Case Manager to Carer

From Case Manager to Carer – What I learnt working as a carer during the pandemic

There are several reasons why I signed up with a care agency during the pandemic. Firstly, like many people I wanted to help, I could see the strain that many care homes were under and I knew I had transferrable skills that could be utilised. Secondly, I have always wanted to get some hands-on experience to complement the training I provide to carers and thirdly I could see this was a unique opportunity to learn what it is like to be a carer which would in turn help me to become a better supervisor to the carers working with my case management families.

After a very short induction most of which was online I successfully signed up with a care agency and shifts soon started coming in. I donned my purple tunic and turned up at my first care home feeling nervous. The nature of agency work is you are there because there are short staffed so you pretty much hit the ground running. Despite the time pressures, I learnt that as with case management, that you must always remain client centred. Little things can make a big difference – whether it is taking a few minutes to read a letter that has arrived, finding out a resident’s likes and dislikes or making sure you give choices were possible. Flexibility is a key skill for case managers and this skill was used continuously. One moment I would be working with another carer providing personal care for people with very severe physical disabilities using hoists and other equipment. The next moment I would be encouraging a very mobile person to do as much as they could by themselves and supporting them to join in with social activities within the home. Another skill of case management I found invaluable was communication, both with residents and the other carers. Simple things that we take for granted such as introductions which are common place in case management, are also important when in working in care homes. Simply changing my name badge so that my name was in large print and introducing myself everytime I entered a room made a huge difference.

As an Occupational Therapist I was familiar with a lot of the equipment used which was a positive. What I wasn’t prepared for was using the equipment in a training session is very different to using in a real-life scenario especially with time pressures that are often present.  Anyone who has done a shift in a care home will realise that there is always something to do. Tea and coffee to make, beds to change and personal care to give. You must work closely with others and be prepared to take and follow advice.

I learnt that whilst being a carer is rewarding it can be both physically and emotionally draining. When you are caring for “real” rather than going through scenarios in a classroom you realise that the environment makes a big difference. Having the right bed, hoist, sling and room to manoeuvre can make the difference between a safe and an unsafe transfer. As previously mentioned, it is vital to remain client centred. A person who is living with dementia may misinterpret your actions and may become physically and verbally aggressive. It is important to remain calm and think about why you may have triggered this response.

Living in a care home during the pandemic was a confusing and stressful time for residents and carers alike. Some residents did not understand why they could not see their relatives and felt abandoned, they disliked the masks and how it muffled your voice and covered your lips, being confined to their room felt like a being a prisoner and getting used to new members of staff was stressful. I have learnt not to take things personally and to try to put yourself in their shoes. I also learnt that humour can be deployed in many different circumstances and that a lot of residents have a wicked sense of humour.

There is never a dull moment when working with people who are living with dementia. Some of tips I picked up along the way is to avoid direct questions where you can, instead of asking do you want a coffee? Try saying I am putting the kettle on do you fancy joining me? Go along with their version of the truth, if they think today is their birthday, wish them a happy birthday and help them to enjoy their special day. Never forget their past, today they may be dependent on you to help meet their basic needs but they have years of happy memories which can bring them feelings of joy. Spending the time to find out their history is important. I have met officers that fought in World War II, who beamed with delight when I called them sir and stood to attention at their bedside. I took great delight in tucking in a former Great Ormond Street nurse who had the met the Queen and went to bed every night with a baby doll which she cradled as though it was her own child. I found out about a resident who came across from India as a baby on a ship, she was handed over to another passenger for her passage. She would take great delight in telling me this story as well as the time she met her husband at a dance, and I would play songs from that era on the phone.

The experience was certainly not without its up and downs but I am proud of the small part I played and have learnt so much not only from the carers I worked alongside but also from the people I cared for. Time spent learning about others is rarely wasted and taking time to reflect on why someone has behaved in the way they have is important. It is easy to jump to conclusions rather than to stop and think and put yourself in their shoes. As a case manager I have a new respect for parents and carers. Caring for anyone is a physically and emotionally demanding job and I believe we do not always give carers the respect they deserve. I am grateful for all the residents who allowed me to help and learn from them, for sharing their past and letting me part of their present. By allowing me to make mistakes, being patient and understanding and especially to the 94-year-old resident who always told me how beautiful I was. I often went home with an extra spring in my step despite the 12-hour shift.

When a carer tells me they are finding it difficult to carry out the tasks in the way I have suggested. I will take the time to listen to them and work together to find a solution that works. When interviewing potential carers, I will look beyond the qualifications and ask them about what they would do to make the improve the life of those they are caring for. During supervision I will listen more and talk less and never underestimate their importance of their caring role not just a carer but as so much more.

Alison Walker, Case Manager