website and a Facebook page. We had business cards and leaflets made up and were advertising on various platforms.   

We had lovely customers; we were able to earn money without working ourselves in to the ground. We had a much better work life balance and were able to provide a much better standard of care to our customers too.

Our little business began to grow, and we realised we needed another pair of hands to help us out, so we approached a friend who was also a qualified carer who had the same awful experiences working in care companies as we had, and she happily joined us.

For the first time in ages, I was actually happy in my job, doing a job I enjoy and having a much better work life balance. Being treated well by both my customers and my colleagues.

We have plans to continue to grow and provide a continuing excellent level of home care for people. 

 

This, in my opinion, is what working in Domiciliary care should be like!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REFLECTION

 

I do not have all the answers as to how to fix the problems in home care, nor do I have the solutions of how to improve it either.

I just hope this helps those who need it, enlightens those who are unaware and brings attention of its struggles to those who can help it.

This is just my reality of domiciliary care. I do not claim to be an expert, and I cannot speak for everyone.

 

Carers do provide an invaluable service though to so many vulnerable people and their families.

Carers are massively under paid as well and over worked.

We are treated as expendable workers with next to no respect from our employers and at times even service users.

We, at times, face traumatic situations. Both physically and verbally abusive situations and stressful situations with no support during or afterwards.

However, saying all that, being a home carer can be an extremely rewarding role to have in society, and you do get to meet some truly lovely, interesting, and inspirational people and brilliant characters along the way.

You get to share some unforgettable times with unforgettable people, ease their loneliness and help make them happy memories in their final days/months/years.

 

I would definitely recommend this job to anyone who wants to make a difference.

 

It is just so regrettable that this vital and amazing profession is so damaged and misunderstood, and the wonderful loving people who keep this profession going are so poorly treated.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONCLUSION

 

This is a profession that in my opinion needs a lot of help in order to keep it going.

Domiciliary carers are providing an invaluable service keeping people in their own homes and where they want to be, this in turns frees up hospital beds.

Domiciliary care helps families during very upsetting and difficult times and keeps them together, as well as promoting people’s freedom and independence and maintaining their dignity and happiness.

However, as it currently is it is not sustainable. The cost of living far exceeds what a carer can earn unless they work hours which are not conducive with their own health, either way there will be no carers to provide home care to those who need it unless things change.

People need to recognise the importance of this profession and the importance of looking after vulnerable adults properly.

 

Not only does the Domiciliary care industry need more money, but I also think the whole model surrounding how home care is delivered needs looking at and changing.

There are so many deep-rooted problems now that the current model of delivering home care is simply not working. Service users are not happy, and carers are not happy and financially none of it is sustainable.

I am not going to pretend that is going to be anything else but a mammoth undertaking, but as life expectancy increases, and the cost of care homes increases and with peoples understandable desire to stay at home as long as possible, the demand for home care will not be going away, quite the opposite, it will be increasing, and if we are to deliver that service to a high standard, promoting dignity and compassion and respect then we need to greatly rethink and redesign how Domiciliary care is delivered.  

 

However sadly, I cannot see this profession changing for the better in my lifetime, it is like a profession that is taken for granted and forgotten about.

I know there are a lot of professions that are like this one and need help with restructuration and investment etc. but I can only write about my own experience in this one.

Although It was lovely to see the newfound respect and recognition carers were receiving during the Corona Virus pandemic. Suddenly politicians and other official bodies were realising how important and how hard-working carers are in society, and now more than ever we were really needed.

The Corona Virus brought more difficulties to carers. People were lonely and scared, and some did not understand the virus and what it all meant, and some would simply forget about it the very next minute. We had to provide constant reassurance to people, constantly explaining what it all meant. We had to provide them with extra support and companionship as they were lonely and scared. Some people had gone from seeing their family members popping by every day to not seeing them at all during the lockdown.

 

I hope for all our sakes this profession improves, and that Domiciliary care workers are given the recognition and respect long term that they deserve!

 

KIRI WILLIAMS

FURTHER SHORT STORIES OF MY TIME WORKING IN CARE

 

Below are a few of my experiences of the people I have met and the situations I have been in whilst working in Domiciliary Care. Some are funny, some are sad, and some are unbelievable, but ALL are true!

 

 

I visited a gentleman who used a stair lift to get upstairs to his bedroom and then had to use additional equipment to transfer from his stair lift across the landing and into his bedroom. This gentleman didn’t want to use his additional equipment. Instead he wanted to use me.

This gentleman was about 6ft and weighed about 16/18 stone and he expected me (5ft4 and maybe 9stone at that time) to support his weight transferring to his bedroom. I suggested he use the equipment; it will be safer and easier for you to use it as that is what it is designed for and I am simply not strong enough and if we both fall; we could end up falling down the stairs too. He was not happy at all with this as he didn’t like using the equipment.

He started to shout at me and demand for me to support his weight, I remained calm and explained ‘I cannot do that it is dangerous’. He continued shouting at me and proceeded to tell me that if he falls it will be fine as he will land on me. I said ‘what about me’. He said ‘what about you, its your job to sacrifice yourself, if I fall you are to catch me or let me land on you, so I don’t hurt myself’. I stood there shocked at what he said, I then continued to place his equipment for him to use and prevented him from using me. He scoffed at me and told me I am neglecting my job role and how dare I think myself more important than him.

