SOCIAL CARE is about connection, about reaching out and making someone’s day better. Care is about the little things, like checking on someone or helping out with shopping (remember the solidarity of Covid, when people checked on their neighbors?) ..Well that is social care!

How can you be a superhero and make social care work for the people that need it you ask?

Well here are my top 5 tips to be a superhero

1) Take action… be PROACTIVE

Ask yourself what your nan, grandad, neighbor or family member (yes that aunt that you only talk to at Christmas) would like to do, and ask them if they want to do it! If they have a pet, cat, dog, dragon or a bunny rabbit, talking about it will be enough to get the conversation going and they will open up.

2) Listening to their needs

Everyone is different, so listening is the key to understanding a person. Please give time and don’t interrupt someone when they are talking. If possible nod and approve what they say and ask for additional information. This will build trust and empathy and is a very useful skill for life, relationships and business. If it works in social care it will work in your life!

3) Make someone smile 🙂

”People will remember how you made them feel, not what you have said” . If you can’t make someone feel a little bit better after they see or hear you, then you are doing it wrong!

Be present, listen and make eye contact with someone without saying anything. If you smile they will smile back. Win – win.

4) Celebrate the little things

In our digital world, when we are constantly overexposed to negative news (war, covid-19 or the cost of living) it is easy to loose track of the small things that matter. Making a cup of tea and sharing a biscuit with a friend, neighbour or elderly relative may not feel like much, but for someone that doesn’t have any visitors or family around it will make a big difference.

5)… ……………………………………. this is for you to complete

Social care only works if we all participate, so please leave a comment with what you think is missing or what social care means for you.

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Avoid!

1) Looking for the bright side (pro-tip: if you are thinking of saying ‘at least’ just stop)

Instead

1) Acknowledge the pain, don’t minimize or look for the silver lining

Avoid!

2) Forcing common experience (pro-tip: you don’t know what they feel, even if you’ve been through it)

INSTEAD

2) Acknowledge their pain and remind them that you are there and will listen. Share memories and stories.

Avoid!

3) Offering unsolicited advice (pro-tip: if the person grieving didn’t ask what you think they need or should do, keep your thoughts to yourself).

INSTEAD

3) Listen and offer support with what identify as their needs. Only offer advice if you have a concern for the person’s safety and well-being.

Avoid!

4) Projecting into the future.(Pro-tip: if you are thinking about suggesting that it will get easier, that they will meet someone else, or that time heals all wounds, DON’T)

INSTEAD

4) BE PRESENT AND OPEN TO THE PAIN THEY ARE EXPERIENCING. GET COMFORTABLE WITH DIFFICULT EMOTIONS AND AFFIRM THEY DO NOT NEED TO HIDE THEM OR RUSH THEM.

Supporting a person with difficult behaviors begins when we make a commitment to know the person. Sadly, it is often the case that people who develop an intervention to stop someone from engaging in difficult behaviors do not know the individual in any meaningful sense. Instead, they see the person as someone (or something) that needs to be fixed, or modified. But attacking a person’s behavior is usually ineffective and always disrespectful.
Think about someone you know who engages in difficult behaviors. Ask yourself, ‘What kind of life is this person living?’ Consider how you would feel if you lived the person’s life. How would you behave?
What follows are 10 things you can do to support a person whose behavior is troubling you. It is not a list of ”quick fix” strategies for stopping unwanted behavior. It is a list of ideas for uncovering the real things that a person might need so that you can be more supportive.

1. Get to know the person.
The first step in supporting a person with difficult behaviors almost seems too obvious to state: get to know the person! It is too often the case that people who develop interventions to eliminate unwanted behavior do not know the person in any meaningful sense. They know the person as the sum total of his or her labels, but know little about the person as a ”whole” human being.
Make a point of spending time with the person in places that he or she enjoys, during times of the day that he or she chooses. It should be a comfortable place where both of you can feel safe and relaxed (e.g. a quiet room, a nice restaurat, a walking trail in a nearby park).
At a time that feels right (you will have to trust your intuition on this one), tell the person about your concerns and ask for permission to help(it’s rude not to). If the person has no formal means of communication, ask anyway. Sometimes people understand what is being said, but they have a difficult time letting other know that they understand.
The important point, always, is to ask the person for permission/consent to stick your nose into their business, even at the risk of seeming silly in front of people who think the person cannot understand (usually they’re wrong).

