How do we value those who work as care workers with our elderly? Current perceptions would say the care sector is undervalued and underfunded and with this, many carers can undervalue themselves and the work they do.
It’s partly because care work is positioned on the lowest rung of work structures and characterised by low and minimal wages, shift work and long hours that the lowly designation persists, however it is a travesty that a service that provides for elders, disabled, people with learning needs, chronically sick or those with progressive illnesses is poorly valued. The sad truth is we live in a society that values work that is seen as prestigious and according to how much people are paid, rather than the nature of the work itself.
Working as a carer is often classed as ‘unskilled’ and often considered demeaning, degrading, hard, distasteful and menial. Often these judgements on care work can influence how we see this type of work, resulting in our not seeing its inherent value from the inception. Many carers carry these broad perceptions of care work themselves. And if some carers feel less because of the nature of the work they do, one must wonder how this affects the level and quality of care offered clients
So, what then are the myths of caring? What are our prevailing attitudes, beliefs and pictures that can very often if not always distort the truth of what care work or working in a caring role is? It’s important we question and expose so that we can then recognise the true purpose and value of caring for another.
1. ‘To care’ is an expression of love, whereas ‘caring’ is something that is functional
At the heart of a true caring relationship is love, and yet the word love is nowhere to be found in the training of carers, or anyone whose work involves ‘caring’. The emphasis instead is on function – the practical, the doing – not the ‘how’ of care. Less is spoken about the quality of relationship between client and elder, although ‘person-centred care’ is talked about. Even some online training focusses less on the quality of relationship between client and carer and more on functional precautions the carer should take to protect themselves from prosecution, should something go wrong.
We can go through the motions of doing what is needed for a person who is needing care, without an ounce of care. How does this even happen? We have seen footage of people working as carers move a frail elderly resident roughly, left in wet and soiled beds. There is a long list of things here that we do all in fact know. When true care is a natural extension of the love that is at the very core of our being, our essence and who we are, how do we find ourselves at a place where we are too busy, tired or exhausted to care?
This is certainly saying that something is not right here. Our ‘norms’ are being eroded right under our noses, and they have been for some time and we are only starting to realise. Or are we?
2. Caring work is about our quality of being versus what we do
True there is a lot of functional activity in caring, with many practical everyday tasks carried out for the client. Carers also need to have an awareness of medication administration, health and safety, food hygiene, housekeeping etc. In the UK a mandatory Care Certificate lists all the essentials for care practitioners. But carers must be watchful that functional activity does not become the only aspect of care.
Similar to how the connective tissue, though unseen, binds everything together in the human body, the important link in care is a true connection with the client. Difficult to define, this quality is one that sees the essence of the person first and not the person’s condition. The singular quality is the presence the carer brings to the client.
The unseen is the carer’s inner relationship with themselves. How they regard themselves, the depth of love they live in their body, how they move from their innermost to the day-to-day activities. The being of the carer is what is brought to and holds the client in a loving space: unimposing, gentle, settled and tender. This simply occurs because this is the quality that they themselves live, day in and day out. This way what we do is infused with the quality of who we are.
3. All work is worthy work versus care work is unskilled work.
A live-in carer looks after a client’s medical, physical and emotional care needs. When clients reach old age, they often have multiple and complex physical, psychological and mental health needs. A carer may work with older clients who present with any number, if not multiple chronic, progressive, degenerative and deteriorating health conditions. A carer must understand and respond to these conditions and how they present. In addition, they must constantly attune themselves to the changing and declining health of an elder as they reach the end of life. Typically, a live-in carer will work with a single client until they die and then be assigned the next client, very likely with a different ill-health condition. Again, they have to learn, adapt, understand and respond.
