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Blurred Lines? (or Human Beings?)

November 22, 2014

This afternoon, I read a rather alarming article in Community Care magazine. The link to the full article is here:

The headline is: “Personal assistants at risk of abuse because of poor support” and goes on to discuss the “vulnerability” of a PA on the basis of their isolation at working in their client’s home. Here is a typical quote from the article to give you a flavour of the author’s position – “Their close working relationship with their  employer also meant professional boundaries could get blurred, leaving both sides more vulnerable to abuse. PAs face unique risks and challenges associated with their isolation and vulnerability, working often in people’s own homes.”

It made me wonder what the author would have made of the week I’ve just had.

All the furniture for my new flat was meant to be delivered on Wednesday. The shop gave me a very wide delivery space of between 7am and 6pm. I would have been very hard pushed to get Steven sorted and at the flat by 7am. One of the support workers finishes his Tuesday shift at 6pm and starts a Wednesday shift at 6am. On Tuesday lunchtime, he nabbed me in the kitchen and asked me whether I wanted him to stay overnight on Tuesday – “you can slip away before Steven gets up tomorrow. I’ll take charge of bath, breakfast and Mr Bean”. What an offer, which I accepted.

Before he was leaving last weekend, the Saturday worker asked me whether I needed his help with the move. He volunteered to come in on Wednesday and help with whatever needed to be done. I remembered from our move to Steven’s house last year what a dab hand he is with an electric screwdriver and took him up on his offer. I got to the flat by 6.30am and he arrived about 8am. It was 11am before the first delivery came and we spent a lovely couple of hours chatting about stuff and nonsense. Looking out of the window across the river, he told me several stories about the men back home in Nigeria who worked on water. I found it enlightening and moving. Perhaps, someone with different eyes may have seen a blurring of professional boundaries. I saw it as two human beings sharing precious stories.

This great support carried on throughout the week. Since we moved into Steven’s house, my books and DVDs have been stored away in the fitted wardrobe in my bedroom. Now I have my own space, I thought it was about time they saw the light of day. One of the other PAs asked me weeks ago what I planned to do with my collections and he offered to come in at a time Steven was out and help me move them to the flat. That scores points for me on several levels, especially that he knew Steven might be a bit spooked by me carrying some of my belongings out of the house. Although, I don’t think Steven even knew they were in the wardrobe, he would have noticed us carrying four large packing boxes down the stairs! And if that wasn’t enough, he stayed on afterwards and helped me assemble the bookshelves.

Whenever any of the PAs offer to do something that I might consider above and beyond the call of duty, they always say the same thing – “If you’re okay, then Steven is okay”. They make a big deal about me having a “rest” and are forever shovelling me up to my bedroom for a lie down. They know that Steven’s time with me is very intense -his conversation is on the go from morning to night. All of them, at one time or another has talked to me about their values and the importance they put on family. This attitude couldn’t be more different from the staff at the Unit in 2010. I couldn’t speak to any of them. They weren’t interested in anything I had to say. I always felt like a massive interference to the rigid running of their home. And, of course, they consistently held the “we know best” view. I believe that what makes the relationship with the current PAs work as well as it does is the mutual respect. Working in someone’s home is very different to working in a home. I’m not saying that you become part of the family but it engenders a very unique, close relationship. I guess the author of the report and the social care world in general is very threatened by that concept.

Boundaries have been on my mind a lot this week because I will be using the second bedroom in the flat as my counselling room. For the first time in my 16 year career, my clients will be coming into my home. I’ve had so many people issue warnings about this and announce that for them it would be a complete no-no. I don’t really share that foreboding. My relationship with my clients changed a lot in 2011. For years, I had been this fairly anonymous figure that they met once a week and then all of a sudden, after our court case, I was appearing on the front page on the national newspapers and the BBC. Since then, I sometimes get asked about Steven and occasionally get a bit of a ribbing along the lines of “Are you appearing in Hello magazine this week?” At the time, and since, I have checked out with my clients how they feel about this and the response has always been positive. It’s leavened out the power dynamic for the advantage of the clients. I was trained as a person centred counsellor and I like the idea of person centred care. But I think the people who hold the power in both professions are threatened by the model. It means letting go of the expert role and accepting that the person you are dealing with knows themselves better than anyone. A massive challenge. The people using the service become more important than the people providing the service.