2. Remember that all behavior is meaningful
Difficult behaviors are ”mesages” witch can tell us important things about a person and the quality of their life. In the most basic terms: difficult behaviors result from unmet needs. The very presence of a difficult behavior can be a signal that something important that the person needs is missing.
Obviously there are many needs that a person may be conveying with her behaviors. A single behavior can ”mean” many things. The important point is that difficult behaviors do not occur without reason.
All behavior, even if it is self-destructive, is ”meaning-full”.

Ask the person (and/or the person’s supporters) what he or she needs to be happy. Find out who he or she counts on in a pinch. How often he or she sees loved ones and friends? What are his or hers favorite activities? Where does he or she likes to go? Ask the person what leads to unhappiness. Who are the people who the person does not like? How often he or she sees them? What are the person’s least favorite activities?
It is also important to know something about the person’s physical and emotional health. Does the person have a way to let others know what he or she needs and feels? Is the person experiencing physiological or psychological distress? What kinds of medications is he or she taking? Do they help?

”Are there times when the person exhibits this behavior frequently?” and ”Are there times when the person exhibits this behavior infrequently or not at all?” Answering this two questions can tell you a great deal about the meaning of the person’s behavior. With time you should be able to see a discernible pattern. (Hint: it often has something to do with the things a person is being asked to do, and/ or who is asking the person to do it).

3. Help the person to develop a support plan
People who exhibit difficult behaviors are usually subjected to a behavior plan at some point in their lives. Help the person and the person’s family or loved ones to develop a plan that reflects a real and authentic life. You can do this by asking some of this questions in order to develop a person centered care plan.
a) How can we help the person to achieve health and wellbeing?
b) How can we help the person to maintain his or her relationships and make new ones?
c) How can we help the person to increase his or her participation in everyday community life?
d) How can we help the person to have more choice in life?
e) How can we help the person contribution to others?

The team can ask ” Is our vision for the person similar to the vision we hold for ourselves and each other? When we think about what the person needs, do we focus on ‘fixing’ deficits or do we think about supporting the person in achieving a real life?”

4. Develop a support plan for the person’s supporters
Take time with your colleagues to develop support plans for each other. For example:
What can you do to increase each other’s level of safety and comfort when someone is behaving dangerously?
What can you do to have more fun at work?
How can you have more control over your schedule and input into decisions?
How can managers better support you?
If you stopped responding to the person’s behavior the way you do now, who would you be?

5. Don’t assume anything
It is easy to make the mistake of underestimating a person’s potential just because of her labels or because she has failed to acquire certain skills. This is a tragic mistake. An individual’s potential depends largely upon the adequacy of his/her support rather than some inherent flaw or ‘defect’.
Always remember that people are people first. Labels tell us nothing (in any real sense) about how we can be supportive. We must remember that people have gifts and potential that eclipse our labels.
Always remember to speak directly to the person and explain things as clearly as you can, even if the person’s labels suggest that he cannot understand (as the very least the person will understand the tone of your voice). Never speak about the person as if he were not in the room.

6. Relationships make all the difference
Loneliness is the most significant disability of our time. Many people with disabilities, young and old, live lives of extraordinary isolation. Some depend entirely upon their families for support. A brother or a sister or a mum or a dad are the only source of company. Friends are often absent altogether.
All too often, the only relationships people have are with paid staff. Although staff can offer a great deal, they change jobs frequently or take on new responsibilities. The resulting instability can be devastating to someone who is fundamentally alone.
Remember that there are many people in the community who will benefit from knowing the person and chances are that the person has already made someone’s life fuller. Be confident that she or he will make someone’s life richer again and again.

7. Help the person to develop a positive identity: We all need to be needed.
Help the person to find a way to make a contribution. Start when the person is young if you can. Giving is a lifelong endeavor. Things as simple as helping with household chores can teach the person that she can make a contribution.
Talk with the person to join a ‘volunteer/ charity organisation’ together with you or a friend(National Trust, local food shelter, an environmental group).
Remember that is is important to overcome the belief that her person has nothing to share. It takes time and determination to help the person and others to see strength and the capacity to give when deficits were all that anyone ever saw before.

