We are led to believe that caring for a client is a one-way relationship and that we are the ones supporting clients. Rarely spoken about is the enriching nature of care and what clients offer carers, or what carers can learn from clients. I’ve worked for over ten years as a carer and know that every caring relationship offers the carer endless opportunities to learn and evolve.
Here are some of the gems offered by clients I have worked with:
Be an observer, not a judge
My first assignment was with a client, a woman, with advanced stage breast cancer who lived with her husband. The purpose of this assignment was to teach me to not judge and how to be in the presence of one who is close to death. I observed as her husband, who was unable to accept his wife was dying, wanted to keep things as normal as possible. This ‘normalising’ ultimately affected the quality of life of both the wife and the husband. I was learning to support them both without judgement. I was shown what happens when families do not have many, if any, conversations about death and dying, and what happens when conversations are avoided, even though it may be the ‘elephant in the room’. It taught me the importance of talking about death as part of life, so we are more prepared for it when it comes to us. This also gave me the opportunity to reflect on my own life and occasions when I too had been unprepared for or saw death coming. Importantly here, it was to reflect on my own experiences without judging or harshly critiquing myself, but truly learning and growing from my own observations.
Be Self-Aware
Every assignment, every relationship, teaches us about ourselves. The caring relationship is heaven sent, with each new client assigned revealing a whole new set of teachings, if we’re open to receive them. With one client in particular, my need to exert control was exposed. I thought I knew what was best for her. A simple example of this was when we were out food shopping I would prompt my client to buy certain foods that reflected my values and preferences – not hers – and then became frustrated when she bought what she wanted. Over the years with this client, I came to understand the importance of not imposing on another and accepting her choice to buy or do whatever she wanted. I learned to observe, step back and allow the client to take full responsibility for herself. I also appreciated her for not bowing to my impositions, for I would not have learned this very important lesson.
Inner qualities of care
Every client offers us the opportunity to develop our inner qualities of care. In the home of a client who had been diagnosed with multiple sclerosis and was unable to walk, the purpose was to live, be with and understand someone who was very controlling. This client, who was dependant on a wheelchair and hoists for every transfer – for example from bed to wheelchair, wheelchair to toilet and back – had organised her home so she had control over most things. She prescribed and managed every aspect of care and expected me to follow her instructions, to the letter, even with simple tasks like washing dishes and driving her to the supermarket. I learned to accept, that this was this client’s way. I understood how loss of control for her was synonymous with loss of self. I learned to accept her as she was. I did not react, but quietly and playfully obediently (mostly) did what I was asked to do, without fight. I learned to respond in a way that supported the client. I learned to not judge and regardless of how she was, continued to offer her a gentle, loving service. Over time, I saw her as a kind and generous woman at heart and we developed a close relationship.
Become a student
Every client is a mirror to us, and once aware of this, relationships can truly deepen. When I closely observed clients, their responses and reactions, I found each one presented an opportunity for me to learn. This brought humility. Clients are not always able to express what they want; observation supported me to read and respond to what was needed. If a meal I had prepared was left half eaten, I would want to know why. If I sensed a client felt affected by something I had said or done, I went to them, apologised and together we reflected on what had happened, without being harsh or critical. I learned equally from what went ‘well’ and what didn’t go so well, such as when I reacted to something compared to when I responded to something. This was a revelation.
Become an observer and ‘follow the client’
In the final year of one client’s life and as her condition declined, I was faced with questions of how to respond. I observed within myself a tendency to want to keep the relationship the way it had always been (which was all about me).I had to let go of beliefs and pictures I had about the nature of our relationship and way things needed to look as I realised that got in the way of my responding to what the client needed in the here and now. I was shown the value of not holding on to any particular pattern, routine or procedure, and began the practice of ‘following the client’. For example, in the mornings if she was unresponsive when called, I left her to sleep. I waited until I saw she was able to eat and take medication and then offered them – I did not impose anything but waited until she was ready. I observed her energy levels and knew when or not to take her outside for a supported walk in the wheelchair. With personal care, she often wanted to do things for herself so I moved to support her when she signalled that was what she wanted. The client lived with a degenerative neurological condition, which affected her mobility and consciousness. There were periods when she was ON and periods when she was OFF, barely conscious, unable to speak, walk or do anything. This could happen mid-stream. For example, when preparing a meal together and I observed her movements, if I saw her body switching off, I intervened and guided her to a safe place. When her body switched back on, where possible we resumed the activity. In this, I learned to be ever attentive to the client as her movements and energy levels could change at any time. I learned to never switch myself off but remain ever-present so I could be present for her.
Be in the here and now – appreciate the client and what they bring.
When one client died, I realised how throughout our relationship I had appreciated who she was and what she brought to our relationship. She openly expressed her appreciation of me as a person and carer. It was wonderful to be openly acknowledged in this way. She also appreciated her own life and always considered herself lucky – a way of being I found inspirational and an example to not take life for granted. She lived with every material comfort, but retained her humility. She chose to remain as active for as long as possible and always wanted ‘to do things for herself first,’ rather than be fully dependent on me. In this, she represented the fact that elders can choose to live gracefully, retaining some independence and dignity until death. She always thanked me for my support: after personal care, cooking her meals, attending to her in the night, or shopping for and driving her by day. Nothing was taken for granted and through her I learned the value of expressing appreciation in the here and now. She never identified with the degenerative and neurological health condition she lived with for twenty years. She never talked or complained about it. She was an extra-ordinary example of what happens when we connect to the beauty of life, visible and invisible, and not be entrapped by outer and physical restrictions. There were moments of frustration, yes, but in the main she accepted and made full use of each moment. This client was playful, looked for lightness and humour where possible and never felt sorry for herself.
Each one of these examples reflects the richness of working with clients when we’re open to see what each placement and client offers us. When we are willing to learn from our clients, our work becomes purposeful and we are enriched by the work we do, in all of its detail, because of the people we care for.