Saturday, May 25, 2013

An Aide is Not a Maid : Dealing with Expectations

I'm back at it, training new aides again.

There's the joy of getting to know new people and the sheer hard work and energy output that goes into all of that - plus training often inexperienced people who have never done a care-giving gig.  At least for a quadriplegic.

Everyone comes into the job with expectations about what it's going to be like.

I have some folks who come in and think that all I need is a maid - cleaning, for example.  They mean well - they don gloves and go at it.  You can go down the list - I'm amazed by how some folks define the job! It can be amusing at times, but it just doesn't work if tasks don't get done.

So the first thing I always spend time on with a new aide is: handle expectations.  From both ends. I also need to compromise and be realistic about what people can do.  It's not a rehearsal, it's real life and it involves expensive equipment and my health and quality of life.

There are privacy issues. Someone is coming into my home.  It can feel intrusive when done in a certain way. Nevertheless, the longer I do this, the more I realize I need to give what I'm asking of them - patience, flexibility and understanding. My feelings matter, but there's a lot more involved than that in choosing the right aide.

It's work, quite frankly and a matter of both of us adjusting our sails as we go along.

The first few times a new aide comes over to help, I work closely with him or her.  I watch their reactions to tasks and see how they respond to taking direct instructions and/or requests (e.g. do they do what I ask the way I ask or do they do the exact opposite?  Do they ignore me totally?).   The response I get is important because I need to staff hours here, but I don't want to put someone in a position of a lot of responsibility if they ignore my instructions. That can be dangerous in certain situations. It can mean equipment or food is left out of my reach, for example.

So what do you do if a certain person falls into that category?  I assign tasks accordingly and will backup certain aides - make sure I have someone else to call to come in to cover, so I don't get stuck in an unsafe situation.  I also work longer with them one on one and give them more time to adjust to the job.  Clear communication on my part can help.  This includes feedback to them as to how what they do affects me after they leave. (e.g., moving things out of my reach matters.)

There's a limit to how much training I have the time/energy to do, but some of the best aides I've had required a lot of one on one time at first, simply due to inexperience. It's worth it as long as they're willing to learn.

If we can both adjust our expectations and find a common middle ground, the miracle is that it all starts to work.  Every relationship with every aide I have is different - and special.  My advice to anyone new at this is to be careful  not to expect a new aide to be like your last one.  Look for the talents in the new aide and nurture those rather than criticize how they're different.  We teach people how to treat us and vice versa - so set your expectations wisely.

I remember visiting a doctor's office where he had a sign up that read something like "Do not piss on the person who is carrying you". I'd like to add to that - and don't piss off the person who's paying you to carry them.

An aide relationship will work when both people understand that it's give and take from both directions.

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