전유나 선생에게 : Working in Partnership with Carers

[정보원]

WITH CARERS 

Sadly, the needs of carers can often be allowed to slip out of the picture. 

Informal carers (family members, neighbours, friends and so on) can be under immense pressure in terms of the demands of caring for someone they care about. Likewise, paid carers face a difficult and demanding job which, if it is to be carried out properly, relies on having proper information and clear plans to work to. 

So, in both cases, partnership is an important issue, in the sense that all involved in providing care need to be ‘on the same page’ and totally clear about needs to be done and what is not to be done. Consequently, much of what has already been said in relation to partnership with clients also applies to working in partnership with carers: clarity about what is to be achieved and how, effective and appropriate communication and effective conflict management. This last issue is particularly important. This is because:

• We should not assume that the relationship between carer and cared for is an entirely harmonious and positive one. There may be conflicts and tension, and these will often be kept out of sight of ‘outsiders’, including the social worker. We therefore need to be tuned in to the possibility of any such conflicts or tensions and be alert to any tell-tale signs (for example, as revealed in body language). In some cases, such tensions could actually amount to abuse. Unfortunately, in some circumstances the pressures of caring can evoke an abusive response. In addition, there may have been pre-existing tensions before the caregiving relationship began. For example, I recall dealing with a situation where an elderly man who had become dependent on his wife for his day-to-day care and who was being treated very harshly by her. The reason why became apparent when she confided in me that, before he became incapacitated, he had been physically and emotionally abusive towards her on a regular basis.
• There may be a conflict between what has been agreed between social worker and client about what needs to be achieved and how, but the carer may not agree. If the disagreement is openly voiced, it can be discussed and appropriate negotiations take place. However, what is much more difficult is if the disagreement is kept secret for whatever reason, as that can easily result in plans being foiled by the actions, inactions and/or attitudes of the carer. This can be deliberate sabotage for whatever reason, but it can also arise from genuine concern. For example, a carer who is impatient to get an elderly relative who has had a fall back to normal as soon as possible may rush the rehabilitation plan and risk making the situation worse.
• There may at times be resentment on the part of some carers that there is a social worker involved, a professional who is now, as it were, invading their territory. In my own practice I often had to ‘win over’ carers to convince them that professional help was needed, as they seemed to see such help as a sign that they had failed, that they were inadequate in some way. 

It should be clear, then, that working in partnership with carers has much in common with partnership work with clients, but with some extra issues to take account of.

REFLECTIVE MOMENT 

If you were in a caregiving role and a social worker became involved, what would you expect from him or her in terms of making a reality of the idea that they would be working in partnership with you? How would this partnership manifest itself in concrete terms?

The Social Worker’s Practice Manual. pp.72~74