Tuesday, 8 October 2013

Who cares?

... Well, me as it happens. And most other carers I've worked with. Because that's what we're paid for, yes, but also because the people we're working with matter to us. I love my job and doing it well is important to me. I genuinely care about 'my ladies' (and gents :p) I want to give them the best possible care.
And, yes, sometimes that involves fifteen minute visits.
Now I recognise that the news is criticising the system and not me personally. BUT given I'm part of the system it's hard not to take stories like this to heart. Elderly welfare and rights is a cause that means a lot to me (of yes another one!), and I'd be the first to suggest the system is inadequate. But I really don't think fifteen minute calls are the issue here. They're at best a symptom of a wider problem.
And, actually...I seriously disagree with the idea of banning them. Please don't hate me til you've heard me out.
Firstly, not one of my ladies has ever had to choose between continence care and getting a drink... aside from anything else I wouldn't allow it. Most of the fifteen minute calls I attend are welfare checks, calls designed for people who *can* manage independently... and prefer to. The call is simply in place to ensure that's still the case. Some are medication calls, mainly to people with dementia who need support with that but not much else at the present time. As for building relationships there are people I've been visiting for fifteen minute a day for years, we've shared major life events, silly in jokes and everything in between... We know each other. Yes I still have meaningful relationships with people I only see for a short time. I've no doubt the are people being let down by the system but not everyone who gets fifteen minute visits is. Which brings me nearly on to the first point on my list of reasons not to ban them:
1. I'm a major advocate of holistic and person centred care, care plans designed around an individual and not some standardised rule book. A blanket ban would be a huge step away from that.
2. Not all care is government funded. Most people pay at least some of their care costs. Why should someone who's needs are comfortably met within fifteen minutes pay for a call twice as long so I can sit and do nothing?
3. Without major changes to the system at the same time, where is all this extra time coming from? With the same resources and workforce someone has to make up the difference. So does someone who would have had a forty five minute call get cut down to half an hour to compensate? Do carers have their already limited travel time cut so they have to rush and skimp on visits just to keep up? Do people receive morning calls at twelve and lunch at three because there's too much to fit in?
4. For some people fifteen minute calls provide a neat way into the system. It's a lot easier to change your care plan than start one from scratch. So for someone who's condition is deteriorating or unstable a fifteen minute call may help monitor that and allow for swifts action at such a time as more intensive care is needed.

So, no the system isn't perfect. Not everybody gets the support they need, and deserve. But judging and generalising from that isn't helpful and could in fact be damaging. If I feel one of my service users need a higher level of care I will fight and nag and make a nuisance of myself til they get it... But some of them are fine as they are.
I'm not a bad carer or a bad person (though often I fell like it) I just think it's better to consider every person individually (so no I don't think of my ladies as robots or jobs and problems or whatever the article said). I care.