Anyway, back to the PAs. Of course, I paid them for the extra work they did this week. And out of my pocket, as they were helping me, not from the personal budget. I don’t believe for one moment that money was the driver for their offers. They did it because they recognise and respect the unit that is a family. I don’t think that is making them vulnerable or crossing boundaries. I call that being human.

From → Social Care

  1. Jayne knight permalink

    I don’t know how many times I have and the staff who worked at Ling were told this as an accusation rather than what we saw it as, a compliment. My mum has Carers who we view as part of our extended family now. My mum says they are her friends. They do things outside of work together. My dad always used to say Ling was so different, like a family he used to say. That’s how I think social care should be. People who become part of your circle, your wider family and friends. Why on earth not?

  2. Shirley Buckley permalink

    Mark in 2005 Martin was in supported living with a team of Zimbabwean carers, who cared. Martin was to them part of the family in all the best traditions. They welcomed him into their care. The psychiatrist wrote “It is a well known phenomen that care staff become very loyal to those in their care, they accept a high degree of abuse as part of the job and do not write entries,either because they do not want to get the client into trouble or because they see the incidents as being nothing out of the ordinary. The other statements attest to the warm and positive feelings that the carers have towards Martin. This same psychiatrist (madman) did everything possible to get Martin illegally sectioned, with the judge’s approval. I hardly ever cry, but just sending this has me in tears The carers he has now don’t even talk to him most of the time.

  3. Weary Mother permalink

    Complicated. (Sorry for length)

    I was a post grad social work student in the eighties.

    I remember two people I worked for with clarity, and for the same reason. One was a 93 year old lady whose life long partner had died. My job was to put this old lady in a home. I was under massive pressure by the family doctor, a beneficiary, to do this. These old ladies had shared the home and possessions of the dead old lady. Within days her possessions were being moved out. When I met this old lady she was not in the slightest bit confused, just shocked. She was clear that she did not want to go into a care home. I resisted the pressure from beneficiaries, and sought an assessment from an independent doctor plus home support I was warned not to get ‘personally’ involved. I was powerless. Three weeks later this grieving, sparky intelligent old lady was in a geriatric ward. ‘Sans teeth (they lost them) and hair’ and her wits. She died.

    The other was a young man in his mid twenties with Down’s, who had been placed for whatever reason, in one of the nastier big LD bins at the age of twelve. He had grieved for his mother for all these years. My job was to initiate some kind of reunion. We achieved this while I was at versity and on placement.

    What brought me before my supervisor again, was my report on what I saw in this bin. It included (and much more) routine control over the most benign of people, through bullying and jeering by suited and booted nasty nurses…. Permission had to be grovelled for, just to visit this intelligent and sad young man. I brought some buns for him one day for us to share in the grounds. They were removed from me, and he was taunted to say please over and over before he was refused them.

    I complained for him – and I was warned again not to become personally involved.

    Now we have passionate care managers joining the care professions to personalise care and lives…. but find the job is ‘needs not wants only’ – to ‘ reduce choice, care and costs’…

    There are worse things than getting too ‘personally involved’. They include carelessly and cheaply recruiting unsuitable people including managers who cant/wont. And by undervaluing the best …..and their innate ability to question and to build and maintain relationships.

  4. Sally permalink

    The Carers you described have found a way to bring warmth and friendship into their role, without either of you losing sight of your reasonable boundaries. That’s how it should be.

  5. meg permalink

    Thank you Mark, for showing better than I can explain, how person centred planning should be centred on the service user not the provider. I have had stand up, head to head and toe to toe rows with other professionals on this very point. One of my adult LD service users described our relationship to a waiter in a restaurant recently. We were having pre-performance dinner at a local theatre; “we’re not real friends but we are very friendly”. There is nothing wrong with being helpful, being thoughtful. There should be no boundaries for such things
    Oh, and all the very best to you in your new home-cum-office.

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