What makes you, you?

As a follow on from my last post How Do You Feel About Memories I think it is also important to consider how we stereotype those who need care services and what we need to consider, especially when thinking about older peoples services.

Stereotyping is a natural human trait, we find it easier to put groups of people in specific categories rather than struggle with having to think about everyone as an individual. It is easier, for example, to put all football fans, in the same category rather than struggle to think about the 100’s of thousands of individuals within that category.

In many instances stereotyping is used as a political weapon to demonise a ‘group’ of people, as shown recently by labeling all benefits claimants as ‘shirkers’ who live of the hard work of the ‘strivers’ in society. Of course that analogy, much touted recently, fails to take into account,perhaps the worst type of benefit fraudster, those who work but still claim benefits – are they shirkers or strivers? This is why stereotyping politically in dangerous.

Yet even in the social care world, where awareness of individuality is more recognised there is a tendency to stereotype, not as a means of demonization but as bureaucratic convenience. Yet there are pitfalls we must avoid if we are to ensure that social care services are truly personalised.

We don’t just stereotype people we also tend to stereotype history. The bulldog British spirit of World War Two, the Swinging Sixties, etc and there is a tendency toward selective memory of the past. How often, for example, do we see moans about the youth culture of today yet the complaints are made by those who grew up during the era of ‘mods and rockers’ ‘punk rockers’ etc who were on the receiving end of similar complaints.

How does all this apply to social care?

Imagine a care home, in one seat a 75 year old in the next a 100 year old. Both old people in an old peoples home to most, yet there is a 25 year age gap. Now imagine someone 25 years younger or older than you. The 100 year old is actually sufficiently older to be the younger persons parent.

The 100 year would have been born in 1913, just before the First World War and would have reached their teens in 1926 and spent their formative years during the depression and would have been 26 at the outbreak of World War Two and approaching their 50’s as the Swinging Sixties started.

The 75 year old was born in 1938, so just 7 as the Second World War ended. What can you remember about your life as a seven year old? They entered their teens in the early 50’s, the time of rock and roll and the beginning of modern youth culture. Just 22 as the 60’s started so, as someone in their 20’s, their experience of the decade would have been completely different from the older person, now middle-aged.

As the general population ages and degenerative diseases impact on lives more and more it is so important that we take into account all aspects of the individual. Old people are not just old people, their lives can be worlds apart as can be their memories and how life has impacted on them over time.

Our experiences through our life make us unique individuals. Each of us is touched by different experiences which then impact on how we move forward in life. We are influenced by different people and we are influenced by the events of the world around us, and how we see those events depends on our past influences and our age.

We are, individually, a complex make up of different memories and experiences and to deliver the best possible services we have to take time to understand both the individual and the wider world which influenced them. Delivering quality is not just about clinical execution of care duties but of taking time to help people to live the life they want, which is, inevitably, based on their age and life experiences.

Being Gay is Wicked: Language, Leadership & Social Care

"Being Gay is Wicked”

What does that phrase mean? Fifty or sixty years ago it would mean “being happy is sinful” today it would mean “being in a same sex relationship is a really good thing”.

What this illustrates is that the language we use can change meaning quite drastically is a relatively short period of time and while the example above is quite extreme in nature more subtle changes exist that impact on our understanding of everyday things and social care is not immune to this.

Take, for example, the discourse of institutions. The current social care system was created out of a  desire  to get people out of institutions, at that point institutes were the large, impersonal, usually Victorian, buildings that held people with learning disabilities or age related conditions that impacted capacity. These places were notorious for their lack of privacy, dignity and respect where people were treated as objects of pity rather than as individuals with their own personalities, preferences and rights. The people incarcerated in these institutions had no control over their lives, no chances to participate in how their lives were being run and little opportunity for any decision making.

It is no wonder then that the term ‘institution’ developed an extremely negative meaning.

The answer was, of course, to close these institutions and develop smaller care homes for the elderly and frail and those more severely disabled whilst promoting care in the community for the more able.

Yet, just a few decades on, the term ‘institution’ is used to describe those care homes which grew up out of the  desire  to rid the country of those old institutions!

Because of that, and the negative connotations of the word, care homes are seen by the public at large as bad places where the practices of old institutions still take place. Obviously there are bad care homes where institutional practices still take place but, in general, care homes have considerably improved the level of care from the dark days of the institutions.

The principle reasons for painting care homes as bad places is to promote the agenda of more community care and this is a perfectly normal way we operate in language. If we want to show that something is better we contrast it with something that is not as good but there are implications in doing this with social care.

For many there is no alternative to living in a care home. Those with advanced dementia, for example, may need the 24 hour care and support that their families (if they have one) are no longer able to provide. Some, with severe and profound learning disabilities, may benefit from the community setting of a care home rather than the potential isolation of living alone and for other elderly people a care home setting may free them from loneliness.

The negative image of care homes also impacts on the hundreds of thousands of care workers in the country, the majority of who deliver the best possible care they can. Being associated with the impersonal, autocratic staff of the old institutions is hardly a basis for improving moral in the sector!

This is where effective leadership across social care is so important.

To promote social care and to raise the standards those who lead must  present a positive image  of the sector. Being positive does not mean ignoring the deficits and problems of care homes nor does it mean painting a false picture.

Truth and honesty are important traits in leadership as they generate trust as does a recognition that things are not as good as they could be. But the important things is that those deficits are accompanied by visions and goals to show a way to correct those deficits in an achievable way.

Leadership is also about working with what you have got. So there has to be a recognition in social care that care homes are a part of the system, there also has to be a recognition that care homes have changed dramatically over the last few years. The average age of entering a care home has risen and, more often than not, care homes are the final stage of the care process when home care is no longer appropriate for the safety of the individual.

Leadership is about using language that is positive but honest and realising that using stereotypical labels may do more harm than good.