In addition to this, live-in carers replace family members who for whatever reason, cannot or do not live with their parents or close by. Live-in carers accept and adapt to the many roles assigned to them. They are companions, confidants and counsellors, having an awareness of aspects of nursing, psychology, physiotherapy and occupational therapy needs of clients. They must be adept at developing relationships with family, friends, healthcare professionals and the extended community of the client. They are also personal shoppers, homemakers, housekeepers, personal assistants, drivers, menu planners and cooks. Again, these multiple responsibilities confirm that caring is a role that requires responsiveness, adaptability and sensitivity.
And yet despite this, carers are considered to be second-rate and low-class workers; less worthy than other healthcare practitioners such as doctors, nurses and physiotherapists. A ranking system exists that places carers with no set qualification framework on the lowest rung possible. We live in a society that differentiates between one group of healthcare workers and another and ranks them, resulting in separation and division.
4. Personal care – the art of love and nurture versus being regarded as demeaning work.
There are many reasons why care is dismissed and derided. With increasing dependency, carers are responsible for the personal care needs of elders; washing, bathing, dressing, attending to and cleaning bodily fluids. This last is often regarded with revulsion and disgust. Very often a carer supports another to continue to carry out daily activities for themselves for as long as they can. At some stage, many clients due to advanced ageing lose physical or mental capacity and are unable to do things for themselves they formerly were able to. Carers (whether family or paid) step in to support the cared for. I have learned it is possible to lovingly clean bodily fluids in such a way the client does not feel embarrassed or sense that it’s unpleasant for the carer.
Rather than demeaning, this is an expression of love in the true understanding of the word. However unpleasant it may at times appear to be, carers place the person before the task, quality before function. On the surface, the responsibility is to support, clear, clean, and bring comfort back to the client. There is always more we can bring. The deeper purpose when carrying out personal care tasks is the quality: how we touch – with tenderness, and our pace – unhurried and settled. Personal care is an opportunity to deeply nurture a client by relating to them with utmost tenderness and ensuring they are held in love throughout, rather than just going through the motions. This requires self-awareness, strength, sensitivity, willingness and most of all, love. This is no different if two carers are providing personal care for a client in bed, for example. A core standard is that carers do not have separate conversations with each other over the client. That way they can together provide respectful and tender care to maintain the client’s dignity.
5. Elders are of equal value and worth as babies
A question to ask is, what is the difference between a baby and an elder? Apart from age and physical changes, most human beings pass through distinct life stages from baby to child, to teenager, adult, middle and old age. Yes, there is the fact of a huge age differential between child and elder, but are they not one and the same human being? The baby is the elder and the elder the baby: one life, one body. So why is it considered acceptable to shower a newborn baby with adoration and ‘love’ and yet shun and treat elders as untouchable? Why is it acceptable to change a baby’s nappy to ensure they are clean and comfortable, and menial or repulsive to do the same for an elder? Where, in the continuum of life, did we stop caring for and regarding elders with the same love, regard and attention we give a baby?
Would we consider this difference because a baby has all their life ahead of them? Why would we not consider the richness of the life lived by an elder in the same way? Revulsion of any kind towards another human being, for whatever reason, separates and discriminates. The dual standard that gives a baby preference to an elder is rotten to the core. Can we have one standard that applies to all equally? Is it possible to clean bodily fluids lovingly and with lightness regardless of who the person is? After all, we have to do the same for ourselves; are elders not equal to us?
Where does this distaste stem from? Is it because physical and psychological decline in elders is more difficult to accept? Is it because we focus on the physical and forget the human and the being within? How have some societies lost the capacity to connect to an elder in the same way they connect to a baby and young child? Although we know of course that neglect and abuse of babies and children also exists, most would never neglect a baby in the way elders are neglected. We can only act in this way in the absence of love. To deny ourselves the offering to deeply connect to and love elders in their later life passage robs us of the grace, richness and wisdom they bring to us.
When this absence of love and connectedness with elders is normalised and institutionalised, we have as a society sunk to the deepest depth of inhumanity. That we care less for elders, the chronically sick and disabled than we do a ne w born baby is indicative of how bad things are. And yet this is the norm and because of this, is accepted practice. It is this that must be exposed and denounced.