8. Instead of ultimatums, give choices.

Choice is a powerful alternative to punishment. If the person’s behavior challenges you, help him to find more desirable ways to express the needs underlying the behaviors. Instead of ultimatums, give choices (e.g. Bill, I know you are upset. What would help? Would you like to go for a walk? or take a ride? You need a chance to calm down.)
Allow the person to make decisions through the day. If he has trouble making choices, find a way to help.
Don’t assume that helping the person to have more choices means letting him do whatever he wishes. Limit-setting is an important and fair part of any relationship. The real question is who is setting the limits and why. If limits are imposed upon the person without their input, and if the limits are part of a life the person is powerless, even your best advice will be interpreted as one more statement of ”do it my way or else.”
You can expect a general disregard for your advice if the person on the receiving end of the advice is ”out of power.”
Make a sustained commitment to the person and to ”fairness” in the relationship. If the person has been on the outside of power for too long, you may need to bend more often than not for awhile.
The goal is to teach the person that giving is a two-way street.

9. Help the person to have more fun.

Fun is a powerful antidote to problem behaviors. It is often the poverty of reward, not a lack of skills, that keeps people separate from community members. Many must endure reward schedules for good behavior. The very few things that they enjoy are used contingently to reinforce compliance (talk about spoiling a good thing!).
Count the number of things the person enjoys, the number of places she likes to go. Compare this to the number of things other people enjoy, the number of places other people go. Ask yourself, ”Is the person having fun? Is she experiencing enough joy? Is this an interesting life with things to look forward to?”
Help the person to add to her list of interesting (and really fun) things to do.

Make fun a goal!

10. Establish a good working relationship with the person’s GP practice.

How often have you experienced a decline in your mood or your ability to empathize with the needs of others when you don’t feel well? When we are sick, we are not ourselves.
Many people who display difficult behaviors do so because they don’t feel well. The sudden appearance of behavior problems may be a sign that the person does not feel well. Illnesses as common as cold or ear ache can result in behaviors as inconsenquential as grumpiness or as serious as head banging.

It is important to establish a good working relationship with a GP who can help the person to stay healthy and well.
Remember that it is important to go beyond a concept of health as the absence of a disease or illness.
”Feeling well” and ”being healthy” involves everything from a balanced diet to a good night’s sleep. Help the person to achieve a state of ”wellness and wellbeing”.

Please be advised that these are GENERAL suggestions. Be sure to contact your local GP or the Falls Prevention Team in your area if you have any concerns. The Falls Prevention Team can provide: a thorough holistic falls assessment, specific exercise classes to improve strength and balance (OTAGO), equipment, advice on footwear vision and Telecare. They can also provide onward referrals to specialist departments.

Falls prevention: Information for patients, carers and relatives

Falls are not inevitable and many can be prevented. This ‘post’ gives you tips on how to prevent falls and details of organizations that may be helpful to you.

1. Improve strength and balance
Exercise to strengthen your body and leg muscles and improve your coordination are known as ‘strength and balance training’. This is one of the most effective ways to reduce the risk of falling and can be done at home as well as in group classes.
Other activities such as Tai Chi and chair-based exercise classes can build or maintain strength and balance. Contact your loca Leisure Center or day centers for details of classes, activities and events.

2. Have an eye test
Good eyesight is vital for balance and for moving around safely. Eye tests are free if you are aged 60 or over and you might be eligible for vouchers towards lenses etc. Some opticians will even visit you at home if you are unable to get to them.
You should have your eyes tested at least every two years. Take extra care if you need to use bifocal or varifocal lenses as these can affect how you perceive objects, distances and heights.

3. Manage your medicines
Let your GP know if you ever feel faint or unsteady after taking medication. It is important that you do not stop taking medication. It is important that you do not stop taking any medication unless advised to by your GP. If you take for or more different kinds of medicines per day, ask your GP or pharmacist to check your prescription every six months.

4. Eat well and drink lots of fluids
Eat regularly, choosing a broad range of foods every day for good health, and drink at least eight cups of fluid each day.

5. Make your home safe
Most falls occur at home. Keep an eye out for things that could cause you to slip or trip, e.g. rugs, wires, worn out carpet or things left on the floor. Either remove them or make them safe. Take extra care on stairs and only use aids for walking and balancing that have been specifically tailored to your needs.