 

He ended up having to use his equipment though.

 

 

 

I used to visit this lady regularly, a lovely lady that lived alone. We used to have a good laugh together. The one morning I carried out my normal visit and we were in her bathroom getting her ready to have a shower – note: this lady had a particular way in which she used to transfer in and out of her shower and it involved leaving her shoes on as it made her feel safer. So, she was sat down in her shower and I turned her shower on. We were so busy chatting and laughing that I forgot to take her shoes off before turning the shower on. I gasped and said, ‘oh no I forgot to take your shoes off, they’re soaked!’. She replied with laughter and said she forgot too and didn’t realise she still had them on.

We both just laughed and couldn’t stop laughing at how she was sat in her shower with her shoes still on soaking wet!

 

I did sort it out and remove her shoes and put dry ones on her after her shower, but we found it so funny and still laughed about it for a long time after.

 

 

 

I used to visit this couple who had live in care and we just used to go in for a 4hr sit twice a week or so to give the live-in carer a break. This couple were a lovely sweet and endearing couple. They were elderly and both had dementia, but they never forgot how deeply in love with each other they were. They were also naughty and cheeky towards each other and were so funny and sweet. You never knew what antics they were going to get up to when you were there.

They were devoted to each other and could not be separated. Even though they were no longer able to look after themselves anymore they insisted on trying to help each other look after themselves.

 

I will always remember thinking when I first met them how romantic they are and how what they have is true love and special!

 

 

 

Another couple I used to visit made me laugh out loud the one day I went there. I had gone a few times before and the husband had been reported as being profoundly deaf and we were to write everything down on a mini white board to communicate with him. No problem, that is what we did.

Any way the one evening I was there, and his wife was cross and was shouting at him and he was just ignoring her as he was deaf and so couldn’t hear her, well when she wasn’t looking, he looked up at me and winked and smiled at me and as soon as she looked over again and started shouting, he looked down again as though he couldn’t hear her. I thought to myself can he hear? Is he pretending he can’t for a peaceful life? No surely not.

Anyway, as the evening progressed on, I continued to communicate with him using the white board and when it came for me to leave, I said goodbye to his wife and out of ear shot of her he said goodbye to me and winked again.

I got back to my car and burst out laughing, he can hear, he is just pretending to his wife that he can’t.

 

I did not know whether to be impressed by the ruse, or whether to feel sorry for his wife lol!

 

 

 

I was working with another carer on a double handed call one shift, we were doing the bedtime shift, so getting people ready for the night and putting them to bed. We were on a visit to this one lady who was bed bound and catheterised. We noticed her bed sheet was wet as was her night dress, and closer examination revealed that her catheter was leaking (this does happen sometimes; however, we can’t fix this, this needs a medical professional to come out and fix it.). I looked at my colleague and said we need to change her nightdress and bed sheet and give her a quick wash down, my colleague rolled her eyes and said ‘eugh don’t worry about it, just leave it for the morning shift’, I said ‘no we can’t leave her like this all night, we have to change her and wash her’. I went to inform her husband what had happened and for him to inform her Nurse of the catheter leaking and to get a clean night dress, wash stuff and clean bed sheet. I went back into her room, and my colleague ‘said I’m going so you’ll have to leave with me, just leave this for the morning carers’. I replied, ‘fine go I’ll do this on my own’.

 

She did not go in the end, she stayed and helped me, but she was not happy, and we didn’t become friends either. I was shocked by her attitude and did not want to work with her again!

 

 

 

I used to visit this lady who lived alone. It wasn’t a hard call, just sweeping her kitchen floor and if she wanted you to, make her porridge too. She was very able bodied and independent.

Well during the one winter we had there was quite a bit of snow and we had a reduced number of carers available, and so we had to prioritise the very vulnerable service users who needed us.

This lady was not happy about this and would not accept the situation but there really wasn’t any thing we could do about it.

Once the snow had cleared and normality returned, a colleague of mine went to visit her as was normal and the lady’s neighbour came out and said how disappointed she was that this service user didn’t get her call during the snow, my colleague explained the situation and the neighbour went on to say ‘well why didn’t you call in the army to help you? The army could have come and swept her floor and made her porridge for her, after all that is what they’re there for when there is a crisis.’

My colleague didn’t know what to say to that, and just replied with ‘I will suggest it to the office.’

 

She did inform the office of that conversation but to this day I am not aware of the army ever being called out to sweep some one’s floor and make them porridge lol!

 

 

 

I used to work with this carer who was a lovely girl. We had taken on this new service user whose house was tricky to find. This carer was given her address, directions and an explanation of how to find this house. We thought all was fine.

Then the office received a call from said service user enquiring as to where the carer was, she hadn’t arrived. The office apologised and rang the carer. The carer replied with I’m here, I’m with the service user now, I’ve just made her a cup of tea and we are having a chat. The office asked her if she was sure as the service user has just rung up asking where you are. This poor carer realised she had gone to the wrong house, same number house but it was around the corner from the correct house.

 

Aww bless her. I will never forget that. None of us could stop laughing!  

 

 

 

 

 

 

 

 

 

 

 

KIRI WILLIAMS


Submitted: April 04, 2021

© Copyright 2021 kiri1. All rights reserved.

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