One of the residents opened up about her life and the trauma she had gone through today. Although on the outside I listened attentively and offered advice, on the inside I was upset by the horrors or what she had dealt with. I thought that I would probably become desensitised to the things I would hear whilst working but that it would be important for me to reflect on my feelings through journaling and during supervision. I feel positive in knowing how rewarding this job will be but also mindful that I need to process my own feelings, otherwise things may become emotionally draining. I learnt that it’s important to read through the patients’ referrals and daily logs so that I’m aware of their diagnoses, likes/dislikes and then apply this to the support that’s offered to them.
One of the residents was having a bad morning and would not get out of bed and the staff recommended that I go down; this made me feel positive that I had managed to build a rapport with one of the residents so quickly. Although I could not convince her to take her medication, I managed to persuade her to have a shower and make something to eat and the manager said that it was important that someone had made the first step in engaging with her. I learnt how important it is to be creative when working with people with mental health problems to motivate them and encourage them. I also went away thinking how developing trust with residents is important as by doing this they open up; you can then understand them better and know how to tailor care towards them.
When I came into work, I heard that one of the residents had gone with a support worker to collect earnings that she had accumulated from several scratch cards at the local newsagent. After handing them to the shopkeeper, the resident said that he had not given back all of her scratch cards, which amounted to £200 of stolen money. The shopkeeper claimed that he had not taken anything but the consensus with the staff was that money was stolen. This made me feel so angry that someone could take advantage of a vulnerable person and reinforced to me the stigma that people with mental health problems face. I felt that if the person was not someone living in a supported living arrangement with mental health needs that the shopkeeper would not have tried to take the money. This outright prejudice shocked me. If someone else had taken food and run out, the shopkeeper would have reported it as a criminal offence but could not apply the law to himself when stealing £200 from someone unable to defend themselves. Ultimately, this made me more passionate about supporting the residents in the service but wary of the challenges that will be faced in working with this population of people.
When I did a placement with the NHS, one of the things I discussed with my supervisor was how I felt uncomfortable and often irritated by the sexist comments made by some of the males. As they had dementia, they often could not control their inhibitions and because it was an older adult service, generational differences often meant my values as a younger woman were quite different. Although it irritated me I accepted it, these feelings were triggered again today when one of the residents made a few racist and homophobic comments. As I understand her condition it did not upset me but I was curious how someone could harvest such hateful thoughts about large groups of people. As I work with her more I hope to broaden her perspective.
Today during hand-over, there were concerns over two tenants and interesting themes were raised in our discussions that apply broadly to the field of mental health. Firstly, one tenant, against advice from staff, has increasingly been spending more money on scratch cards, sometimes £20 in one visit. She has been winning quite a bit of money and then gambling again on more scratch cards. What is challenging is balancing your duty of care as a support worker against the resident’s mental health capacity. According to the Social Care Institute of Excellence (SCIE), duty of care is defined as the legal obligation to act in the best interest of the individual. As her support workers’ we feel protective over her but she is not spending money to the point where she has none left for essentials, such as, rent or food.
All tenants are deemed as having the mental health capacity to make their own decisions. This means that although we can offer advice and make suggestions, we cannot create restrictions. Part of me was relieved that the residents had some level of freedom because I think anyone would feel dejected if they had no sense of control over their life. However, one of the important features of having mental health capacity is the ability to retain relevant information to the decision long enough to make the decision. This tenant has been known to have memory difficulties, which makes her mental health capacity questionable. Moreover, she is also prone to financial exploitation. Although I’m at points concerned with some of the tenants, I’m grateful to work in a facility that offers people more support. In some services, patients get a very basic level of care.
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