6. Look after your feet
Painful feet can trip you up. Have regular foot check-ups to keep your feet healthy. Choose shoes that fit well and are suitable for your activities. Generally, high-sided, thin-soled footwear with a good grip will give you extra stability. Replace slippers that are to loose, worn out or that have no backs around your heels.

7. Deal with anxiety and fear
Fear of falling can stop people doing their usual activities. This can lead to reduced fitness and increased isolation. Following the advice in this ‘post’ is a good start to regaining lost confidence.
It is recommended to talk to your GP if you have any questions or concerns.

8. Look after your bones
Preventing and treating osteoporosis (brittle bones) helps to prevent fractures. Contact your GP or the National Osteoporosis Society if you have any concerns about bone health / brittle bones.

The National Osteoporosis Society is staffed by nurses who provide information on osteoporosis and details of local support groups.

If you are concerned about falling, please contact your GP in the first instance.

Please be advised that these are GENERAL suggestions. Be sure to seek out a formal clinical swallowing evaluation with a registered speech therapist trained in dysphagia management (dysphagia = swallowing disorder).

PREPARING FOR A MEAL
If possible reduce auditory/visual distractions during mealtimes (i.e. loud radios, TV, noisy visitors etc.) You want as much focus as possible on the task of eating/swallowing safely.
Ensure your loved one is sitting as upright as possible for the meal (ideally in a chair).
However if bed-bound make sure they are propped up as high as possible. Most important is that the chin is tucked slightly down towards the chest. This reduces the risk of food/liquid prematurely spilling back into the throat. Placing a small rolled towel behind the neck to gently prop the head/neck forward and slightly down can help.
Make sure all sensory aids are in place (glasses, hearing aids etc.). If worn, dentures should be freshly cleaned and secured well in the mouth. If dentures are mod-extremely ill fitting – best to leave them out and downgrade to a smoother texture until they are properly refitted.

SELF FEEDING AND ASSISTED FEEDING
Present only one or two food items at a time. Many items at once can be cognitively overwhelming.
If within their ability, continue to encourage the person with dementia to feed themselves, but monitor to ensure small bites/sips taken. If independent self feeding becomes difficult, a gentle hand-over hand tactic works wonders.
The brain will get a BETTER signal if the person with dementia is in any way involved in feeding themselves. Your own hand coming towards your mouth is a long-ingrained pattern that tells the brain (open your mouth, food is coming, prepare to chew… swallow! etc.).
Being fed by someone can feel invasive and often causes people to “clam up” and “refuse”. If you are getting this response, try the hand-over-hand method along with gentle verbal cues – “John, we’re having a spoon of yogurt now..”, “this is a bite of chicken”. I’ve seen this work WONDERS over the years!

FOOD TEXTURE MODIFICATIONS
There are many different stages of food texture modification that are possible. If “regular/unmodified” food is challenging, try downgrading meals to “casserole soft” or “fork mashable”.The important thing is that the food is soft/moist and more “cohesive” i.e. it sticks together. Usually the most difficult solids to manage are ones that are: fibrous (ie. celery, pineapple) or granular/particulate/flaky (dry seeds/nuts, granola, dry rice, crumbly biscuits/crackers).
Eventually you may get to the point where pureed foods are necessary, but again your SLT can let you know if/when that is necessary.
Another sneaky culprit to watch out for are the TWO TEXTURED or MIXED TEXTURED foods. These are foods that have both a liquid and a solid component together (i.e. chicken noodle soup, dry cereal with milk, fruit cocktail with syrup, even a really juicy piece of watermelon). The reason these are so difficult is that the mouth has to manage TWO different things at once: chewing and keeping the solid bits in a formed bolus whilst trying to control the liquid portion from prematurely falling back into the throat . This is a highly cognitive task that is beyond many people in the moderate to later stages of dementia.
So what can you do? You can either avoid these items altogether (i.e. choose broth or cream soups, drain the liquid from the fruit cocktail etc.) OR if you have a very diligent caregiver who is assisting with feeding you can ALTERNATE liquid bites and solid bites. For example when eating chicken noodle soup, the first spoonful would be just the broth and the next one would be just the noodle/veg bits with the liquid drained off the spoon.

