Caring for our elderly is a society wide responsibility. On a micro level, individuals care for family members or friends. On a macro level, the government must create a framework that permits this to happen effectively as well as ensuring that supporting services for carers are accessible and fair. This blog is about the former, suggesting a way of thinking to help carers optimise their effectiveness. However, if a policy maker is reading, you should be considering how to best facilitate and support these straight forward strategies.
There are a multitude of problems associated with being older, but we must not forget that it is a person and not just a range of conditions. An individual is living the experience that we observe, and if this lived experience is painful, limiting, confusing or isolating, we can only imagine what this must be like. There is no better example than dementia, when that person’s reality is shifted brutally into a seeming groundhog day. We have no idea what this can be like, but we must empathise and realise that many of the behaviours are due to fear and anxiety re-lived over and over.
A simple example: an individual spending more time in bed than being up and about, also suffering dementia. The stiffness in the body ensues and often needs easing with gentle therapy. The passive movements when another person takes hold of your body to move the joints or massage the muscles can be painful as a norm. However, this can provoke a protective response as the person withdraws their limb for fear of pain or it actually hurts. The pain eases with the treatment and relief can be obvious. The next day, the same fear is evoked as there has been no memory laid down from the previous day, so the whole experience is repeated as if new, fears and all.
Remembering that the person is that, a person, is a guiding light in our thinking. Cultivating compassion through the practice of working with the vulnerable is a valuable skill to benefit both the recipient of the care and the giver. Seeing the experience for what it really is, rather than clouding it with thoughts, allows the carer to focus on the individual and their needs. These are simple practices that just need to become habits, and when they do, amazing things can happen. It is not for me to tell you what they are, but if you do practice, you will soon know.
Here are a handful of tips that I routinely give to carers:
- Create calm in your own mind before every interaction, even if it is just a few moments of breathing and re-focusing.
- Be present throughout the session, noticing all that is happening right now.
- Use a calm voice and smooth movements — before changing someone’s position or encouraging them to move, explain calmly what you will be doing and why; even if you are not sure they will understand. It will put you in the right frame of mind and perhaps they will pick up on your tone and compassioned intention.
- Use touch skillfully. Stroking has amazing effects on the body sense, sculpting the feel of the body for that person as you send signals into the brain maps as well as creating a soothing atmosphere and calming the person.
- Position the individual so that they can be alert to all the stimuli around them. You know what it feels like to be slumped in bed or in a chair — stiff, lethargic etc. Change their position so that they can be part of what is happening whilst you talk to them and engage as much as possible in a positive tone. Remember that the position our body takes affects how we feel. Make someone feel good by giving them height and posture.
There are many more easy things that we can do to make a massive difference. Carers have a key role and if they know and understand all the influence that they can have, it changes everything for the better.
I encourage carers to come to sessions or to come alone to learn about what they can do. Feeling empowered as a carer is really important, and the Pain Coach programme incorporates the needs of the carer so that the relationship with the patient is bi-directionally healthy.
Call me for further details on the Pain Coach programme: 07518 445493