LIQUIDS
Let’s talk about liquids. It CAN get to the point where thickening liquids with commercial thickening agents are necessary for safety reasons however I would not start doing this unless advised by an SLT. Why? Because they don’t taste good! They don’t feel natural. People tend to take less of them and then run the risk of dehydration. If you’re noticing some difficulty with liquids here are some things to try first:
If sips of liquid are not going well. Try offering them on a teaspoon. A smaller volume can sometimes solve the problem.
Ensure you are offering liquids only when the mouth is completely clear of food. Again, this may seem counter-intuitive. Most people would think to offer a sip of liquid to help get the food down right? Well.. think back to the TWO TEXTURED FOOD problem. We are trying to avoid having liquids and solids in the mouth at the same time. It’s better to encourage clearing their mouth of food, then offer a small sip of fluid.
If they need something moist to help clear a dry item, offer instead a spoon of applesauce or yogurt – these have a natural thickness that will be easier to control in the mouth.
Try offering “naturally” thicker items with meals like smoothies, tomato juice or chocolate milk.
As a last resort, keep thin liquids separate from food. Offer them in between meals on their own (not with any food). The rationale for this is that if a bit of liquid is going to go down the wrong pipe (this is called “aspiration”) at least it won’t take a piece of food with it into the lungs.
ORAL CARE
One of THE MOST IMPORTANT habits to implement is DILIGENT ORAL CARE. This is the most protective thing you can do to prevent aspiration type pneumonias.
Did you know that the real culprit for these types of pneumonias is NOT the food or liquid entering the lungs? The food and liquid are merely the vehicles for the MOUTH BACTERIA to enter the lungs and colonize.
Remember A CLEANER MOUTH = CLEANER LUNGS. You cannot do enough oral care. Especially just before a meal and just after.

For further information please contact: MedUKCare

When a person with dementia is confused, communication may be difficult. The following advice may be of help to you in making conversation more successful. However, never assume that the person is understanding fully, and do not expect to base any major decisions (e.g. about finances) around their response to a conversation.

• Try to sit at the same level as the person, and make eye contact
• Make sure that you have the full attention of your listener
• Remove background noise – a TV or radio can be very distracting
• Use a reassuring, calm and friendly tone of voice at all times
• Slow down your speech and take regular pauses between sentences/ phrases
• Use simple language, as this can be easier to understand
• Repeat key words or phrases to help the person understand more
• Don’t change to topic of the conversation suddenly- it is easier to talk about one topic at a time
• Allow enough time for the person to respond
• Use questions that require a Yes/No response can be easier to answer for people with dementia
• Use visual references where possible (e.g. hold a cup when asking whether someone with dementia requires a drink)
• Use gesture to help the person understand
• Do not raise your voice unnecessarily
• Do not expect perfect sentences/ vocabulary from the person – it is enough that you have understood what they have said
• Give feedback and confirm that you have understood
• Looking at photos and magazines or playing simple games are a good idea and don’t require any real understanding of conversation to be enjoyed.

Above all, remember that it is not that important that the person understands everything that you say. The most important thing is that this is a friendly and enjoyable experience for the person with dementia, that stimulates them, and makes them feel included.

For further information please contact:

MedUKCare

In these difficult times, most people feel safe at home and as the saying goes “there is no place like home!’’ For the most vulnerable in our society this is possible thanks to the hard work of all the ‘key workers’.These include, but are not limited to, home-schoolers, scientists, volunteers, mask-wearers, those who have stayed at home, shop workers, people in the arts and hospitality sectors, everyone who has battled or is still battling Covid-19 (or caring for a loved one who is unwell) and those lost to the virus.

Here at MedUKCare we made it our mission to provide home care support for people that want to live in the comfort of their own home and enjoy every moment of it. We are here to deliver a bespoke service, tailored around the care needs of your loved ones. Our staff and Care Manager will work together with you and your family to create a personalised care plan to enable us to provide the best possible home care service in line with your wishes and preferences.

Our philosophy is that we want to give something back to the community that we belong to by empowering our clients to have a voice in ‘where’ and ‘how’ they live their life, in a way that adds value and meaning to them and others.MedUKCare is here to support you in your everyday life, so that you can take pleasure in spending time with your family and friends at home.

Our business model is built around people that truly care about others, people that believe in being kind, helpful and respectful. We made it our goal to recruit the very best healthcare workers in the field, and train them to a high standard to deliver top quality care.

We know that our care team is made of people that are really passionate about helping others and making a difference in the lives of our clients. For us our healthcare workers are the real heroes.